Analysis of a Refractory Case of Pediatric Meningitis Caused by Klebsiella pneumoniae Co-Resistant to Carbapenems and Polymyxins

Xu Huang; Mingxiao Han; Fei Jin; Zhichen Zhu; Haifang Zhang

doi:10.2147/IDR.S376776

Analysis of a Refractory Case of Pediatric Meningitis Caused by Klebsiella pneumoniae Co-Resistant to Carbapenems and Polymyxins

Infect Drug Resist. 2022 Sep 7:15:5309-5313. doi: 10.2147/IDR.S376776. eCollection 2022.

Authors

Xu Huang¹, Mingxiao Han², Fei Jin³, Zhichen Zhu², Haifang Zhang²

Affiliations

¹ Department of Clinical Laboratory, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
² Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
³ Department of Laboratory, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

Abstract

We report our clinical exploration experience treating a 6-year-old girl with a postoperative central nervous system (CNS) infection of prolonged invasion with Klebsiella pneumoniae (K. pneumoniae) co-resistant to carbapenems and polymyxin B. Although rational antibiotic therapy and effective source control measures were applied, the infection was not controlled eventually. To understand the mechanism of infection, whole-genome sequencing (WGS) was used to explore the resistance mechanism, and the susceptibility test was used to observe the efficacy of ceftazidime-avibactam (CAZ-AVI) in vitro. It is currently uncertain whether CAZ-AVI could be used as a salvage therapy for pediatric CNS infection. Therefore, we hope to share this case to seek medical help worldwide to treat pediatric CNS infection.

Keywords: Klebsiella pneumoniae; ceftazidime–avibactam; central nervous system; co-resistant to carbapenems and polymyxin B; whole-genome sequencing.

Publication types

Case Reports

Grants and funding

This study was supported by the National Natural Science Foundation of China (82172332), the Science and Technology Development Fund of Nanjing Medical University (No. NMUB2018082), Gusu health youth talent of Suzhou (GSWS2019039, GSWS2020030), the Science and Technology Program of Suzhou (SKY2021007) and Discipline Construction of The Second Affiliated Hospital of Soochow University (XKTJ-TD202001).