Long-term, low-dose tigecycline to treat relapsing bloodstream infection due to KPC-producing Klebsiella pneumoniae after major hepatic surgery. (July 2015)

• Record Type: Journal Article
• Authors: Morelli, Luca; Tartaglia, Dario; Furbetta, Niccolò; Palmeri, Matteo; Ferranti, Simone; Tagliaferri, Enrico; Di Candio, Giulio; Mosca, Franco
• Is Part Of: International journal of infectious diseases. Volume 36(2015:Jul.)
• Page Start: 4
• Page End: 5
• Publication Date: 2015-07
• Subjects: Hepatectomy -- Klebsiella pneumoniae -- Long-term therapy; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2015.05.001
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: KPC- Klebsiella pneumoniae biliary infection after hepatic surgery is reported. Combination therapy failed to provide source control, and bacteraemia relapsed. A low-dose, long-term regimen of tigecycline was administered. Six months after the end of treatment the patient was clinically infection-free. Tigecycline might be effective as a suppressive treatment in biliary infections. Summary: A 68-year-old male underwent a right hepatectomy, resection of the biliary convergence, and a left hepatic jejunostomy for a Klatskin tumour. The postoperative course was complicated by biliary abscesses with relapsing bloodstream infections due to Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp). A 2-week course of combination antibiotic therapy failed to provide source control and the bacteraemia relapsed. Success was obtained with a regimen of tigecycline 100 mg daily for 2 months, followed by tigecycline 50 mg daily for 6 months, then 50 mg every 48 h for 3 months. No side effects were reported.