Extended-Spectrum β-Lactamase <i>Klebsiella Pneumoniae</i> Meningitis Treated with Tigecycline

Wadi, Jamal; Selawi, Fadi

doi:10.5144/0256-4947.51776

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Many other case series and case reports have revealed the success of treatment with tigecycline against MDR isolates, such as MRSA (27,29), Acinetobacter spp. (10,37,41,47), Klebsiella pneumoniae (8,11,14), Klebsiella pneumoniae causing meningitis (48), VRE (25,36), E. coli (28,40), and Clostridium difficile (21), although in some of these studies tigecycline was combined with other antibiotics, such as colistin (8,37,38), daptomycin (25), and ciprofloxacin (48). However, recent several articles (1, 33) reported on the emergence of tigecycline-resistant strains after tigecycline therapy.…”

Section: Discussionmentioning

confidence: 98%

Systematic Review and Meta-Analysis of the Effectiveness and Safety of Tigecycline for Treatment of Infectious Disease

Cai

Wang

Liang

et al. 2011

Antimicrob Agents Chemother

173

103

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The aim of this study was to compare the efficacy and safety of tigecycline, a newly developed glycylcycline antibiotic, with those of empirical antibiotic regimens which have been reported to possess good efficacy for complicated skin and skin structure infections (cSSSIs), complicated intra-abdominal infections (cIAIs), community-acquired pneumonia (CAP), and other infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE CI ‫؍‬ 0.69 to 1.07, P ‫؍‬ 0.19). The incidence of adverse events in the tigecycline group was significantly higher than that in the other therapy groups with a statistical margin (for the modified intent-to-treat [mITT] population, OR ‫؍‬ 1.33, 95% CI ‫؍‬ 1.17 to 1.52, P < 0.0001), especially in the digestive system (mITT population, OR ‫؍‬ 2.41, 95% CI ‫؍‬ 1.67 to 3.46, P < 0.00001). No difference regarding all-cause mortality and drug-related mortality between tigecycline and the other regimens was found, although numerically higher mortality was found in the tigecycline group. This meta-analysis provides evidence that tigecycline monotherapy may be used as effectively as the comparison therapy for cSSSI, cIAIs, CAP, and infections caused by MRSA/VRE. However, because of the high risk of mortality, AEs, and emergence of resistant isolates, prudence with the clinical use of tigecycline monotherapy in infections is required.The threat of antimicrobial resistance has been identified as one of the major challenges facing public health, and antimicrobial resistance has increased rates of morbidity and mortality and socioeconomic costs. The rapid rate of microbial evolution underscores the urgent need for development of new agents that overcome existing mechanisms of resistance displayed by multidrug-resistant bacteria.Tigecycline is a first-in-class expanded-broad-spectrum glycylcycline. It inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit but with a five times higher affinity than that for the tetracyclines (4). In vitro studies demonstrate that it has good activity against many commonly encountered respiratory bacteria, including multiple resistant Gram-positive, Gram-negative, anaerobic, as well as multidrug-resistant (MDR) pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE), vancomycin-resistant Enterococcus (VRE), penicillin-resistant Streptococcus pneumoniae (PRSP), and ␤-lactamase-producing Haemophilus influenzae, among others (5). Tigecycline overcomes the two key tetracycline resistance mechanisms (efflux pumps and ribosomal protection) and is unaffected by other bacterial mechanisms of resistance, such as extended-spectrum ␤-lactamases (32).Tigecycline was first approved for use for indications of complicated skin and skin structure infections (cSSSIs) and complicated intra-abdominal infections (cIAIs). Currently, it is approved for use for community-acquired pneumonia (CAP). It has also been found to be effective for the trea...

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Section: Discussionmentioning

confidence: 98%

Systematic Review and Meta-Analysis of the Effectiveness and Safety of Tigecycline for Treatment of Infectious Disease

Cai

Wang

Liang

et al. 2011

Antimicrob Agents Chemother

173

103

View full text Add to dashboard Cite

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“…We searched the English literature using PubMed and have summarized the features of these cases (2,4,(6)(7)(8) in Table 2. Based on the patient information we obtained, five cases were posttrauma and/or postoperative.…”

Section: Discussionmentioning

confidence: 99%

“…In other countries, K. pneumoniae meningitis is almost always seen in nosocomial or postsurgical patients (5). Although some cases (2,4,(6)(7)(8) have been reported, extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae meningitis is very rare. We herein report a case of meningitis and epidural abscess with artificial dura mater caused by ESBL-producing K. pneumoniae and also provide a review of the existing literature.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Meningitis and Epidural Abscess due to Extended-spectrum β-Lactamase-producing <i>Klebsiella pneumoniae</i>: A Case Report and a Review of the Literature

et al. 2012

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17-year-old man had been involved in a traffic accident. He underwent a bilateral craniotomy with artificial dura mater to remove bilateral acute subdural hematomas. Seven months later, a right cranioplasty was performed using frozen auto-bone, and he developed extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae meningitis and an epidural abscess. Since his general status was poor, we could not remove the foreign body (artificial dura mater). He was successfully treated with meropenem and chronic suppression with oral trimethoprim-sulfamethoxazole. By describing this case and the results of a review of the pertinent literature, we discuss the importance of ESBL-producing Klebsiella pneumoniae meningitis in posttraumatic/postoperative patients.

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Successful treatment of postoperative multidrug-resistant Acinetobacter baumannii meningitis by tigecycline

Kooli

Brahim

Kilani

et al. 2016

Journal of Global Antimicrobial Resistance

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Extended-Spectrum β-Lactamase Klebsiella Pneumoniae Meningitis Treated with Tigecycline

Cited by 4 publications

References 6 publications

Systematic Review and Meta-Analysis of the Effectiveness and Safety of Tigecycline for Treatment of Infectious Disease

Systematic Review and Meta-Analysis of the Effectiveness and Safety of Tigecycline for Treatment of Infectious Disease

Postoperative Meningitis and Epidural Abscess due to Extended-spectrum β-Lactamase-producing <i>Klebsiella pneumoniae</i>: A Case Report and a Review of the Literature

Successful treatment of postoperative multidrug-resistant Acinetobacter baumannii meningitis by tigecycline

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