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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
| ArticleTitle |
A case of suppurative septic thrombophlebitis due to IMP-6 metallo-β-lactamase producing Klebsiella pneumoniae with good treatment outcome |
| Language |
J |
| AuthorList |
Kaori Ichikawa1), Mitsutaka Iguchi2), Yuki Mitani1), Yoko Takaishi1), Takae Aoki1), Tetsuya Yagi2) |
| Affiliation |
1) Department of Clinical Laboratory, Nagoya Ekisaikai Hospital
2) Department of Central Infectious diseases, Nagoya University Hospital |
| Publication |
J.J.C.M.: 30 (2), 64-68, 2020 |
| Received |
August 9, 2019 |
| Accepted |
October 28, 2019 |
| Abstract |
We report the case of suppurative septic thrombophlebitis with IMP-6 metallo-β-lactamase-producing Klebsiella pneumoniae. A 70-year-old man was admitted to our hospital with fever and blood pressure lowering. His right inguinal area showed a reddish-brown scab and an umbilical cord extending to the center. Contrast-enhanced CT showed a defect in the right femoral vein and perivascular inflammation and was diagnosed as suppurative septic thrombophlebitis. Antimicrobial agent therapy with meropenem was initiated after taken two sets of blood cultures. IMP-6 metallo-β-lactamase producing K. pneumoniae was detected from all two sets of blood cultures. Treatment with aztreonam, amikacin and tigecycline was initiated for 4 weeks. Thereafter the administration of sitafloxacin was initiated for two weeks, he was discharged. Suppurative septic thrombophlebitis causes thrombus formation and persistent bacteremia due to pyogenic inflammation of the vein wall and is intractable. In addition, infections caused by carbapenemase-producing Enterobacteriaceae (CPE) have fewer antimicrobial treatment options and are intractable. In this case, even if intractable risk is very high, detecting CPE appropriately and selecting the antimicrobial agents based on the results of antimicrobial susceptibility test provided a good treatment outcome. |
| Keywords |
metallo-β-lactamase, IMP-6, sitafloxacin |
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