Case series of carbapenemase-producing Enterobacteriaceae osteomyelitis: Feel it in your bones

Abstract

Objectives: Limited data have been reported regarding osteomyelitis due to carbapenemase-producing Enterobacteriaceae (CPE), including co-infections with extended-spectrum β-lactamase (ESBL)-producing micro-organisms.

Methods: We conducted a retrospective study in a reference centre for bone and joint infections from 2011 to 2019 among patients infected with CPE.

Results: Nine patients (mean age 46.8 ± 16.6 years), including three with infected implants, were identified. Infections were mostly polymicrobial (n = 8/9), including Staphylococcus aureus (n = 6/9). CPE were mainly OXA-48-type, associated with ESBL-producing Enterobacteriaceae (n = 8/9), of which 5/9 isolates were Klebsiella pneumoniae. Control of the infection was achieved in seven cases.

Conclusions: CPE osteomyelitides are essentially polymicrobial and fluoroquinolone-resistant infections, highlighting the need for efficient surgery with implant removal.

Keywords: Bone; CPE; Carbapenemase; Enterobacteriaceae; Infection; Osteomyelitis.