Disseminated organ and tissue infection secondary to carbapenem-resistant Klebsiella pneumoniae bloodstream infection for acute lymphoblastic leukemia treated with ceftazidime-avibactam: Two case reports

Medicine (Baltimore). 2025 Jan 10;104(2):e41195. doi: 10.1097/MD.0000000000041195.

Abstract

Rationale: Carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections are a severe complication resulting from granulocyte deficiency following chemotherapy for hematologic malignancies and have a high mortality rate. However, reports of disseminated organ infections secondary to bloodstream infections are rare.

Patient concerns and diagnoses: We report 2 cases of patients with acute lymphoblastic leukemia who both developed CRKP bloodstream infections during the granulocyte deficiency stage following chemotherapy, with 1 case of secondary bacterial liver abscess and 1 case of secondary septic arthritis.

Interventions and outcomes: Based on the results of drug sensitivity testing, both patients were treated with ceftazidime-avibactam, and the infections were rapidly and effectively controlled without significant adverse effects.

Lessons: Ceftazidime-avibactam exhibited satisfactory efficacy and safety in the 2 cases of disseminated organ infection secondary to CRKP bloodstream infection following chemotherapy for acute lymphoblastic leukemia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / adverse effects
  • Anti-Bacterial Agents* / therapeutic use
  • Azabicyclo Compounds* / adverse effects
  • Azabicyclo Compounds* / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / microbiology
  • Carbapenem-Resistant Enterobacteriaceae
  • Ceftazidime* / therapeutic use
  • Drug Combinations*
  • Female
  • Humans
  • Klebsiella Infections* / drug therapy
  • Klebsiella pneumoniae* / drug effects
  • Klebsiella pneumoniae* / isolation & purification
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy

Substances

  • Ceftazidime
  • avibactam, ceftazidime drug combination
  • Azabicyclo Compounds
  • Drug Combinations
  • Anti-Bacterial Agents