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Salmonella infection in total hip replacement: tests to predict the outcome of antimicrobial therapy
A F Widmer1, V E Colombo, A Gächter
1Department of Medicine, University Hospital, Basel, Switzerland.
Abstract:
We report a hematogenous implant infection with Salmonella dublin in a renal transplant patient with total hip replacement. A 16-month treatment with cotrimoxazole failed, as evidenced by culture and electron microscopy, despite persisting low MIC after therapy. Data from a foreign body animal model and in vitro tests, which take into account the properties of adhering and stationary-phase bacteria, explain the failure of a long-term treatment with cotrimoxazole. The patient was subsequently cured by ciprofloxacin which was successful in these tests. No relapse was noted after a follow-up of 1 year.
Insights
A Salmonella dublin implant infection in a renal transplant patient failed to resolve with cotrimoxazole. Ciprofloxacin successfully treated the infection, demonstrating its efficacy in challenging cases.
Area of Science:
- Infectious Diseases
- Nephrology
- Orthopedic Surgery
Background:
- Hematogenous implant infections pose significant treatment challenges, particularly in immunocompromised patients.
- Salmonella dublin is an uncommon cause of implant infections, especially in renal transplant recipients.
- Long-term antibiotic therapy may fail due to bacterial adaptation and biofilm formation.