Carbapenem-Resistant Klebsiella Pneumonia (CRKP)

umcRN, BSN, RN · Apr 9, 2011

I took care of a baby with Klebsiella pneumonia & osteomyelitis (of her hard palate, post choanal atresia repair), not sure of the Carbapenem resistance. She was VERY sick and later (after an initial 3 weeks of great improvement/preparing to go home) died of complications of pulmonary hypertension, probably initially brewing from the pneumonia and it escalated pretty quickly. Anyways during her initial illness she was on the HFOV/Nitric/Dopamine & Epi. She was treated with a 40 day course of a variety of antibiotics that included vanc/gent/amp/cefotaximine and meropenum, and maybe another, I can 't remember

Clinical findings? Well when I first had her like I said she was knocking on deaths door, copious respiratory secretions, fluid filled lungs, fever, hypotension, acute renal failure etc. I guess she initially presented to an outside hospital ER with respiratory distress (and as I said she was post choanal atresia repair so they might not have looked into infection as the first cause). She had a fistula in her palate from the repair (the osteomyelitis) and they intubated her, the bacteria in the palate was klebselia which was likely transferred to the lungs pre or post intubation as she reportedly (per her parents/OSH report) had a very traumatic intubation