Extended-spectrum beta-lactamase-producing and carbapenemase-producing Enterobacter cloacae ventriculitis successfully treated with intraventricular colistin

Summary We present a case of post-neurosurgical ventriculitis caused by carbapenemase-producing Enterobacter cloacae successfully treated with intraventricular colistin. Enterobacter spp are intrinsically resistant to aminopenicillins, cefazolin, and cefoxitin due to the production of constitutive c...

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Bibliographic Details
Published in:International journal of infectious diseases 2014-03, Vol.20, p.66-67
Main Authors: Cascio, Antonio, Mezzatesta, Maria Lina, Odierna, Antonino, Di Bernardo, Francesca, Barberi, Giuseppina, Iaria, Chiara, Stefani, Stefania, Giordano, Salvatore
Format: Article
Language:English
Subjects:
Administration, Intravenous
Amikacin - therapeutic use
Anti-Bacterial Agents - therapeutic use
Bacterial Proteins - metabolism
beta-Lactamases - metabolism
Carbapenemases
Ceftazidime - therapeutic use
Cerebral Ventriculitis - drug therapy
Child, Preschool
Colistin
Colistin - therapeutic use
Drug Resistance, Multiple, Bacterial
Enterobacter cloacae
Enterobacter cloacae - classification
Enterobacter cloacae - drug effects
Enterobacteriaceae
Enterobacteriaceae Infections - drug therapy
Humans
Infectious Disease
Intraventricular
Male
Meningitis
Pulmonary/Respiratory
Teicoplanin - therapeutic use
Treatment Outcome
Ventriculitis
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Summary:Summary We present a case of post-neurosurgical ventriculitis caused by carbapenemase-producing Enterobacter cloacae successfully treated with intraventricular colistin. Enterobacter spp are intrinsically resistant to aminopenicillins, cefazolin, and cefoxitin due to the production of constitutive chromosomal AmpC beta-lactamases. Moreover, extended-spectrum beta-lactamase-producing Enterobacter spp have been identified in the USA and Europe, and carbapenems are considered the drug of choice in these cases. Our isolate was sensitive only to fosfomycin, tigecycline, and colistin, and 6 days of intravenous colistin had failed to eradicate the infection. This case provides clinical evidence to support the administration of intraventricular colistin in such patients.
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2013.11.012