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, Volume 1738, Issue 1, pp 26–26 | Cite as


Renal tubular toxicity and development of antimicrobial resistance in Klebsiella pneumoniae infection: case report
Case report
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An event is serious (based on the ICH definition) when the patient outcome is:

  • * death

  • * life-threatening

  • * hospitalisation

  • * disability

  • * congenital anomaly

  • * other medically important event

A 24-year-old man developed antimicrobial resistance during treatment with avibactam/ceftazidime for Klebsiella pneumonia infection. He also developed renal tubular toxicity during treatment with polymixin-B, tigecycline and gentamicin.

The man, who had stage liver disease secondary to primary sclerosing cholangitis underwent orthotopic liver transplantation with Roux-en-Y hepaticojejunostomy. On day 4, he developed a fever and respiratory failure, which needed mechanical ventilator support. Blood and bronchoalveolar lavage fluid cultures grew Klebsiella pneumonia. A rapid nucleic acid microarray technology revealed presence of Klebsiella pneumoniae carbapenemase (KPC) encoding gene in the blood specimen. Consequently, an empirical regimen comprising of vancomycin and...


  1. Athans V, et al. Meropenem-vaborbactam as salvage therapy for ceftazidime-avibactam-resistant klebsiella pneumoniae bacteremia and abscess in a liver transplant recipient. Antimicrobial Agents and Chemotherapy 63: e01551-18, No. 1, Jan 2019. Available from: URL: - USAPubMedGoogle Scholar

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© Springer Nature Switzerland AG 2019

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