Thoracic aorta graft infection by avibactam-resistant KPC-producing K. pneumoniae treated with meropenem/vaborbactam: a case report and literature review

阿维巴坦耐药的产KPC肺炎克雷伯菌引起的胸主动脉移植物感染,采用美罗培南/瓦博巴坦治疗:病例报告及文献综述

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Abstract

Meropenem/vaborbactam (M/V) is a new carbapenem-carbapenemase inhibitor combination drug active against extensively drug resistant Gram-negative pathogens. Studies about its efficacy and place in therapy are limited in "real-life" and no data are available for deep site infections, like vascular graft infections. We present a case of a patient successfully treated with M/V for a thoracic aorta graft infection, placed for a traumatic penetrating aortic ulcer, due to an extensively KPC-producing Klebsiella pneumoniae resistant to ceftazidime/ avibactam. Furthermore, we conducted a systematic literature review concerning vascular graft infections caused by carbapenem-resistant Klebsiella pneumoniae and the papers published until now about the use of M/V for the treatment of ceftazidime/avibactam-resistant K. pneumoniae. Meropenem/vaborbactam is a promising antibiotic for difficult-to-treat Gram-negative bacteria with limited therapeutic options. Only few reports have been published and more studies are needed to assess which is the best place in therapy of M/V.

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