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Volume 48, Number 2, April 2015

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:

Yusuke Yoshino
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.