Fatal case of donor-derived colistin-resistant carbapenemase-producing Klebsiella pneumoniae transmission in cardiac transplantation

Lisia Miglioli Galvão, Anna Paula Romero de Oliveira, Aline Santos Ibanês, Jussimara Monteiro, Fernanda Inoue, Daniel Chagas Dantas, Flavio Sanchez, Daniel Wagner Santos, Cely Saad Abboud
2018 Brazilian Journal of Infectious Diseases  
Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation. A 59year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation. On day 5 post-operation, blood cultures from the donor were positive for colistin-resistant carbapenemase-producing K. pneumoniae (ColR KPC-Kp) susceptible only to amikacin. Recipient blood cultures were also positive for ColR
more » ... itive for ColR KPC-Kp with the same sensitivity profile as the donor isolate with an identical PFGE pattern. The patient was treated with double-carbapenems and amikacin. The patient evolved to pericarditis, osteomyelitis, and pulmonary necrosis, all fragment cultures positive for the same agent. The patient developed septic shock, multiple organ failure and died on day 50 post-transplantation. Based on current microbiological scenario worldwide the possibility of transmitting multidrug resistant (MDR) organisms should be considered.
doi:10.1016/j.bjid.2018.04.005 pmid:29806996 fatcat:3sebofsqrfhnviopsvkpd2sree