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[Infection with multidrug-resistant pathogens]
Urszula Zielińska-Borkowska1, Małgorzata Złotorowicz
1Klinika Anestezjologii i Intensywnej Terapii SPSK CMKP w Warszawie. ula_zielinska@poczta.onet.pl
Background:
Intensive therapy units are the places where pathogens can easily spread. Improper antibiotic therapy contributes to the selection of new strains called multidrug-resistant, extensively drug-resistant or pandrug-resistant. For ITU patients, such pathogens are particularly dangerous.
Case Report:
The case of a 50-year-old man diagnosed with septic shock after repeated surgeries due to Vater's ampulla tumour was described. In blood and peritoneal fluid cultures, Enterobacter cloacae ESBL and Klebsiella pneumoniae were first isolated; then Acinetobacter baumannii was also detected. The targeted antibiotic therapy instituted did not bring the expected results. On day 5, tigecycline and imipenem were started and continued over 10 days. After 4 days of combined therapy, bacterial strains were eradicated. The patient was sent to the referring ward in good condition.
Conclusion:
Combined use of imipenem and a new antibiotic - tigecycline provides effective treatment of septic shock in the course of intra-abdominal infection.
Insights
This study shows that combining tigecycline and imipenem effectively treated septic shock caused by multidrug-resistant bacteria in an intensive therapy unit (ITU) patient. This combination therapy eradicated dangerous pathogens, improving patient outcomes.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Pharmacology
Background:
- Intensive therapy units (ITU) are high-risk environments for pathogen transmission.
- Antimicrobial resistance is a growing threat, leading to multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) strains.
- These resistant pathogens pose a significant danger to ITU patients.
Observation:
- A 50-year-old male patient with septic shock following surgery for Vater's ampulla tumor presented with infections.
- Initial cultures identified Enterobacter cloacae ESBL and Klebsiella pneumoniae, later joined by Acinetobacter baumannii.
- Standard targeted antibiotic therapy proved ineffective.
Findings:
- A combination therapy of tigecycline and imipenem was initiated on day 5 and continued for 10 days.
- Within 4 days of combined treatment, bacterial eradication was achieved.
- The patient's condition improved significantly, and he was discharged to the ward.
Implications:
- The combination of tigecycline and imipenem offers an effective treatment strategy for severe intra-abdominal infections complicated by septic shock.
- This therapeutic approach can successfully combat infections caused by challenging multidrug-resistant organisms.
- Successful treatment in critical care settings highlights the importance of novel antibiotic combinations for managing resistant infections.
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