[Case of sepsis caused by multidrug-resistant neutropenic-phase Pseudomonas aeruginosa treated successfully with antibiotic combination therapy].

Abstract

Multidrug-resistant Pseudomonas aeruginosa (MDRP), defined as Pseudomonas aeruginosa resistant to aminoglycosides, carbapenems, and fluoroquinolones, has emerged as an increasingly problematic cause of hospital-acquired infection. With parenteral colistin unavailable in Japan, effective antimicrobial options are severely limited. We report a case of MDRP bacteremia successfully treated with antibiotic combination therapy screened by a 'Break-point Checkerboard Plate'. A 54-year-old man with malignant lymphoma who became febrile 9 days after a recent course of chemotherapy had a neutrophil count of 176/microL. Treatment with meropenem and vancomycin was ineffective and high fever persisted. Methicillin-resistant Staphylococcus aureus (MRSA) and MDRP were isolated from blood culture and combination therapy with aztreonam and amikacin was selected for MDRP based on 'Break-point Checkerboard Plate' results. Linezolid was used for MRSA. The patient recovered successfully from MDRP and MRSA sepsis.

• Authors: Hideki Araoka, Masaru Baba, Keita Tatsushima, Shinsuke Takagi, Naofumi Matsuno, Atsushi Wake, Shuichi Taniguchi, Akiko Yoneyama
• Journal: Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases (Kansenshogaku Zasshi) Vol. 82 Issue 5 Pg. 466-70 (Sep 2008) ISSN: 0387-5911 [Print] Japan
• PMID: 18975592 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Amikacin
• Aztreonam

Topics

• Amikacin (administration & dosage)
• Anti-Bacterial Agents (administration & dosage)
• Aztreonam (administration & dosage)
• Drug Resistance, Multiple
• Drug Therapy, Combination
• Humans
• Male
• Middle Aged
• Pseudomonas Infections (drug therapy, microbiology)
• Pseudomonas aeruginosa (isolation & purification)
• Sepsis (drug therapy, microbiology)
• Treatment Outcome