A case of recurrent ventriculitis associated with Colistin-Resistant Klebsiella pneumoniae in patient with ventriculoperitoneal shunt treated with intrathecal amikacin

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CR-KP) strains have been increasingly seen as agents in the nosocomial infections in recent years. Many drugs, especially colistin are mostly used in the treatment of these pathogens [1]. As a natural result, we encountered colistinresistant strains in the hospital outbreak and infections. This challenge provide very limited treatment options for us and it shows that not only carbapenem but also colistin need to be used appropriately because of possibility of resistance [2]. Antibiotic resistance is seen due to unnecessarily and inappropriately using and not implementing hospital infection control procedures. Herein, we presented a patient who was administered intravenous (IV) + intrathecal colistin therapy due to recurrent ventriculitis associated with ventriculoperitoneal (VP) shunt. But the condition of the patient worsened under this treatment and then colistin-resistant Klebsiella pneumoniae (CoR-KP) was isolated from cerebrospinal fluid (CSF) culture. Finally, she could be successfully treated with intravenous and intrathecal amikacin use.