TABLE 6.

Clinical features and outcomes of bloodstream infections due to CMY-1-related AmpC β-lactamase-producing K. pneumoniae isolatesa

Isolate no.Age (yr)/sexUnderlying diseaseComorbid conditionType or site of infectionEmpirical therapyDefinitive therapyOutcome
2673/MCBD stoneNoneCholangitisCTX, AMKCTX, AMKCured with biliary decompression and antimicrobial therapy
2955/MCBD cancerPost-ERCPCholangitisCAZ, CIPCTX, CIPDeath on day 15 of treatment
3263/MCBD stonePost-ESTCholangitisCIP, AMKCIP, AMKCured with antimicrobial therapy
3365/MCBD stonePost-ESTCholangitisCIP, AMKCIP, AMKCured with biliary decompression
3450/FPancreas cancerNoneCholangitisCTX, AMKCTX, AMKCured with antimicrobial therapy
4457/MIHD stone, DMLiver segmentectomyAbdominal abscessIPMIPMCured with drainage and antimicrobial therapy
4554/FIHD stoneNoneCholangitisCTX, CIPCIPCured with antimicrobial therapy
4856/MGB cancerNoneCholangitisCAZ, AMKIPMPersistent fever after 3 days; treatment changed to imipenem, with cure
5128/MWilson's diseaseLiver transplantationLiver abscessCTXIPMCured with drainage and antimicrobial therapy
5249/MLiver cirrhosis with biliary obstructionPost-PTBDCholangitisCTX, AMKIPM, AMKPersistent fever after 2 days; treatment changed to imipenem and biliary decompression, cure
5362/MCBD cancerPost-ERCPCholangitisCIP, AMKIPMPersistent fever after 3 days; treatment changed to imipenem and biliary decompression, cured
5445/FLiver cirrhosis, HCCFoley catheterPeritonitisCTX, AMKCTX, AMKDeath on day 3 of treatment
5968/FPeriampullary cancerPost-ERCPCholangitisCTX, AMKIPMPersistent fever after 5 days; treatment changed to imipenem, with cure
6161/MLiver cirrhosis, HCCNoneUnknownCTX, AMKIPMPersistent fever after 2 days; treatment changed to imipenem, with cure
  • a Abbreviations: M, male; F, female; GB, gall bladder; IHD, intrahepatic duct; CBD, common bile duct; EST, endoscopic sphincterotomy; ERCP, endoscopic retrograde cholangiopancreaticography; PTBD, percutaneous transhepatic biliary drainage; DM, diabetes mellitus; ESRD, end-stage renal disease; HCC, hepatocellualr carcinoma; CTX, cefotaxime; CAZ, ceftazidime; AMK, amikacin; CIP, ciprofloxacin; IPM, imipenem.