Successful treatment with aztreonam of a patient with disseminated hypervirulent Klebsiella pneumoniae infection

Abstract

Klebsiella pneumoniae is a highly pathogenic and resilient Gram negative bacterium often found colonising the gastrointestinal (GI) tract in humans. The hypervirulent strain of bacterium possesses unique virulence mechanisms which can cause primary liver abscesses with septic metastatic complications. In recent decades, there has been a continual rise in global health concern regarding the emergence of antimicrobial resistance for this organism.

We present a case of a hypervirulent Klebsiella pneumoniae infection with liver abscesses and central nervous system (CNS) embolic disease which was treated successfully with the monobactam aztreonam. Although the isolate tested sensitive to a wide range of antibiotics including third-generation cephalosporins and carbapenems, her treatment regime was altered due to a lack of clinical response and adverse drug reactions. The patient made significant improvement clinically, biochemically and radiologically on aztreonam, despite lesser use in CNS disease than conventional beta-lactams.