scholarly journals Faecal Microbiota Transplantation Eradicated Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae from a Renal Transplant Recipient with Recurrent Urinary Tract Infections

2019 ◽  
Vol 9 (2) ◽  
pp. 102-107 ◽  
Author(s):  
Anne Karmisholt Grosen ◽  
Johan Vestergaard Povlsen ◽  
Lars Erik Lemming ◽  
Simon Mark Dahl Jørgensen ◽  
Jens Frederik Dahlerup ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Transplant ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Beta Lactamase ◽  
Faecal Microbiota ◽  
Extended Spectrum Beta Lactamase ◽  
Faecal Microbiota Transplantation ◽  
Extended Spectrum ◽  
Tract Infections

Renal transplant recipients (RTRs) are highly susceptible to infections, and antimicrobial resistance is an increasing problem with limited treatment options. Faecal microbiota transplantation (FMT) is effective for recurrent Clostridium difficile infection and may be used for patients with intestinal carriage of multidrug-resistant (MDR) microorganisms. We present a RTR who suffered from recurrent urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase-producing (ESBL+) Klebsiella pneumoniae. Blood and urinary isolates revealed the same antibiotic susceptibility pattern, and whole-genome sequencing confirmed identical isolates in blood and urine. Despite several treatments with meropenem, the patient experienced recurrent infections that caused hospitalisation. ESBL+ K. pneumoniae was isolated in faeces. In an attempt to decolonise the gut, FMT was performed. A few days after nasojejunal infusion of donor faeces, the patient experienced a single relapse of UTI. During the subsequent 12 months, no further episodes of UTI occurred. Absence of ESBL+ K. pneumoniae in urine and faeces was demonstrated during follow-up. We conclude that FMT may be an effective treatment in RTRs with recurrent UTIs caused by intestinal colonisation with MDR organisms.

scholarly journals Incidence of extended spectrum Beta-Lactamase producing Klebsiella pneumoniae among patients with urinary tract infections in Kano Metropolis Nigeria

2020 ◽  
Vol 12 (1) ◽  
pp. 139-144
Author(s):  
A. Mohammed ◽  
A.M Magashi ◽  
M. Yushau
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Clinical Laboratory ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Synergy Test ◽  
Tract Infections ◽  
Pharmacologically Active

Extended Spectrum Beta-Lactamase (ESBLs) production is one of the ways by which bacteria become resistant to antibiotics and pathogens of UTIs such as Klebsiella pneumoniae have been incriminated at global scale. This study was conducted to investigate the incidence of Extended Spectrum Beta lactamase producing Klebsiella pneumoniae from Urinary Tract Infections in Kano metropolis. The work involved One hundred and fourty seven K. Pneumoniae isolates obtained from patients with suspected urinary tract infections were studied from January to July 2017. The identity of the isolates was confirmed using MicrogenTMGnA + B-ID System. Antibiotic susceptibility testing was carried out using the Kirby-Bauer Disc Diffusion Technique. Screening for ESBLs production was done using Clinical Laboratory Standards Institute breakpoint. Suspected ESBLs producers were subjected to confirmation using Double Disc Synergy Test. Standard Discs of Augmentin (AMC 30µG Oxoid England), Ceftazidime (CAZ 30µG, Oxoid England) and Cefotaxime (CTX 30µG, Oxoid England) were used for the screening and confirmation. Accordingly, Multidrug Resistant K. pneumoniae were found to be 63.3% and all were ESBLs producers. The Double Disc Synergy Test however confirmed 6.8% ESBLs producing K. pneumoniae. Antimicrobial sensitivity of the ESBLs producing organisms showed 100% resistance to Augmentin, ceftriaxone, ceftazidime, cefotaxime while resistance to gentamicin was 91.5%, chloramphenicol 23.4%, Nitrofurantoin 61.7%, Ciprofloxacin 93.6% and cotrimoxazole 95.7%. However, Imipenem was the most pharmacologically active drug. ESBL producing K. pneumoniae are incident in Kano and are resistant to commonly prescribed antibiotics. We, therefore, suggest screening and confirmation for ESBL in any attempt to treat UTIs due to such pathogens Keywords: Extended Spectrum Beta Lactamases, K. pneumoniae, Urinary Tract Infection, Incidence, Kano

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