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Multidrug-Resistant Klebsiella pneumoniae in a Patient with SARS-Cov-2 Pneumonia in an Intensive Care Unit in Guayaquil, Ecuador: A Case Report.
- Source :
-
American Journal of Case Reports . 7/22/2022, Vol. 23, p1-7. 7p. - Publication Year :
- 2022
-
Abstract
- Objective: Unusual clinical course Background: Multi-resistant microorganisms are a public health problem. Their incidence has risen due to COVID-19, indiscriminate antibiotics use, corticosteroid treatments, and higher admissions to intensive care units (ICUs) of patients requiring invasive mechanical ventilation. These are risk factors for bacterial over-infection. The present case study that is relevant because of the multiple isolated strains with a resistance pattern: Klebsiella pneumoniae carbapenemases (KPC), extended-spectrum beta lactamases (ESBL) and New Delhi metallo-P-lactamase (NDM) in a patient without comorbidities. Case Report: A 53-year-old Ecuadorian man with no past medical history arrived at the Emergency Department (ED) with dyspnea, nasopharyngeal swab with a positive reverse transcription polymerase chain reaction (RT-PCR) test for SARS-CoV2, and a chest computed tomography (CT) scan showing bilateral ground-glass pulmonary infiltrates with 40% involvement. On day 10 in the ICU, the presence of Klebsiella pneumoniae KPC strain was reported in an axillary swab culture. Consequently, the antibiotic was rotated to vancomycin 1 g intravenously (i.v.) every 12 h and meropenem 1 g i.v. every 8 h. On day 15 in the ICU, a tracheal secretion culture was reported with the presence of Klebsiella pneumoniae ESBL and a blood culture with Klebsiella pneumoniae NDM. Conclusions: The COVID-19 pandemic is a perfect scenario for superinfection with multi-resistant pathogens such as car-bapenem-resistant Klebsiella pneumoniae (CRKP), due to the increase in patients admitted to ICUs requiring invasive mechanical ventilation, the use of corticosteroids, and empirical broad-spectrum antibiotic management based on guidelines. The emergence of combined multidrug-resistant strains is a challenge for laboratory detection and the selection of antimicrobial treatment. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 19415923
- Volume :
- 23
- Database :
- Academic Search Index
- Journal :
- American Journal of Case Reports
- Publication Type :
- Academic Journal
- Accession number :
- 159860012
- Full Text :
- https://doi.org/10.12659/AJCR.936498