Early-onset septicemia due to CMY-2-producing Escherichia coli in a woman with blunt abdominal trauma
Chan, K.-S.; Yu, W.-L.; Kuo, C.-Y.; Tsai, C.-L.; Chuang, Y.-C.
Journal of Microbiology Immunology and Infection 42(5): 442-444
2009
ISSN/ISBN: 1995-9133 PMID: 20182676 Document Number: 631034
Escherichia coli remains one of the most common etiologies of secondary peritonitis. CMY-2 is the most prevalent AmpC enzyme identified in nosocomial E. coli isolates causing bacteremia in Taiwan. This report is of a patient who underwent surgery for intestinal perforations due to blunt abdominal trauma and developed unexpected CMY-2-producing E. coli septicemia in the early postoperative period. The AmpC-type CMY-2 enzyme might partially contribute to the poor response to antimicrobial therapy of amoxicillin-clavulanic acid or flomoxef. Late changes in antibiotic therapy to an appropriate regimen of cefpirome based on the culture results did not result in a positive outcome and the patient died. Whether selection of an anti-AmpC regimen is appropriate as first-line treatment for traumatic abdomen-associated septicemia should be an area of further investigation in Taiwan.