A 62-year-old man presented with fever, abdominal pain, and malaise 13 months after emergency endovascular aortic repair. Computed tomographic angiograms showed a periprosthetic fluid and gas collection, so infection was diagnosed. Open conversion was performed, involving endograft explantation and in situ aortic reconstruction. Cultures and the explanted prosthesis were positive for carbapenemase-producing Klebsiella pneumoniae, resistant to colistin. Because of the sparse data on endograft infections caused by this pathogen, we placed the patient on an empiric double-carbapenem regimen for 4 weeks. Symptomatic recovery occurred after 21 days. On the 30th day, we deployed a stent to treat a new pseudoaneurysm. Three years later, the patient had no signs of persistent or recurrent infection. We think that this is the first report of aortic endograft infection caused by colistin-resistant, carbapenemase-producing K. pneumoniae.
Keywords: Anti-bacterial agents/therapeutic use; Klebsiella pneumoniae/drug effects/growth & development; aortic aneurysm, abdominal/surgery; bacterial infections/drug therapy/etiology/microbiology; blood vessel prosthesis implantation/adverse effects; drug therapy, combination; endovascular procedures/adverse effects; postoperative complications; prosthesis-related infections/diagnosis/drug therapy/microbiology/surgery; treatment outcome.