Nasal Spray Herein we report a fatal case of donor-derived transmission of XDR-resistant carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) in cardiac transplantation.A 59-year-old male patient with non-obstructive hypertrophic cardiomyopathy underwent heart transplantation.On day 5 post-operation, blood cultures from the donor were positive for colistin-resistant carbapenemase-producing K.pneumoniae (ColR KPC-Kp) susceptible only to amikacin.
Recipient blood cultures were also positive for ColR KPC-Kp with the same sensitivity profile as the donor isolate with an identical PFGE pattern.The patient was treated with double-carbapenems and amikacin.The patient evolved to pericarditis, osteomyelitis, and pulmonary necrosis, all fragment cultures positive for zakeke-design the same agent.The patient developed septic shock, multiple organ failure and died on day 50 post-transplantation.
Based on current microbiological scenario worldwide the possibility of transmitting multidrug resistant (MDR) organisms should be considered.Keywords: Cardiac transplantation, Klebsiella pneumoniae, Donor-derived infection, Carbapenem-resistant.