Successful Treatment of Urinary Tract Infection in Kidney Transplant Recipients Caused by Multiresistant Klebsiella pneumoniae Producing New Delhi Metallo-Beta-Lactamase (NDM-1) With Strains Genotyping

In Vivo Efficacy of Meropenem with a Novel Non-β-Lactam–β-Lactamase Inhibitor, Nacubactam, against Gram-Negative Organisms Exhibiting Various Resistance Mechanisms in a Murine Complicated Urinary Tract Infection Model

“…In patients with UTIs caused by KPC-producing Enterobacteriaceae, inactive antibiotics were given 33% of the time, causing a median delay in adequate therapy of 72.5 h (19). In case reports of UTIs caused by K. pneumoniae NDM-1 strains, combination therapy of a carbapenem plus gentamicin or colistin was required (20). The use of gentamicin or colistin potentially increases the risk of adverse events, such as nephrotoxicity (21,22).…”

“Double carbapenem” and oral fosfomycin for the treatment of complicated urinary tract infections caused by blaNDM‐harboring Enterobacteriaceae in kidney transplantation

“…This regimen was successfully used for the treatment of sepsis and bacteremia secondary to complicated UTI with Morganella morganii harboring NDM‐1 in a renal transplant recipient . Wilkowski et al described a series of three renal transplant recipients with UTI caused by NDM‐1–producing K. pneumoniae successfully treated with a variety of regimens: Case 1 was treated with imipenem‐colistin‐fosfomycin; Case 2 received imipenem‐gentamicin, later modified to gentamicin‐colistin‐fosfomycin; and Case 3 was initially treated with colistin‐gentamicin‐imipenem, followed by oral suppression with fosfomycin, and a recurrent episode was treated with trimethoprim‐sulfamethoxazole‐fosfomycin. All regimens achieved eradication of K. pneumoniae in urine .…”

“…Wilkowski et al described a series of three renal transplant recipients with UTI caused by NDM‐1–producing K. pneumoniae successfully treated with a variety of regimens: Case 1 was treated with imipenem‐colistin‐fosfomycin; Case 2 received imipenem‐gentamicin, later modified to gentamicin‐colistin‐fosfomycin; and Case 3 was initially treated with colistin‐gentamicin‐imipenem, followed by oral suppression with fosfomycin, and a recurrent episode was treated with trimethoprim‐sulfamethoxazole‐fosfomycin. All regimens achieved eradication of K. pneumoniae in urine . The heterogeneity of the aforementioned regimens used in clinical practice reflects the struggles transplant clinicians face when dealing with these extremely drug‐resistant organisms.…”

A putative multi-replicon plasmid co-harboring beta-lactamase genes blaKPC-2, blaCTX-M-14 and blaTEM-1 and trimethoprim resistance gene dfrA25 from a Klebsiella pneumoniae sequence type (ST) 11 strain in China

“…Since the increase of carbapenem-resistant Enterobacteriaceae , which are frequently resistant to many different antibiotic substances, some older generation antibiotics (e.g., trimethoprim) have been used alternatively for treating infections [ 4 , 5 ]. With a structure similar to that of folic acid, trimethoprim is a competitive inhibitor of dihydrofolate reductase [ 6 , 7 ].…”