19. TREATMENT OF MULTIDRUG-RESISTANT KLEBSIELLA PNEUMONIAE AFTER TRAUMATIC BRAIN INJURY: A CASE STUDY IN A READY-TO-USE HOSPITAL
Main Article Content
Abstract
Overview: The resuscitation process of patients after surgery for traumatic brain injury is complicated not only by severe skull injury but also by many types of accompanying infections, including meningitis. Currently, the emergence of multidrug-resistant bacteria such as multidrug-resistant Klebsiella pneumoniae poses challenges in treatment, increasing mortality rates, increasing hospital stays, and increasing health care-related costs.
We report a case of a 40-year-old male patient with multiple trauma, no history of underlying diseases, admitted to the hospital in a coma after a serious traffic accident causing multiple trauma including left hemisphere depressed skull injury, severe left hemisphere brain contusion. The patient underwent emergency surgery to treat the traumatic brain injury and other injuries. During treatment in the intensive care unit, the patient was diagnosed with meningitis caused by K. pneumoniae with multidrug-resistant KPC and CTX-M genes and also had hospital-acquired pneumonia. The patient was transferred to the department after 21 days of successful treatment for meningitis and hospital-acquired pneumonia. The treatment of meningitis was achieved through antibiotic therapy including intrathecal Amikacin and intravenous Amikacin combined with Ceftazidime/Avibactam.
This case emphasizes the need for early clinical recognition, close clinical and microbiological monitoring, and effective use of antibiotics to treat meningitis after traumatic brain injury, especially when the agent is multidrug-resistant bacteria such as KPC-producing K. pneumoniae.
Article Details
Keywords
Meningitis, Klebsiella pneumoniae, KPC, CTX-M, Ceftazidime/Avibactam, intrathecal Amikacin.
References
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