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Successful treatment of extreme drug resistant Acinetobacter baumannii infection following a liver transplant.
- Source :
-
Journal of infection in developing countries [J Infect Dev Ctries] 2020 Apr 30; Vol. 14 (4), pp. 408-410. Date of Electronic Publication: 2020 Apr 30. - Publication Year :
- 2020
-
Abstract
- Orthotopic liver transplantation is a life-saving procedure for patients with end-stage liver failure. However, Acinetobacter baumannii infections and acute rejection are important causes of morbidity and mortality following transplants. Here we present a case report of a cadaveric donor liver transplantation with infectious complications detected after transplantation. The patient was a 64-year-old female. Because of non-alcoholic steatohepatitis due to hepatic insufficiency (model for end-stage liver disease (MELD): 12; Child-Pugh: 9B), liver transplantation from a cadaveric donor was performed. Following the transplantation, the patient developed a blood stream infection, urinary tract infection (UTI) and postoperative wound infection from biliary leakage. A. baumannii was isolated from blood, urine and wound cultures. Imipenem (4×500 mg), tigecycline (2×50 mg) and phosphomycin (4×4 g) were administered intravenously (IV). On the 14th day of treatment, the bile fistula closed and there was no bacterial growth in blood and urine cultures. The patient was discharged with full recovery. The duration of a transplant patient's hospital stay, intensive care unit stay, invasive interventions, blood transfusions and immunosuppressive treatments cause an increased risk of extensively drug-resistant (XDR) A. baumannii infections, and a high mortality rate is seen despite antibiotic treatment. Phosphomycin, used in combination therapy, may be an alternative in the treatment of XDR pathogens in organ transplant patients, due to its low side effect profile and lack of interaction with immunosuppressives.<br />Competing Interests: No Conflict of Interest is declared<br /> (Copyright (c) 2020 Muhammed Rasid Aykota, Tugba Sari, Sevda Yilmaz.)
- Subjects :
- Acinetobacter Infections diagnosis
Acinetobacter baumannii drug effects
Cadaver
Female
Humans
Middle Aged
Sepsis drug therapy
Sepsis etiology
Sepsis microbiology
Surgical Wound Infection microbiology
Treatment Outcome
Acinetobacter Infections drug therapy
Anti-Bacterial Agents therapeutic use
Drug Resistance, Multiple, Bacterial
Liver Transplantation adverse effects
Surgical Wound Infection drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1972-2680
- Volume :
- 14
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of infection in developing countries
- Publication Type :
- Academic Journal
- Accession number :
- 32379720
- Full Text :
- https://doi.org/10.3855/jidc.11842