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Clinical outcomes of patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae after treatment with imipenem or meropenem

https://doi.org/10.1016/j.diagmicrobio.2009.02.004Get rights and content

Abstract

Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae may appear susceptible to imipenem or meropenem by routine susceptibility testing. We report a series of patients with infections caused by K. pneumoniae isolates, which yielded imipenem-susceptible results but were subsequently KPC-positive by polymerase chain reaction. When these infections were treated with imipenem or meropenem, frequent clinical and microbiologic failures were observed.

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  • Assessment of mortality stratified by meropenem minimum inhibitory concentration in patients with Enterobacteriaceae bacteraemia: A patient-level analysis of published data

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    In 2010, the Clinical and Laboratory and Standards Institute (CLSI) lowered susceptibility breakpoints for meropenem, imipenem and ertapenem to reduce the prevalence of organisms harbouring carbapenemases deemed ‘susceptible’ by contemporary breakpoints [14,15]. This action was spurred, in part, by reports of clinical failures in patients treated with carbapenems who were infected with ‘susceptible’ carbapenemase-producing Enterobacteriaceae [16,17]. Pharmacokinetic studies, however, suggest that contemporary dosing strategies should provide adequate exposures for minimum inhibitory concentrations (MICs) relative to the current breakpoints [14].

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Authors contributed equally to the work.

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