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Prosthetic valve endocarditis caused by metallo-beta-lactamase-producing Pseudomonas aeruginosa

Yasuyuki Kato1, Hirokazu Ohashi, Yasushi Tsutsumi

  • 1Department of Cardiovascular Surgery, Fukui Cardiovascular Center, Shinbo, Fukui, Japan. ayak0511@yahoo.co.jp

Journal of Cardiac Surgery
|May 15, 2009
PubMed

Insights

Prosthetic valve endocarditis caused by metallo-beta-lactamase-producing Pseudomonas aeruginosa is a serious challenge. This report details a successful redo aortic valve replacement and antimicrobial treatment for this rare infection.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Surgical Innovation

Background:

  • Prosthetic valve endocarditis (PVE) is a severe complication of cardiac surgery.
  • Pseudomonas aeruginosa infections, particularly those producing metallo-beta-lactamases (MBLs), pose a significant therapeutic challenge due to extensive antibiotic resistance.
  • The emergence of MBL-producing P. aeruginosa necessitates novel treatment strategies for PVE.

Observation:

  • A rare case of early PVE caused by MBL-producing P. aeruginosa is presented.
  • The patient underwent successful redo aortic valve replacement using a Prima Plus stentless valve.
  • A 6-week course of ciprofloxacin and gentamicin was administered post-surgery.

Findings:

  • This case demonstrates the feasibility of surgical intervention and targeted antibiotic therapy for PVE caused by extensively drug-resistant P. aeruginosa.
  • Successful management of early PVE with MBL-producing P. aeruginosa was achieved.

Implications:

  • This successful outcome suggests that redo valve replacement with appropriate antimicrobial therapy can be effective in managing PVE caused by MBL-producing P. aeruginosa.
  • Highlights the importance of considering MBL-producing organisms in refractory PVE cases.
  • May inform future treatment guidelines for this challenging clinical scenario.

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