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Journal of Clinical Microbiology, September 2005, p. 4891-4894, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4891-4894.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Failure of Cefepime Therapy in Treatment of Klebsiella pneumoniae Bacteremia

Wonkeun Song,1 Ellen S. Moland,1 Nancy D. Hanson,1 James S. Lewis,2 James H. Jorgensen,3 and Kenneth S. Thomson1*

Center for Research in Antiinfectives and Biotechnology, Department of Medical Microbiology and Immunology, Creighton University School of Medicine, 2500 California Plaza, Omaha, Nebraska 68178,1 Departments of Pharmacology,2 Pathology, The University of Texas Health Science Center, San Antonio, Texas 782293

Received 19 April 2005/ Returned for modification 12 May 2005/ Accepted 29 June 2005

A case of failure of cefepime treatment of a bloodstream infection with AmpC-producing Klebsiella pneumoniae is reported. The failure was attributed to extended-spectrum ß-lactamase (ESBL) acquisition by the isolate, possibly during therapy. Problems encountered with ESBL detection in AmpC-producing isolates are discussed.

* Corresponding author. Mailing address: Center for Research in Antiinfectives and Biotechnology, Department of Medical Microbiology and Immunology, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178. Phone: (402) 280-2921. Fax: (402) 280-1875. E-mail: kstaac{at}creighton.edu.

Journal of Clinical Microbiology, September 2005, p. 4891-4894, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4891-4894.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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