Klebsiella necrotizing soft tissue infections in liver transplant recipients: a case series

Transpl Infect Dis. 2013 Aug;15(4):E157-63. doi: 10.1111/tid.12103. Epub 2013 Jun 19.

Abstract

Necrotizing soft tissue infections (NSTI) are rare but carry high mortality rates. NSTI with Klebsiella species have been previously described as associated with Klebsiella liver abscesses and endophthalmitis. Here, we describe 6 cases of NSTI in liver transplant recipients associated with Klebsiella pneumoniae, 4 of which were K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae (CRKP). Increased awareness of this emerging pathogen and its association with necrotizing skin and soft tissue infection is critical, as early recognition and debridement may improve survival. Antimicrobial treatment of CRKP infections remains an ongoing challenge and implementation of enhanced infection control measures is essential.

Keywords: Klebsiella pneumoniae; carbapenem resistant; liver transplant; necrotizing fasciitis; necrotizing soft tissue infections.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / biosynthesis*
  • Carbapenems / pharmacology
  • Fatal Outcome
  • Female
  • Humans
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology*
  • Klebsiella Infections / pathology
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / isolation & purification*
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Risk Factors
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / microbiology*
  • Skin Diseases, Bacterial / pathology
  • Soft Tissue Infections / drug therapy
  • Soft Tissue Infections / microbiology*
  • Soft Tissue Infections / pathology
  • beta-Lactam Resistance
  • beta-Lactamases / biosynthesis*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • beta-Lactamases
  • carbapenemase