Fecal Microbial Transplantation for the Treatment of Persistent Multidrug-Resistant Klebsiella pneumoniae Infection in a Critically Ill Patient

• Published in: Case reports in infectious diseases Vol. 2020; no. 2020; pp. 1 - 5
• Main Authors: Geldenhuys, J., De Villiers, N., Hoosien, E., Ueckermann, V.
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2020; Hindawi; John Wiley & Sons, Inc; Wiley
• Subjects: Antibiotics; Bacterial pneumonia; Case Report; Case reports; Colitis; Deoxyribonucleic acid; DNA; Drug resistance; Drug resistance in microorganisms; Drug therapy; Endocarditis; Feces; Health aspects; Hepatitis; Infections; Metabolism; Microbiota (Symbiotic organisms); Multidrug resistant organisms; Pneumonia; Polymerase chain reaction; Scientific equipment and supplies industry; Sepsis; Syphilis; Transplants & implants; Ventilators; United States
• DOI: 10.1155/2020/8462659
• ISSN: 2090-6625

Dysbiosis of the microbiome is a common finding in critically ill patients, who receive broad-spectrum antibiotics and various forms of organ support. Multidrug-resistant (MDR) organisms are a growing threat in all areas of medicine, but most markedly in the critically ill, where there is both loss of host defences and widespread use of broad spectrum antibiotics. We present a case of a critically ill patient with persistent MDR Klebsiella pneumoniae infection, successfully treated with fecal microbiota transplantation (FMT), using stool of a rigorously-screened, healthy donor. FMT for Clostridium difficile colitis has been well described in the literature and is an established therapy for recurrent infections with Clostridium difficile. The use of FMT for other multidrug-resistant organisms is less frequently described, particularly in the context of critically ill patients. In our case, we have culture-documented clearance of the MDR Klebsiella pneumoniae form a patient of FMT.