Infective Endocarditis Caused by Carbapenemase-Producing Klebsiella pneumoniae on a Prosthetic Valve: A Case Report and Review of the Literature

Abstract

Infective endocarditis (IE) is a rare but severe disease due to frequent and serious complications. Healthcare-associated cases often involve <i>Staphylococcus aureus</i>, while Gram-negative bacteria such as <i>Klebsiella pneumoniae</i>, though rare, pose severe challenges due to their resistance profiles. We report a case of a 68-year-old woman with a history of hypertension and mitral valve replacement 12 years ago, who was admitted to the intensive care unit (ICU) for management of non-traumatic, afebrile altered mental status due to intracerebral hemorrhage from anticoagulant overdose. His stay in the ICU revealed septic shock with multi-organ failure caused by carbapenemase (New Delhi metallo-β-lactamase (NDM))-producing <i>K. pneumoniae</i> complicated by IE on the prosthetic mitral valve. Despite treatment with meropenem, colistin, and tigecycline, the patient succumbed to septic shock after 15 days of therapy. This case highlights the importance of close surveillance of nosocomial infections and the need for prompt management strategies integrating medical and surgical approaches to reduce the high mortality associated with such infections.