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Article Abstract
Background: Invasive liver abscess syndrome (ILAS) caused by hypervirulent (hvKp) is a life-threatening infection associated with high mortality, particularly when complicated by brain abscesses. The emergence of carbapenem-resistant hypervirulent (CR-hvKp) during treatment, driven by emerging resistance, poses significant therapeutic challenges.
Case Presentation: We describe a 70-year-old diabetic male with recurrent ILAS who developed sequential multi-organ infections, including urinary tract infection, bacteremia, lung abscess, and brain abscess. Initial isolates were identified as carbapenem-susceptible; however, under prolonged antimicrobial pressure, they were transformed into CR-hvKp carrying the KPC gene. Treatment escalated from meropenem to ceftazidime-avibactam plus tigecycline, resulting in clinical improvement and discharge after 48 days.
Conclusion: This case highlights the critical challenge of emerging resistance in hvKp during prolonged therapy, emphasizing the need for early molecular surveillance, multidisciplinary collaboration, and optimized antibiotic stewardship to mitigate treatment failure in ILAS.
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| http://dx.doi.org/10.3389/fmed.2025.1605284 | DOI Listing |
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