Infective endocarditis due to Enterobacter cloacae resistant to third- and fourth-generation cephalosporins
Yusuke Yoshino, Shu Okugawa, Satoshi Kimura, Eiko Makita, Kazunori Seo, Ichiro Koga, Naohisa Matsunaga, Takatoshi Kitazawa, Yasuo Ota
Received: April 16, 2012 Revised: July 19, 2012 Accepted: July 24, 2012
Corresponding author. Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
Background and purpose:
We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis. Our experience with this case indicates that long-term use of a combination of β-lactam and aminoglycosides might represent a suitable management option for future infective endocarditis cases due to non-Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella spp. (HACEK group) Gram-negative bacilli such as ours.