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