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Revista chilena de infectología

versión impresa ISSN 0716-1018

Resumen

ROBINO, Luciana et al. Treatment failure due to acquisition of antibiotic resistance: report of two clinical cases. Rev. chil. infectol. [online]. 2013, vol.30, n.3, pp.326-328. ISSN 0716-1018.  http://dx.doi.org/10.4067/S0716-10182013000300010.

Objective: We describe two cases of treatment failure due to intra-treatment acquisition of antibiotic resistant microorganisms with the aim of highlighting the possible molecular mechanisms by which treatment failure occurred. Patients and Methods: We analyzed the clinical histories and the isolates obtained from 2 patients, one with a urinary tract infection (UTI) by E. coli, initially treated with cefuroxim (to which the isolate was susceptible), and another with osteoarthritis (OA) treated initially with meropenem plus vancomycin, developing K. pneumoniae susceptible to meropenem. During treatment, in both patients, resistant microorganisms were isolated, and empirical therapy was modified, initially with ceftriaxone and afterwards meropenem in case 1, and adding amikacin in case 2. Both strains (per patient) were compared by PFGE and resistance genes were sought by PCR. Results: Regarding the UTI, the initial strain acquired an IncFIB SHV-5-producing plasmid. In the OA case, the initial susceptible strain was substituted by a CTX-M-9 and AadB-AadA2-Aac(6')Ib-producing K. pneumoniae.

Palabras clave : Treatment failure; antibiotic resistance; ESBL.

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