A 12 yr old castrated male domestic longhair underwent renal transplantation for treatment of chronic interstitial nephritis. Full-thickness intestinal biopsies obtained prior to transplantation revealed mild enteritis. Twelve months following transplantation, the patient underwent surgery for resection of a mesenteric mass causing septic peritonitis. The mesenteric mass was resected and an intestinal resection and anastomosis was performed. Extended–spectrum-β-lactamase producing Klebsiella pneumoniae was cultured from the resected tissue and urinary tract. Bacterial rods were noted to be circulating in the bloodstream, causing septicemia. Despite aggressive treatment of the septic peritonitis and septicemia using surgical debridement, drain placement, aggressive antibiotic therapy with IV meropenem, and vasopressor support, the patient succumbed to persistent hypotension and suffered cardiopulmonary arrest. Extended–spectrum-β-lactamase-producing bacteria are of growing concern in human and veterinary medicine, maintaining susceptibility often only to carbapenem and aminoglycoside antibiotics. Resistance to even those antibiotics is emerging. Veterinary patients with a history of antibiotic therapy, central venous or urinary catheterization, immunosuppression, enteric surgery, and an extended stay in the intensive care unit may be predisposed.
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March/April 2015
Case Reports|
March 01 2015
Septicemia and Infection due to ESBL-producing K. pneumoniae Following Feline Renal Allograft Transplantation
Heidi Phillips, VMD, DACVS-SA;
Heidi Phillips, VMD, DACVS-SA
*Heidi Phillips' present affiliation is the University of Illinois, Urbana, Illinois.
From the University of Illinois, Urbana, IL (H.P.); Veterinary Specialists of Rochester, Rochester, New York (L.O.); and University of Pennsylvania, Philadelphia, PA (L.A.).
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Lindsay L. Occhipinti, DVM;
Lindsay L. Occhipinti, DVM
†Lindsay Occhipinti's updated credentials are DVM, DACVS-SA.
From the University of Illinois, Urbana, IL (H.P.); Veterinary Specialists of Rochester, Rochester, New York (L.O.); and University of Pennsylvania, Philadelphia, PA (L.A.).
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Lillian R. Aronson, VMD, DACVS-SA
Lillian R. Aronson, VMD, DACVS-SA
From the University of Illinois, Urbana, IL (H.P.); Veterinary Specialists of Rochester, Rochester, New York (L.O.); and University of Pennsylvania, Philadelphia, PA (L.A.).
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J Am Anim Hosp Assoc (2015) 51 (2): 119–129.
Citation
Heidi Phillips, Lindsay L. Occhipinti, Lillian R. Aronson; Septicemia and Infection due to ESBL-producing K. pneumoniae Following Feline Renal Allograft Transplantation. J Am Anim Hosp Assoc 1 March 2015; 51 (2): 119–129. doi: https://doi.org/10.5326/JAAHA-MS-6103
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