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コモリ コウジ
Komori Kouji
小森 光二 所属 東邦大学 医学部 医学科 職種 助教 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Successful treatment of an intra-abdominal abscess caused by KPC-2-producing hypervirulent Klebsiella pneumoniae sequence type 11 with imipenem/cilastatin/relebactam in a Japanese patient. |
| 掲載誌名 | 正式名：Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy |
| 掲載区分 | 国外 |
| 巻・号・頁 | 31(6),pp.102717-102717 |
| 著者・共著者 | Kazuhiro Ishikawa,Koko Shibutani,Yumiko Mikami,Sohei Harada,Kohji Komori,Nobuyoshi Mori |
| 発行年月 | 2025/04/22 |
| 概要 | KPC-producing K. pneumoniae is rare in Japan. In China, KPC-2-producing sequence type (ST)11 K. pneumoniae isolates have been rapidly increasing, and a subset of these isolates have acquired hypervirulence. We report a case of a 39-year-old Japanese male who developed bacteremia and intra-abdominal abscesses caused by hypervirulent carbapenem-resistant K. pneumoniae. The patient sustained abdominal injuries following a traffic accident in Xinjiang Uygur Autonomous Region and underwent abdominal surgery before being transferred to our hospital. Abscess drainage was performed, and he was initially treated with meropenem (2 g every 8 hours, prolonged infusion over 3 hours), gentamicin (5 mg/kg/day), and tigecycline (200 mg as a loading, followed by 100 mg every 12 hours). KPC carbapenemase was detected using the NG-Test® CARBA 5 (NG Biotech, France), and the minimum inhibitory concentration for imipenem/cilastatin/relebactam was 1 μg/mL, indicating susceptibility. His treatment was switched to imipenem/cilastatin/relebactam (1 g every 6 hours) for 7 weeks, resulting in clinical improvement. Whole-genome sequencing analysis revealed that the causative strain was hypervirulent KPC-2-producing K. pneumoniae (capsular type K64, ST 11) carrying blaKPC-2 and blaCTX-M-65 on a multireplicon plasmid (pMTY24772_IncFII-R), which was a fusion of IncFII and IncR. Additionally, rmpA and iucABCD genes associated with hypervirulence were detected. The strain carried a resistance plasmid and a virulence plasmid similar to those carried by ST11-K64 KPC-producing strains reported from China. Imipenem/cilastatin/relebactam is potentially an option for treating infections caused by KPC-2-producing hypervirulent K, pneumoniae with porin mutations. Cross-border spread of pathogens that are both multidrug-resistant and hyperviirulent must be closely monitored. |
| DOI | 10.1016/j.jiac.2025.102717 |
| PMID | 40274049 |