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Open Access 01-12-2011 | Case report

Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniaeST258 clone

Authors: Paola Di Carlo, Gianni Pantuso, Alessia Cusimano, Francesco D'Arpa, Anna Giammanco, Gaspare Gulotta, Adelfio M Latteri, Simona Madonia, Giuseppe Salamone, Caterina Mammina

Published in: BMC Gastroenterology | Issue 1/2011

Abstract

Background

Knowledge of the etiology of pyogenic liver and pancreatic abscesses is an important factor in determining the success of combined surgical and antibiotic treatment. Literature shows geographical variations in the prevalence and distribution of causative organisms, and the spread of Klebsiella pneumoniae carbapenemase-producing bacteria is an emerging cause of abdominal infections.

Case presentation

We herein describe two cases of intra-abdominal abscesses due to monomicrobial infection by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp). In case 1, a 50-year-old HIV-negative Italian woman with chronic pancreatitis showed infection of a pancreatic pseudocystic lesion caused by KPC-Kp. In case 2, a 64-year-old HIV- negative Italian woman with pancreatic neoplasm and liver metastases developed a liver abscess due to KPC after surgery. Both women were admitted to our hospital but to different surgical units. The clonal relationship between the two isolates was investigated by pulsed-field gel electrophoresis (PFGE). In case 2, the patient was already colonized at admission and inter-hospital transmission of the pathogen was presumed. A long-term combination regimen of colistin with tigecycline and percutaneous drainage resulted in full recovery and clearance of the multidrug-resistant (MDR) pathogen.

Conclusions

Timely microbiological diagnosis, the combined use of new and old antibiotics and radiological intervention appeared to be valuable in managing these serious conditions. The emergence and dissemination of MDR organisms is posing an increasing challenge for physicians to develop new therapeutic strategies and control and prevention frameworks.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-230X/11/103/prepub

Title: Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniaeST258 clone
Authors: Paola Di Carlo
Gianni Pantuso
Alessia Cusimano
Francesco D'Arpa
Anna Giammanco
Gaspare Gulotta
Adelfio M Latteri
Simona Madonia
Giuseppe Salamone
Caterina Mammina
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: BMC Gastroenterology / Issue 1/2011
Electronic ISSN: 1471-230X
DOI: https://doi.org/10.1186/1471-230X-11-103

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