Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation
Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation. A 59-year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation. On day 5 post-operation, blood...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-05-01
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| Series: | Brazilian Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1413867018300503 |
| _version_ | 1830283521860567040 |
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| author | Lisia Miglioli Galvão Anna Paula Romero de Oliveira Aline Santos Ibanês Jussimara Monteiro Fernanda Inoue Daniel Chagas Dantas Flavio Sanchez Daniel Wagner Santos Cely Saad Abboud |
| author_facet | Lisia Miglioli Galvão Anna Paula Romero de Oliveira Aline Santos Ibanês Jussimara Monteiro Fernanda Inoue Daniel Chagas Dantas Flavio Sanchez Daniel Wagner Santos Cely Saad Abboud |
| author_sort | Lisia Miglioli Galvão |
| collection | DOAJ |
| description | Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation. A 59-year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation. On day 5 post-operation, blood cultures from the donor were positive for colistin-resistant carbapenemase-producing K. pneumoniae (ColR KPC-Kp) susceptible only to amikacin. Recipient blood cultures were also positive for ColR KPC-Kp with the same sensitivity profile as the donor isolate with an identical PFGE pattern. The patient was treated with double-carbapenems and amikacin. The patient evolved to pericarditis, osteomyelitis, and pulmonary necrosis, all fragment cultures positive for the same agent. The patient developed septic shock, multiple organ failure and died on day 50 post-transplantation. Based on current microbiological scenario worldwide the possibility of transmitting multidrug resistant (MDR) organisms should be considered. Keywords: Cardiac transplantation, Klebsiella pneumoniae, Donor-derived infection, Carbapenem-resistant |
| first_indexed | 2024-12-19T02:58:36Z |
| format | Article |
| id | doaj.art-0deb20a09bd6496c8781ccea3feed133 |
| institution | Directory Open Access Journal |
| issn | 1413-8670 |
| language | English |
| last_indexed | 2024-12-19T02:58:36Z |
| publishDate | 2018-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-0deb20a09bd6496c8781ccea3feed1332022-12-21T20:38:15ZengElsevierBrazilian Journal of Infectious Diseases1413-86702018-05-01223235238Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantationLisia Miglioli Galvão0Anna Paula Romero de Oliveira1Aline Santos Ibanês2Jussimara Monteiro3Fernanda Inoue4Daniel Chagas Dantas5Flavio Sanchez6Daniel Wagner Santos7Cely Saad Abboud8Instituto Dante Pazzanese de Cardiologia, Divisão de Doenças Infecciosas, São Paulo, SP, BrazilInstituto Dante Pazzanese de Cardiologia, Divisão de Doenças Infecciosas, São Paulo, SP, BrazilInstituto Dante Pazzanese de Cardiologia, Divisão de Doenças Infecciosas, São Paulo, SP, BrazilAssociação Fundo de Incentivo a Pesquisa – AFIP, Departamento de Pesquisa e Desenvolvimento, São Paulo, SP, BrazilAssociação Fundo de Incentivo a Pesquisa – AFIP, Departamento de Pesquisa e Desenvolvimento, São Paulo, SP, BrazilInstituto Dante Pazzanese de Cardiologia, Divisão de Transplante de Coração, São Paulo, SP, BrazilInstituto Dante Pazzanese de Cardiologia, Divisão de Transplante de Coração, São Paulo, SP, BrazilHospital do Rim – Universidade Federal de São Paulo, Divisão de Doenças Infecciosas, São Paulo, SP, BrazilInstituto Dante Pazzanese de Cardiologia, Divisão de Doenças Infecciosas, São Paulo, SP, Brazil; Corresponding author.Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation. A 59-year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation. On day 5 post-operation, blood cultures from the donor were positive for colistin-resistant carbapenemase-producing K. pneumoniae (ColR KPC-Kp) susceptible only to amikacin. Recipient blood cultures were also positive for ColR KPC-Kp with the same sensitivity profile as the donor isolate with an identical PFGE pattern. The patient was treated with double-carbapenems and amikacin. The patient evolved to pericarditis, osteomyelitis, and pulmonary necrosis, all fragment cultures positive for the same agent. The patient developed septic shock, multiple organ failure and died on day 50 post-transplantation. Based on current microbiological scenario worldwide the possibility of transmitting multidrug resistant (MDR) organisms should be considered. Keywords: Cardiac transplantation, Klebsiella pneumoniae, Donor-derived infection, Carbapenem-resistanthttp://www.sciencedirect.com/science/article/pii/S1413867018300503 |
| spellingShingle | Lisia Miglioli Galvão Anna Paula Romero de Oliveira Aline Santos Ibanês Jussimara Monteiro Fernanda Inoue Daniel Chagas Dantas Flavio Sanchez Daniel Wagner Santos Cely Saad Abboud Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation Brazilian Journal of Infectious Diseases |
| title | Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation |
| title_full | Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation |
| title_fullStr | Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation |
| title_full_unstemmed | Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation |
| title_short | Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation |
| title_sort | fatal case of donor derived colistin resistant carbapenemase producing klebsiella pneumoniae transmission in cardiac transplantation |
| url | http://www.sciencedirect.com/science/article/pii/S1413867018300503 |
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