Hideki Kano1, Akihiko Hirakawa1, Hiromiti Miyabe1, Tomonori Hattori1, Hiroshige Mikamo2, Shunji Yoshida3, Naoshi Takeyama1. 1. Department of Emergency and Acute Intensive Care Medicine Fujita Health University Toyoake Japan. 2. Department of Clinical Infectious Diseases Aichi Medical University Nagakute Japan. 3. Division of Rheumatology and Infectious Diseases, Department of Internal Medicine Fujita Health University Toyoake Japan.
Abstract
CASE: Here we report the fifth case of New Delhi metallo-β-lactamase-1-producing Enterobacteriaceae infection in Japan. A 39-year-old Japanese man suffered a subarachnoid hemorrhage due to rupture of aneurysm in India. Once he was deemed stable enough, he was transferred from a hospital in India to our hospital in Japan. On day 5 after transfer, the patient suddenly developed septic shock and multidrug-resistant Klebsiella pneumoniae was isolated from a blood culture. OUTCOME: Treatment with colistin and high-dose meropenem as well as organ support were initiated, resulting in successful resolution of septic shock. This K. pneumoniae was shown to carry blaNDM-1 by polymerase chain reaction analysis. CONCLUSION: Our case suggests that New Delhi metallo-β-lactamase-1-producing bacteria could be introduced into Japan easily. It is important to apply strict surveillance and infection control measures to prevent the spread of carbapenem resistance genes to Enterobacteriaceae in Japan.
CASE: Here we report the fifth case of New Delhi metallo-β-lactamase-1-producing Enterobacteriaceae infection in Japan. A 39-year-old Japanese man suffered a subarachnoid hemorrhage due to rupture of aneurysm in India. Once he was deemed stable enough, he was transferred from a hospital in India to our hospital in Japan. On day 5 after transfer, the patient suddenly developed septic shock and multidrug-resistant Klebsiella pneumoniae was isolated from a blood culture. OUTCOME: Treatment with colistin and high-dose meropenem as well as organ support were initiated, resulting in successful resolution of septic shock. This K. pneumoniae was shown to carry blaNDM-1 by polymerase chain reaction analysis. CONCLUSION: Our case suggests that New Delhi metallo-β-lactamase-1-producing bacteria could be introduced into Japan easily. It is important to apply strict surveillance and infection control measures to prevent the spread of carbapenem resistance genes to Enterobacteriaceae in Japan.
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