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 Original Articles |
| Failure of Cephalosporin Treatment for
Bloodstream Infection Caused by Apparently
Susceptible Klebsiella pneumoniae which
Produced DHA-1β-Lactamase Induced by
Clavulanic Acid |
| Cheol-In Kang, M.D.1, Hyunjoo Pai, M.D.4, Sung Han Kim, M.D.1, Hong-Bin Kim, M.D.1,
Myoung-don Oh, M.D.1,3, Eui-Chong Kim, M.D.2,3, and Kang-Won Choe, M.D.1,3 |
| Departments of Internal Medicine1 and Laboratory Medicine2, College of Medicine, Seoul National University, Seoul, Korea
Clinical Research Institute3, Seoul National University Hospital, Seoul, Korea
Department of Internal Medicine4, Hanyang University Co |
Vol.36 Num.3 (p127~131)
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Backgroud:The therapeutic option is limited for the infections caused by organisms producing plasmid- mediated AmpC beta-lactamases, increasingly identified worldwide. Two sporadic patients with bacteremia caused by K. pneumoniae possessing an unusual inducible β-lactam resistant phenotype were found in a university hospital.
Materials & Methods:We conducted antibiotic susceptibility test according to NCCLS guideline. Also, we characterized β-lactamase by isoelectric focusing.
Results:DHA-1 gene conferred the resistant phenotype. The patients had experienced treatment failure when treated with extended-spectrum cephalosporin. For the isolates the cephalosporin resistance was induced by clavulanic acid (and cefoxitin).
Conclusion:Theses results suggest that the extended-spectrum cephalosporins might not provide optimal therapeutic option for inducible DHA-1-producing K. pneumoniae infection, even when the pathogens are susceptible in vitro. |
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Keywords : Klebsiella, β-lactamase, Cephalosporin resistance |
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