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Case Reports
. 2017 Oct 30;65(10):1754-1756.
doi: 10.1093/cid/cix652.

Successful Therapy of a Multidrug-Resistant Extended-Spectrum β-Lactamase-Producing and Fluoroquinolone-Resistant Salmonella enterica Subspecies enterica Serovar Typhi Infection Using Combination Therapy of Meropenem and Fosfomycin

Carola-Ellen Kleine  1   2 , Stefan Schlabe  1   2 , Gunnar T R Hischebeth  2   3 , Ernst Molitor  2   3 , Yvonne Pfeifer  4 , Jan-Christian Wasmuth  1   2 , Ulrich Spengler  1   2
Affiliations
Case Reports

Successful Therapy of a Multidrug-Resistant Extended-Spectrum β-Lactamase-Producing and Fluoroquinolone-Resistant Salmonella enterica Subspecies enterica Serovar Typhi Infection Using Combination Therapy of Meropenem and Fosfomycin

Carola-Ellen Kleine et al. Clin Infect Dis. .

Abstract

We report a traveler who acquired a Salmonella enterica subspecies enterica serovar Typhi strain with resistance against β-lactams, cephalosporins (extended-spectrum β-lactamase-producing type SHV-12), and quinolones (plasmid-mediated quinolone resistance gene qnrB7). After clinical deterioration using meropenem monotherapy, treatment success was achieved after commencement of fosfomycin in conjunction with high-dose meropenem. The case illustrates clinical challenges of multidrug-resistant S. Typhi.

Keywords: S. Typhi; antibiotic resistance; carbapenems; enteric fever; fosfomycin.

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Comment in

  • First Report of CTX-M-15 Salmonella Typhi From England.
    Godbole GS, Day MR, Murthy S, Chattaway MA, Nair S. Godbole GS, et al. Clin Infect Dis. 2018 Jun 1;66(12):1976-1977. doi: 10.1093/cid/ciy032. Clin Infect Dis. 2018. PMID: 29471386 No abstract available.
  • Reply to Godbole et al.
    Schlabe S, Kleine CE, Hischebeth GTR, Molitor E, Pfeifer Y, Wasmuth JC, Spengler U. Schlabe S, et al. Clin Infect Dis. 2018 Jun 1;66(12):1977-1978. doi: 10.1093/cid/ciy033. Clin Infect Dis. 2018. PMID: 29471433 No abstract available.

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