A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient
The New Delhi metallo-β-lactamase (NDM) is a mediator of broad antimicrobial resistance among the Enterobacteriaceae and other gram-negative pathogens that cause opportunistic and nosocomial infections. In the decade since its discovery, NDM has spread worldwide and represents an increasing threat t...
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doaj-42348f9c79c64b1a88a6294ab1bdb3d52021-07-02T17:22:27ZengElsevierIDCases2214-25092020-01-0121e00816A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patientKevin H. Toomer0Daniela de Lima Corvino1Katie A. McCrink2Jose Armando Gonzales Zamora3Infectious Diseases Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA; Corresponding author at: Infectious Diseases Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.Infectious Diseases Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USADepartment of Pharmacy, Jackson Memorial Hospital, Miami, FL, USAInfectious Diseases Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USAThe New Delhi metallo-β-lactamase (NDM) is a mediator of broad antimicrobial resistance among the Enterobacteriaceae and other gram-negative pathogens that cause opportunistic and nosocomial infections. In the decade since its discovery, NDM has spread worldwide and represents an increasing threat to public health. NDM is capable of hydrolyzing nearly all known β-lactam antibiotics, including the carbapenems, and due to its zinc ion-dependent catalytic mechanism is unaffected by available β-lactamase inhibitors. We report a case of catheter-related bloodstream infection caused by a pan-resistant, NDM-positive isolate of Klebsiella pneumoniae in an ambulatory end-stage renal disease patient started on hemodialysis approximately 8 weeks prior. The absence of any recent hospitalization indicates that the infection was likely acquired from a hemodialysis center in the United States. This case demonstrates the increasing prevalence of antimicrobial resistance mechanisms in ambulatory as well as inpatient healthcare settings, and highlights the particular risk of the outpatient hemodialysis facility as an optimal environment for colonization with multidrug- and pandrug-resistant pathogens.http://www.sciencedirect.com/science/article/pii/S2214250920301244CarbapenemasesNew Delhi metallo-β-lactamaseKlebsiella pneumoniaeCatheter-related infectionHemodialysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kevin H. Toomer Daniela de Lima Corvino Katie A. McCrink Jose Armando Gonzales Zamora |
spellingShingle |
Kevin H. Toomer Daniela de Lima Corvino Katie A. McCrink Jose Armando Gonzales Zamora A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient IDCases Carbapenemases New Delhi metallo-β-lactamase Klebsiella pneumoniae Catheter-related infection Hemodialysis |
author_facet |
Kevin H. Toomer Daniela de Lima Corvino Katie A. McCrink Jose Armando Gonzales Zamora |
author_sort |
Kevin H. Toomer |
title |
A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient |
title_short |
A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient |
title_full |
A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient |
title_fullStr |
A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient |
title_full_unstemmed |
A New Delhi metallo-β-lactamase (NDM)-positive isolate of Klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient |
title_sort |
new delhi metallo-β-lactamase (ndm)-positive isolate of klebsiella pneumoniae causing catheter-related bloodstream infection in an ambulatory hemodialysis patient |
publisher |
Elsevier |
series |
IDCases |
issn |
2214-2509 |
publishDate |
2020-01-01 |
description |
The New Delhi metallo-β-lactamase (NDM) is a mediator of broad antimicrobial resistance among the Enterobacteriaceae and other gram-negative pathogens that cause opportunistic and nosocomial infections. In the decade since its discovery, NDM has spread worldwide and represents an increasing threat to public health. NDM is capable of hydrolyzing nearly all known β-lactam antibiotics, including the carbapenems, and due to its zinc ion-dependent catalytic mechanism is unaffected by available β-lactamase inhibitors. We report a case of catheter-related bloodstream infection caused by a pan-resistant, NDM-positive isolate of Klebsiella pneumoniae in an ambulatory end-stage renal disease patient started on hemodialysis approximately 8 weeks prior. The absence of any recent hospitalization indicates that the infection was likely acquired from a hemodialysis center in the United States. This case demonstrates the increasing prevalence of antimicrobial resistance mechanisms in ambulatory as well as inpatient healthcare settings, and highlights the particular risk of the outpatient hemodialysis facility as an optimal environment for colonization with multidrug- and pandrug-resistant pathogens. |
topic |
Carbapenemases New Delhi metallo-β-lactamase Klebsiella pneumoniae Catheter-related infection Hemodialysis |
url |
http://www.sciencedirect.com/science/article/pii/S2214250920301244 |
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