Successful Therapy of a Multidrug-Resistant Extended-Spectrum β-Lactamase-Producing and Fluoroquinolone-Resistant Salmonella enterica Subspecies enterica Serovar Typhi Infection Using Combination Therapy of Meropenem and Fosfomycin

Clin Infect Dis. 2017 Oct 30;65(10):1754-1756. doi: 10.1093/cid/cix652.

Abstract

We report a traveler who acquired a Salmonella enterica subspecies enterica serovar Typhi strain with resistance against β-lactams, cephalosporins (extended-spectrum β-lactamase-producing type SHV-12), and quinolones (plasmid-mediated quinolone resistance gene qnrB7). After clinical deterioration using meropenem monotherapy, treatment success was achieved after commencement of fosfomycin in conjunction with high-dose meropenem. The case illustrates clinical challenges of multidrug-resistant S. Typhi.

Keywords: S. Typhi; antibiotic resistance; carbapenems; enteric fever; fosfomycin.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Drug Resistance, Multiple, Bacterial
  • Fluoroquinolones / pharmacology
  • Fosfomycin / therapeutic use*
  • Humans
  • Male
  • Meropenem
  • Salmonella typhi* / drug effects
  • Salmonella typhi* / enzymology
  • Thienamycins / therapeutic use*
  • Typhoid Fever* / drug therapy
  • Typhoid Fever* / microbiology
  • beta-Lactamases

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Thienamycins
  • Fosfomycin
  • beta-Lactamases
  • Meropenem