Abstract
A multiple trauma patient failed treatment with ceftazidime and amikacin for bacteremia and meningitis due to a Klebsiella pneumoniae strain that produced a novel, plasmid-mediated beta-lactamase. Both pre- and posttreatment isolates were resistant to ceftazidime (MIC, greater than or equal to 64 micrograms/ml) and various penicillins but not to other expanded-spectrum cephalosporins. The beta-lactamase had a pI of 5.25 and was encoded on a conjugal plasmid of approximately 150 kilobases. DNA hybridization studies indicated that the enzyme was a TEM derivative.
MeSH terms
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Adult
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Amikacin / therapeutic use*
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Blotting, Southern
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Ceftazidime / therapeutic use*
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DNA, Bacterial / isolation & purification
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Drug Resistance, Microbial / genetics
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Drug Therapy, Combination / therapeutic use
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Humans
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Klebsiella Infections / drug therapy*
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Klebsiella Infections / etiology
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Klebsiella pneumoniae / enzymology
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Male
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Meningitis / drug therapy*
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Meningitis / etiology
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Meningitis / microbiology
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Microbial Sensitivity Tests
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Sepsis / drug therapy*
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Sepsis / etiology
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Wounds and Injuries / complications
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beta-Lactamases / biosynthesis
Substances
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DNA, Bacterial
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Amikacin
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Ceftazidime
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beta-Lactamases