Infect Chemother.
2004 Jun;36(3):127-131.
Failure of Cephalosporin Treatment for Bloodstream Infection Caused by Apparently Susceptible Klebsiella pneumoniae which Produced DHA-1 beta-Lactamase Induced by Clavulanic Acid
- Affiliations
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- 1Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. mdohmd@snu.ac.kr
- 2Department of Laboratory Medicine, College of Medicine, Seoul National University, Seoul, Korea.
- 3Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
- 4Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Abstract
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BACKGROUND: 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 beta-lactam resistant phenotype were found in a university hospital.
RESULTS
We conducted antibiotic susceptibility test according to NCCLS guideline. Also, we characterized beta-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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