Treatment of recurrent urinary tract infections in a 60‐year‐old kidney transplant recipient. The use of phage therapy

We would like to demonstrate the difficulty of treatment in a patient after kidney transplantation (KTX) who developed chronic urinary tract infection (UTI) with a multi‐drug resistant ESBL‐producing Klebsiella pneumoniae. The patient underwent several treatment interventions including supportive th...

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Bibliographic Details
Published in:Transplant infectious disease 2021-02, Vol.23 (1), p.e13391-n/a
Main Authors: Rostkowska, Olga Maria, Międzybrodzki, Ryszard, Miszewska‐Szyszkowska, Dorota, Górski, Andrzej, Durlik, Magdalena
Format: Article
Language:English
Subjects:
antimicrobial resistance
Carbapenems
case report
Case reports
Chronic infection
Colistin
Cysts
Drug resistance
Kidney diseases
kidney transplant recipient
Kidney transplantation
Kidney transplants
Klebsiella
Klebsiella pneumoniae
Nephrectomy
Patients
phage therapy
Phages
Polycystic kidney
Renal insufficiency
Side effects
Therapy
Urinary tract
urinary tract infection
Urinary tract infections
Urogenital system
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Summary:We would like to demonstrate the difficulty of treatment in a patient after kidney transplantation (KTX) who developed chronic urinary tract infection (UTI) with a multi‐drug resistant ESBL‐producing Klebsiella pneumoniae. The patient underwent several treatment interventions including supportive therapy with bacteriophages. This article presents a case of a 60‐year‐old patient after KTX repeatedly admitted to the hospital with recurrent UTIs caused by ESBL‐producing Klebsiella pneumoniae showing variable susceptibility to carbapenems and full susceptibility to colistin only. KTX was performed due to renal insufficiency caused by polycystic kidney disease. The patient experienced 12 severe episodes of UTI due to K pneumoniae within 15 months since transplantation. In an attempt to curb the ongoing infections, phage therapy (PT) was applied on the experimental basis, coordinated by the Phage Therapy Unit of the Hirszfeld Institute in Wroclaw, Poland. Eventually, the patient fully recovered following nephrectomy of his own left kidney where cysts were the suspected reservoir of bacteria. The patient completed 29 days of PT. PT caused no reported side effects in the described case of the KTX recipient, although its role in controlling chronic UTI caused by K pneumoniae is unclear. More studies are needed in the population of kidney transplant recipients.
ISSN:1398-2273
1399-3062
DOI:10.1111/tid.13391