Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation.

Citation data:

The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, ISSN: 1678-4391, Vol: 22, Issue: 3, Page: 235-238

Publication Year:
2018
Captures 3
Readers 3
Citations 1
Citation Indexes 1
PMID:
29806996
DOI:
10.1016/j.bjid.2018.04.005
Author(s):
Galvão, Lisia Miglioli; Oliveira, Anna Paula Romero de; Ibanês, Aline Santos; Monteiro, Jussimara; Inoue, Fernanda; Dantas, Daniel Chagas; Sanchez, Flavio; Santos, Daniel Wagner; Abboud, Cely Saad
Publisher(s):
Elsevier BV; Brazilian Society of Infectious Diseases
Tags:
Medicine
article description
Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation. A 59-year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation. On day 5 post-operation, blood cultures from the donor were positive for colistin-resistant carbapenemase-producing K. pneumoniae (ColR KPC-Kp) susceptible only to amikacin. Recipient blood cultures were also positive for ColR KPC-Kp with the same sensitivity profile as the donor isolate with an identical PFGE pattern. The patient was treated with double-carbapenems and amikacin. The patient evolved to pericarditis, osteomyelitis, and pulmonary necrosis, all fragment cultures positive for the same agent. The patient developed septic shock, multiple organ failure and died on day 50 post-transplantation. Based on current microbiological scenario worldwide the possibility of transmitting multidrug resistant (MDR) organisms should be considered.