Bacteremia due to a VIM-1 Producing Klebsiella Pneumoniae Isolate from an Acute Lymphoblastic Leukemia Patient in Antalya

Akut Prekürsör B Hücreli Lenfoblastik Lösemi tanısıyla izlenen 4 yaşındaki bir çocuğun kan kültürü örneğinden imipenem dirençli Klebsiella pneumoniae izole edildi. İzolatın PCR analizi sonuçları VIM ve CTX- M enzimleri açısından pozitif olarak saptandı. Yapılan DNA sekans analizi sonucunda 160bplik bölge blaVIM-1 ile uyumlu olarak bulundu. Hasta siprofloksasin tedavisinin 15. gününde remisyonla taburcu edildi. Bu olguda Akdeniz Üniversitesi Hastanesinde ilk kez saptanan VIM 1 pozitif Klebsiella pneumoniae izolatı sunulmuştur. Farklı direnç paternine sahip bir vaka görüldüğünde, hızlı bir şekilde antibiyotik politikalarını da içeren infeksiyon kontrol önlemleri alınmalıdır.

Antalya'da Akut Lenfoblastik Lösemili Hastada VIM-1 Üreten Klebsiella Pneumoniae'ye Bağlı Gelişen Bakteremi

A Klebsiella pneumoniae clinical isolate resistant to imipenem was recovered from blood culture of a 4 years old child with the diagnosis of acute precursor B cell lymphoblastic leukemia. PCR assays of Klebsiella pneumoniae isolate were positive with blaCTX-M and blaVIM genes. Sequence analysis of the 160 bp amplicon matched with blaVIM 1. Patient was discharged on the 15th day of ciprofloxacin theraphy with remission. We report here the first VIM-1 positive Klebsiella pneumoniae isolate case from Akdeniz University Hospital. Urgent and rapid precautions must be preferred including antibiotic policy and infection control practices when the first case with different resistance patern is detected.

___

  • 1. Kimura S, Ishii Y, Yamaguchi K. Evaluation of dipicolinic acid for detection of IMP- or VIM- type metallo-β-lactamase– producing Pseudomonas aeruginosa clinical isolates. Diag Microbiol Infect Dis 2005;53:241-4.
  • 2. Psichogiou M, Tassios PT, Avlamis A, et al. Ongoing epidemic of blaVIM-1-positive Klebsiella pneumoniae in Athens, Greece: a prospective survey. J Antimicrob Chemother 2008;61:59-63.
  • 3. Ikonomidis A, Tokatlidou D, Kristo I, et al. Outbreaks in Distinct Regions Due to a Single Klebsiella pneumoniae Clone Carrying a blaVIM-1 Metallo-ß-Lactamase Gene. J Clin Microbiol 2005;43:5344-7.
  • 4. Kassis-Chikhani N, Saliba F, Carbonne A, et al. Extended measures for controlling an outbreak of VIM-1 producing imipenem-resistant Klebsiella pneumoniae in a liver transplant centre in France, 2003–2004. Euro Surveill 2010;15:pii=19713.
  • 5. Loli A, Tzouvelekis LS, Tzelepi E, et al. Sources of diversity of carbapenem resistance levels in Klebsiella pneumoniae carrying blaVIM-1. J Antimicrob Chemother 2006;58:669–72.
  • 6. Fukigai S, Alba J, Kimura S, et al. Nosocomial outbreak of genetically related IMP-1 β-lactamase-producing Klebsiella Received/Başvuru: 04.11.2013,Correspondence/İletişim Dilara ÖĞÜNÇ Akdeniz University, Faculty of Medicine, Department of Medical Microbiology, ANTALYA, TURKEY E-mail: dogunc@akdeniz.edu.tr pneumoniae in a general hospital in Japan. Int J Antimicrob Agents 2007;29:3306-10.
  • 7. Giakkoupi P, Xanthaki A, Kanelopoulou M, et al. VIM-1 Metallo- β -Lactamase-Producing Klebsiella pneumoniae Strains in Greek Hospitals. J Clin Microbiol 2003; 41:3893–6.
  • 8. EARSS Annual Report 2008. On-going surveillance of S. Pneumoniae, S. aureus, E. coli, E. faecium, E. faecalis, K. pneumoniae, P. Aeruginosa. European Centere For Disease and Control (ECDC) 2008.
  • 9. Pitout JD, Nordmann P, Laupland KB, Poirel L. Emergence of Enterobactericeae producing extended-spectrum beta- lactamases (ESBLs) in the community. J Antimicrob Chemother 2005;56:52-9.
  • 10. Poirel L, Nordmann P. Acquired Carbapenem-Hydrolyzing -Lactamases and their Genetic Support - An Update. Medicinal Chemistry Reviews - Online, 2005;2:183-5.
  • 11. Gacar GG, Midilli K, Kolayli F, et al. Genetic and enzymatic properties of metallo-beta-lactamase VIM-5 from a clinical isolate of Enterobacter cloacae. Antimicrob Agents Chemother 2005;49:4400-3.
  • 12. Yıldırım I, Ceyhan M, Gür D, Mugnaioli C, Rossolini GM. First detection of VIM-1 type metallo-beta-lactamase in a multidrug-resistant Klebsiella pneumoniae clinical isolate from Turkey also producing the CTX-M-15 extended- spectrum beta-lactamase. J Chemother 2007;19:467-8.
  • 13. Gudiol C, Tubau F, Calatayud L, et al. Bacteraemia due to multidrug-resistant Gram-negative bacilli in cancer patients: risk factors, antibiotic therapy and outcomes. J Antimicrob Chemother 2011;66:657-63.
  • 14. Meletis G, Tzampaz E, Protonotariou E, Sofianou D. Emergence of Klebsiella pneumoniae carrying bla VIM and blaKPC genes. Hippokratia 2010;14:139–40.
  • 15. Walsh T R, Toleman M A, Poirel L, Nordmann P. Metallo-β- Lactamases: the Quiet before the Storm? Clin Microbiol Reviews 2005;18:306–25.
İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi-Cover
  • ISSN: 1300-1744
  • Yayın Aralığı: Yılda 4 Sayı
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Neonatal Hyperbilirubinemia Due to AB0 Incompatibility

