Question

          A woman with a blood-borne Enterobacter infection was treated with cephalosporin, a preferred antibiotic for such an infection. After the treatment, Enterobacter could not be cultured from her blood, indicating that the bacteria were killed. However, her symptoms were much worse after the antibiotic treatment and she very nearly died from this. Explain why the antibiotic treatment made her symptoms worse and why this condition is so dangerous and often fatal.

Answer 1

In this case, initially the enterobacter species is susceptible to cephalosporin. later the organism developed resistance by producing broad spectrum beta lactamases. Thus, making the symptoms of the patient worsen.

Enterobacteriaceae are a large family of different types of germs (bacteria) that commonly cause infections in healthcare settings. Examples include E.Coli, Klebisiella pneumoniae.

They cause a variety of infections including UTI, lower respiratory tract infections, intestinal infections, CNS infections etc.

It is difficult to treat these organisms as they develop resistant by producing different types of enzymes like broad or beta lactamases or AMP C betalactamases etc. making them resistant to various antimicrobials.

Use of combined antimicrobial therapy prior to susceptibility test is found to be superior .

Avibactam, sulbactam ,tazobactam are the betalactamase inhibitor often combined with other antibiotic to treat the beta latamases producing organisms.

Selection of appropriate antibiotic is important as the members of enterobacter species are highly resistant .