CASE REPORT
Septic shock caused by community-acquired urinary tract infection caused by Klebsiella pneumoniae ESBL+: A case report
 
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1
Department of Anaesthesiology and Intensive Care, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
2
Department of Nursing, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
CORRESPONDING AUTHOR
Lidia Glinka   

Anaesthesiology and Intensive Care Clinical Ward, Clinical University Hospital in Olsztyn, Department of Anaesthesiology and Intensive Care, University of Warmia and Mazury in Olsztyn, Warszawska 30, 10-082 Olsztyn Poland. Tel. +4889 534 54 08.
Submission date: 2018-07-03
Final revision date: 2019-07-10
Acceptance date: 2019-12-19
Online publication date: 2020-04-14
 
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Septic shock is defined as a life-threatening organ failure caused by an abnormal response of the body to infection. Urinary tract infections (UTIs) constitute about 10%–20% of all community-acquired infections and about 40%–50% of hospital-acquired infections. In patients with impaired immunity they may lead to sepsis. Strains of Klebsiella pneumoniae are often multidrug resistant, and therapeutic chances are limited where they occur.

Aim:
The aim of this paper is to discuss the most recent guidelines in diagnosing and treating sepsis, referring to a clinical case report.

Case study:
The study presents a case of septic shock in a 44-year-old female patient in a community-acquired UTI caused by K. pneumoniae extended-spectrum β-lactamases (ESBL+).

Results and discussion:
The course of septic shock proved fatal. As the stay in the intensive care unit (ICU) was short, this precluded implementing full diagnostic procedures and identifying the source of infection. A post mortem examination was performed to establish the cause of death and aetiology of the infection.

Conclusions:
K. pneumoniae ESBL+ has become a growing epidemiological problem in Poland and all over the world. This pathogen increasingly often leads to community-acquired infections and its multidrug resistance makes the applied therapies ineffective. Diabetes, one of the modern lifestyle diseases, impairs resistance and accelerates rapidly progressing septic shock with multiple organ failure. Late diagnosis of sepsis, because of considerable metabolic and cellular changes, brings about tragic results. Despite implementing new diagnostic methods and therapies, the mortality rate in sepsis still remains very high.

CONFLICT OF INTEREST
None declared.
FUNDING
None declared.
 
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