Şahin TAKCI, Deniz ANUK İNCE, Ayşe HENDEKÇİ, Nagehan EREN

Surgical Treatment of Extracranial Internal Carotid Artery Aneurysm: A Case Report

Özgür BULUT, Mustafa Kemal DEMİRAĞ

Peroneal Intraneural Ganglion Cyst Arising from Proximal Tibiofibular Joint: Advantages of Magnetic Resonance Imaging on Preoperative Diagnosis

Ayşe Cemile GÖRMELİ, Zeynep ÖZDEMİR MARAŞ, Meryem Merve HAMURCU, Ayşegül KAHRAMAN SAĞIR, Haldun TOPGÜL, Mustafa KARAKAPLAN

Effects of Long Bones on Fetal Weight Estimation

Nermin KÖŞÜŞ, Aydın KÖŞÜŞ, Müzeyyen DURAN, İkbal KAYGUSUZ

An Unusual Pseudolymphoma on the Eyelid: Jessner's Lymphocytic Infiltration of the Skin (JLIS)

Seyhan DİKİCİ

Brucella Epididymo-Orchitis: An Evaluation of Eight Cases

Seyit Ali BÜYÜKTUNA, Adem KÖSE, Ender AKDEMİR

Erken Dönemde Gelişen Gebeliğin Akut Yağlı Karaciğer Hastalığı

Melih KARINCAOĞLU, Murat ALADAĞ, Yüksel SEÇKİN, Mehmet Ali ERDOĞAN, Yahya ATAYAN, Yasir Furkan ÇAĞIN, Murat HARPUTOĞLU

A Case Report of a Combined Bypass Surgery on Coronary Artery and Right Common Femoral Artery of the Aorta

Atilla KANCA, Soner SANİOĞLU, Ümit HALICI, Ersan ÖZBUDAK, Rıza VALİ, Birkan YAŞAR

Unembriyonic Pregnancy in a Noncommunicating Rudimentary Horn of a Unicornuate Uterus: A Case Report

Mehmet Sıddık EVSEN, Hakan AYTAN, Leyla MOLLAMAHMUTOĞLU, Sema ZERGEROĞLU, Ömer Lütfi TAPISIZ, Bekir SERDAR ÜNLÜ

Non-Operative Treatment of Intraabdominal Hemorrage due to Warfarin Use: Two Patient Reports

Bora BARUT, Volkan İNCE, Cemalettin KOÇ, Hüseyin YÖNDER, Abuzer DİRİCAN, Mustafa ATEŞ