Treatment of recurrent urinary tract infections in a 60-year-old kidney transplant recipient. The use of phage therapy.
Klebsiella pneumoniae
antimicrobial resistance
case report
kidney transplant recipient
kidney transplantation
nephrectomy
phage therapy
urinary tract infection
Journal
Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
17
04
2020
revised:
15
06
2020
accepted:
16
06
2020
pubmed:
1
7
2020
medline:
3
8
2021
entrez:
30
6
2020
Statut:
ppublish
Résumé
We would like to demonstrate the difficulty of treatment in a patient after kidney transplantation (KTX) who developed chronic urinary tract infection (UTI) with a multi-drug resistant ESBL-producing Klebsiella pneumoniae. The patient underwent several treatment interventions including supportive therapy with bacteriophages. This article presents a case of a 60-year-old patient after KTX repeatedly admitted to the hospital with recurrent UTIs caused by ESBL-producing Klebsiella pneumoniae showing variable susceptibility to carbapenems and full susceptibility to colistin only. KTX was performed due to renal insufficiency caused by polycystic kidney disease. The patient experienced 12 severe episodes of UTI due to K pneumoniae within 15 months since transplantation. In an attempt to curb the ongoing infections, phage therapy (PT) was applied on the experimental basis, coordinated by the Phage Therapy Unit of the Hirszfeld Institute in Wroclaw, Poland. Eventually, the patient fully recovered following nephrectomy of his own left kidney where cysts were the suspected reservoir of bacteria. The patient completed 29 days of PT. PT caused no reported side effects in the described case of the KTX recipient, although its role in controlling chronic UTI caused by K pneumoniae is unclear. More studies are needed in the population of kidney transplant recipients.
Substances chimiques
Anti-Bacterial Agents
0
beta-Lactamases
EC 3.5.2.6
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13391Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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