Volume 94, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Treatment of mycobacterial diseases such as tuberculosis (TB) entails long and intense antimicrobial therapy. TB patients are at risk of coinfection with other multidrug-resistant bacteria, such as those from Enterobacteriaceae family, because of antimicrobial selection pressure and nosocomial transmission during prolonged hospital admission. Here, we report on two patients treated for multidrug-resistant TB, who developed severe sepsis due to an extended spectrum β-lactamase producing organism. Diagnostic culture identified the venous access port as source, and upon surgical removal and antimicrobial therapy rapid clinical improvement was achieved. Increased awareness and knowledge on the prevalence of multi-resistant Enterobacteriaceae is needed, notably in TB centers, to provide a safe hospital environment to our patients.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Pérez-Cobas AE, Gosalbes MJ, Friedrichs A, Knecht H, Artacho A, Eismann K, Otto W, Rojo D, Bargiela R, von Bergen M, Neulinger SC, Däumer C, Heinsen F-A, Latorre A, Barbas C, Seifert J, dos Santos VM, Ott SJ, Ferrer M, Moya A, 2013. Gut microbiota disturbance during antibiotic therapy: a multi-omic approach. Gut 62: 15911601.[Crossref]
    [Google Scholar]
  2. Sedláková MH, Urbánek K, Vojtová V, Suchánková H, Imwensi P, Kolář M, 2014. Antibiotic consumption and its influence on the resistance in Enterobacteriaceae. BMC Res Notes 7: 454.[Crossref]
    [Google Scholar]
  3. Leistner R, Gürntke S, Sakellariou C, Denkel LA, Bloch A, Gastmeier P, Schwab F, 2014. Bloodstream infection due to extended-spectrum beta-lactamase (ESBL)-positive K. pneumoniae and E. coli: an analysis of the disease burden in a large cohort. Infection 42: 991997.[Crossref]
    [Google Scholar]
  4. Pepper DJ, Rebe K, Morroni C, Wilkinson RJ, Meintjes G, 2009. Clinical deterioration during antitubercular treatment at a district hospital in South Africa: the importance of drug resistance and AIDS defining illnesses. PLoS One 4: e4520.[Crossref]
    [Google Scholar]
  5. Sarma JB, Marshall B, Cleeve V, Tate D, Oswald T, Woolfrey S, 2015. Effects of fluoroquinolone restriction (from 2007 to 2012) on resistance in Enterobacteriaceae: interrupted time-series analysis. J Hosp Infect 91: 6873.[Crossref]
    [Google Scholar]
  6. Paterson DL, Mulazimoglu L, Casellas JM, Ko WC, Goossens H, Gottberg Von A, Mohapatra S, Trenholme GM, Klugman KP, McCormack JG, Yu VL, 2000. Epidemiology of ciprofloxacin resistance and its relationship to extended-spectrum beta-lactamase production in Klebsiella pneumoniae isolates causing bacteremia. Clin Infect Dis 30: 473478.[Crossref]
    [Google Scholar]
  7. Marchaim D, Chopra T, Bhargava A, Bogan C, Dhar S, Hayakawa K, Pogue JM, Bheemreddy S, Blunden C, Shango M, Swan J, Lephart PR, Perez F, Bonomo RA, Kaye KS, 2012. Recent exposure to antimicrobials and carbapenem-resistant Enterobacteriaceae: the role of antimicrobial stewardship. Infect Control Hosp Epidemiol 33: 817830.[Crossref]
    [Google Scholar]
  8. Huijbers PMC, de Kraker M, Graat EAM, van Hoek AHAM, van Santen MG, de Jong MCM, van Duijkeren E, de Greeff SC, 2013. Prevalence of extended-spectrum β-lactamase-producing Enterobacteriaceae in humans living in municipalities with high and low broiler density. Clin Microbiol Infect 19: E256E259.[Crossref]
    [Google Scholar]
  9. Shaikh S, Fatima J, Shakil S, Rizvi SMD, Kamal MA, 2015. Risk factors for acquisition of extended spectrum beta lactamase producing Escherichia coli and Klebsiella pneumoniae in north-Indian hospitals. Saudi J Biol Sci 22: 3741.[Crossref]
    [Google Scholar]
  • Received : 22 Sep 2015
  • Accepted : 25 Nov 2015
  • Published online : 02 Mar 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error