A Case of Sepsis Due to Carbapenem-Resistant Klebsiella pneumoniae in an Extremely Low-Birth Weight Infant Treated with Trimethoprim–Sulfamethoxazole

Abstract

In recent years, there have been an increasing number of infections due to multidrug-resistant organisms in the neonatal intensive care unit. Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a challenge in clinical anti-infection treatment. Herein, we report the case of CRKP sepsis in an extremely low-birth weight infant (ELBWI) who did not respond to meropenem and vancomycin, but was treated successfully after a 10-day antibiotic course with trimethoprim–sulfamethoxazole (TMP-SMZ). Recent research on CRKP-associated sepsis and the application of TMP-SMZ therapy in children and neonates were reviewed to offer a reference for clinical practice.

Keywords:

• carbapenem-resistance
• extremely low birth weight infant
• Klebsiella pneumoniae
• sepsis
• trimethoprim–sulfamethoxazole

Abbreviations

NICU, neonatal intensive care unit; CRKP, carbapenem-resistant Klebsiella pneumoniae; ELBWI, extremely low birth weight infant; TMP-SMZ, trimethoprim–sulfamethoxazole; K. pneumoniae, Klebsiella pneumoniae; LOS, late-onset sepsis; NRDS, neonatal respiratory distress syndrome; NEC, neonatal necrotizing enterocolitis; CSF, Cerebrospinal fluid; BPD, bronchopulmonary dysplasia; ROP, retinopathy of prematurity; NCPAP, nasal continuous positive airway pressure; BSI, bloodstream infections; CAZ-AVI, ceftazidime avibactam.

Data Sharing Statement

Not shared as it contains confidential patient data.

Ethics Approval and Informed Consent

The parents of the patient provided informed consent for the case details to be published. Shanghai Children’s Hospital approval to publish the case details.

Consent for Publication

The parents of this patient provided the written permission to the publication.

Author Contributions

WBW, CC, and HWC made substantial contributions to the conception and design, and the acquisition, analysis, and interpretation of data. WBW, ZXY, YCB, and CC were involved in drafting the manuscript and revising it critically for important intellectual content. CC and GXH revised the manuscript and gave the final approval for the version to be published. All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval for the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.