BÁO CÁO CA BỆNH NHIỄM KHUẨN TIẾT NIỆU DO KLEBSIELLA PNEUMONIA ĐA KHÁNG Ở BỆNH NHÂN HẸP NIỆU ĐẠO TRƯỚC DO CHẤN THƯƠNG

Abstract

In this report, we present a case of a 55-year-old male patient with a history of anterior urethral trauma 30 years ago. The patient experienced urinary leakage and underwent endoscopic urethrotomy at Hanoi Medical University Hospital. One month post-surgery, the patient had difficulty urinating again and subsequently underwent urethral dilation. One day after dilation, the patient exhibited high fever, chills, and hypotension, requiring resuscitation and transfer to the National Hospital for Tropical Diseases for treatment. After stabilization, the patient was transferred to the General Surgery Department, where a urethral stent was placed. Following surgery, the patient had good urinary function and was discharged. However, one month later, he was readmitted with high fever and chills. Urine and blood cultures grew multidrug-resistant Klebsiella pneumoniae. The patient was treated with antibiotics according to the susceptibility test, but
relapsed every month. During the last episode, K. pneumoniae was resistant to all antibiotics. The patient refused urethral stent removal, so the medical team decided to directly instill antibiotics into the bladder, with a dwell time of 2 hours per session, 3 times daily. After 14 days of treatment, the patient’s urine cultures were negative, and there has been no recurrence.