Selin ŞENOL, Ayşe BÜYÜKDEMİRCİ, Salih CESUR, Yavuz ERDEM, Esra KAYA KILIÇ, Berkay AYHAN, Sami KINIKLI

Panrezistan Klebsiella pneumoniae’ye bağlı olarak gelişen ve kolistin ile başarıyla tedavi edilen bir nozokomiyal menenjit olgusu

Sağlık bakımıyla ilişkili menenjitler önemli bir mortalite ve morbidite nedenidir. Özellikle çoğul ilaca dirençli Klebsiella pneumoniae’ye bağlı menenjitlerde mortalite oranı yüksektir. Bu yazıda, dura defekti onarımı için beyin cerrahisi kliniğinde opere edilen lomber drenaj uygulanan, yatışının 12. gününde panrezistan Klebsiella pneumoniae’ye bağlı olarak nozokomiyal menenjit gelişen 19 yaşında bir erkek olgu sunuldu. Olgu intravenöz meropenem ve kolitsin tedavisine ilaveten 21 gün intratekal kolitsin tedavisi sonrasında BOS kültürü negatifleşti ve tamamen düzeldi.

Anahtar Kelimeler:

Sağlık bakımıyla ilişkili menenjit, , panrezistan Klebsiella pneumoniae, tedavi, intratekal kolistin

Nosocomial meningitis case to successfuly treated with colistin caused by panresistant Klebsiella pneumoniae

Health-care associated meningitis is an important cause of mortality and morbidity. Mortality rate is high especially in multidrug resistant Klebsiella pneumoniae. In this article, we present a 19-year-old male patient who underwent lumbar drainage operated at the neurosurgery clinic for dura defect repair and developed nosocomial meningitis due to panresistant Klebsiella pneumoniae on the 12th day of his hospitalization. With totaly 21 days by intrathecal colistin in addition to intravenous meropenem and colistin treatment, the patient's CSF culture became negative and patient was completely recovered.

Keywords:

Health care associated meningitidis, panresistant Klebsiella pneumoniae, treatment, intratecal colistin,

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1. Trecarichi EM, Tumbarello M. Therapeutic options for carbapenem-resistant Enterobacteriaceae infections. Virulence 2017; 8: 470–84.
2. Potter RF, D'Souza AW , Dantas G. The rapid spread of carbapenem-resistant Enterobacteriaceae. Drug Resist Updat 2016; 29: 30–46.
3. Duin Dv, Lok JJ, Earley M, et al. Colistin versus ceftazidime-avibactam in the treatment of infections due to carbapenem-resistant Enterobacteriaceae. Clin Infect Dis 2018; 66: 163–71.
4. Zhang Y, Wang Q, Yin Y, et al. Epidemiology of Carbapenem-resistant Enterobacteriaceae infections: report from the China CRE Network. Antimicrob Agents Chemother 2018; 62: 2.
5. Sahin K, Tekin A, Ozdas S, et al. Evaluation of carbapenem resistance using phenotypic and genotypic techniques in Enterobacteriaceae isolates. Ann Clin Microbiol Antimicrob 2015; 14: 1-6.
6. Arabacı Ç, Dal T, Başyiğit T, Genişel N, Durmaz R. Investigation of carbapenemase and mcr-1 genes in carbapenem-resistant Klebsiella pneumoniae isolates. J Infect Dev Ctries 2019; 13: 504-9.
7. Pin Liu, Xuan Li, Mei Luo, et al. Risk factors for carbapenem-resistant Klebsiella pneumoniae infection: a meta-analysis. Microbial Drug Resistance 2018; 24: 190-8.
8. Pagliano P, Caggiano C, Ascione T, et al. Characteristics of meningitis following transsphenoidal endoscopic surgery: a case series and a systematic literature review. Infection 2017; 45: 841-8.
9. Chen Y, Liu L. The treatment of nosocomial meningitis and brain abscess by carbapenem-resistant Klebsiella pneumonia. Br J Neurosurg 2019; 1-3.
10. Patrial YC, Tortorelli LP, Rodrigues ACS, et al. Post-neurosurgical meningitis caused by KPC-producing Klebsiella pneumoniae: report of two cases. Rev Inst Med Trop Sao Paulo 2019; 61: e69.
11. Lee B, Yeroushalmi K, Me HM, et al. Community acquired Klebsiella pneumoniae meningitis: a case report. Germs 2018; 8: 92-5.
12. Emiroglu M, Alkan G, Turk Dagi H. Tigecycline therapy in an ınfant for ventriculoperitoneal shunt meningitis. Pediatrics 2017; 139: pii: e20160963.
13. De Bonis P, Lofrese G, Scoppettuolo G, et al. Intraventricular versus intravenous colistin for the treatment of extensively drug resistant Acinetobacter baumannii meningitis. Eur J Neurol 2016; 23: 68-75.
14. Çerçioğlu D, Cesur S, Hatipoğlu ÇA, et al. İntratekal kolistinle başarıyla tedavi edilen çoğul dirençli Acinetobacter baumannii’ye bağlı nozokomiyal menenjit. Klimik Derg 2017; 30: 155-7.