Carbapenem-resistant Klebsiella pneumoniae endocarditis in a young adult Successful treatment with gentamicin and colistin

Introduction: Enterobacteriaceae are rarely the etiologic agents of endocarditis, with Klebsiella species being especially rare. From the end of 2005, isolates of carbapenem-resistant Klebsiella pneumoniae began to appear in various hospitals across Israel, sensitive only to colistin and gentamicin. We present a case of hospital-acquired endocarditis caused by carbapenem-resistant K. pneumoniae in a young adult. Case report: An 18-year-old man with 40% full thickness burns developed acute bacterial endocarditis complicated by embolic myocardial infarction. Carbapenem-resistant K. pneumoniae carrying the bla(KPC)3 gene was isolated from multiple blood cultures. He recovered fully after antibiotic treatment with colistin and gentamicin. Conclusions: To our knowledge, this is the first reported case of acute bacterial endocarditis caused by carbapenem-resistant K. pneumoniae. The combination of intravenous colistin and gentamicin was effective and resulted in the cure of this patient's endocarditis without the need for surgical intervention. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.