Treatment of a meningitis due to an Enterobacter aerogenes producing a derepressed cephalosporinase and a Klebsiella pneumoniae producing an extended-spectrum beta-lactamase

Infection. 1991 May-Jun;19(3):181-3. doi: 10.1007/BF01643247.

Abstract

A case of nosocomial meningitis due to a Klebsiella pneumoniae producing a CAZ-5 extended-spectrum beta-lactamase and an Enterobacter aerogenes producing a derepressed cephalosporinase is reported. The intrathecal catheter incriminated was removed and a treatment with ceftazidime (4 g/24 h) and amikacin (1.5 g/24 h) was started. After 24 h ceftazidime was replaced by imipenem (2 then 4 g/24 h). This treatment failed to obtain cerebrospinal fluid sterilization; therefore the imipenem dosage was increased to 8 g/24 h and two intrathecal infusions of amikacin (50 mg) were carried out. Thereafter the patient recovered.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Cephalosporinase / biosynthesis
  • Cross Infection / drug therapy*
  • Cross Infection / microbiology
  • Drug Resistance, Microbial
  • Enterobacter / enzymology
  • Enterobacter / isolation & purification*
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / microbiology
  • Humans
  • Klebsiella Infections / drug therapy*
  • Klebsiella Infections / microbiology
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / isolation & purification*
  • Male
  • Meningitis / drug therapy*
  • Meningitis / microbiology
  • Microbial Sensitivity Tests
  • beta-Lactamases / biosynthesis
  • beta-Lactams

Substances

  • Anti-Bacterial Agents
  • beta-Lactams
  • Cephalosporinase
  • beta-Lactamases