TABLE 6.
Clinical features and outcomes of bloodstream infections due to CMY-1-related AmpC β-lactamase-producing K. pneumoniae isolatesa
Isolate no. | Age (yr)/sex | Underlying disease | Comorbid condition | Type or site of infection | Empirical therapy | Definitive therapy | Outcome |
---|---|---|---|---|---|---|---|
26 | 73/M | CBD stone | None | Cholangitis | CTX, AMK | CTX, AMK | Cured with biliary decompression and antimicrobial therapy |
29 | 55/M | CBD cancer | Post-ERCP | Cholangitis | CAZ, CIP | CTX, CIP | Death on day 15 of treatment |
32 | 63/M | CBD stone | Post-EST | Cholangitis | CIP, AMK | CIP, AMK | Cured with antimicrobial therapy |
33 | 65/M | CBD stone | Post-EST | Cholangitis | CIP, AMK | CIP, AMK | Cured with biliary decompression |
34 | 50/F | Pancreas cancer | None | Cholangitis | CTX, AMK | CTX, AMK | Cured with antimicrobial therapy |
44 | 57/M | IHD stone, DM | Liver segmentectomy | Abdominal abscess | IPM | IPM | Cured with drainage and antimicrobial therapy |
45 | 54/F | IHD stone | None | Cholangitis | CTX, CIP | CIP | Cured with antimicrobial therapy |
48 | 56/M | GB cancer | None | Cholangitis | CAZ, AMK | IPM | Persistent fever after 3 days; treatment changed to imipenem, with cure |
51 | 28/M | Wilson's disease | Liver transplantation | Liver abscess | CTX | IPM | Cured with drainage and antimicrobial therapy |
52 | 49/M | Liver cirrhosis with biliary obstruction | Post-PTBD | Cholangitis | CTX, AMK | IPM, AMK | Persistent fever after 2 days; treatment changed to imipenem and biliary decompression, cure |
53 | 62/M | CBD cancer | Post-ERCP | Cholangitis | CIP, AMK | IPM | Persistent fever after 3 days; treatment changed to imipenem and biliary decompression, cured |
54 | 45/F | Liver cirrhosis, HCC | Foley catheter | Peritonitis | CTX, AMK | CTX, AMK | Death on day 3 of treatment |
59 | 68/F | Periampullary cancer | Post-ERCP | Cholangitis | CTX, AMK | IPM | Persistent fever after 5 days; treatment changed to imipenem, with cure |
61 | 61/M | Liver cirrhosis, HCC | None | Unknown | CTX, AMK | IPM | Persistent fever after 2 days; treatment changed to imipenem, with cure |
Abbreviations: M, male; F, female; GB, gall bladder; IHD, intrahepatic duct; CBD, common bile duct; EST, endoscopic sphincterotomy; ERCP, endoscopic retrograde cholangiopancreaticography; PTBD, percutaneous transhepatic biliary drainage; DM, diabetes mellitus; ESRD, end-stage renal disease; HCC, hepatocellualr carcinoma; CTX, cefotaxime; CAZ, ceftazidime; AMK, amikacin; CIP, ciprofloxacin; IPM, imipenem.