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Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation
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Multi-drug-resistant Enterococcus faecium bacteraemia in a liver transplant recipient
Nathan A Summers1, John Gharbin2, Rachel Friedman-Moraco1
1Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA.
JMM Case Reports
|March 14, 2019
Summary
A rare case of extensively drug-resistant Enterococcus faecium caused a liver abscess in an immunocompromised patient. This highlights the growing threat of multidrug-resistant organisms and the need for novel therapeutic strategies.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Enterococcus faecium is a common gut bacterium, but can cause severe infections in vulnerable individuals.
- Immunocompromised patients, such as transplant recipients, are at higher risk for serious E. faecium infections.
- Antimicrobial resistance in E. faecium poses a significant global health challenge.
Observation:
- A liver transplant recipient with diabetes developed recurrent liver abscesses and fever.
- Blood cultures revealed vancomycin-resistant E. faecium (VRE) with resistance to multiple antibiotics, including ampicillin, penicillin, vancomycin, daptomycin, and linezolid.
- Initial treatment with chloramphenicol was ineffective due to non-susceptibility, and tigecycline was administered.
Findings:
- The identified E. faecium strain exhibited pan-resistance to commonly used antimicrobial agents.
- The patient's clinical presentation was complicated by multidrug resistance, limiting treatment options.
- Despite interventions, the patient opted for hospice care.
Implications:
- This case underscores the critical need for surveillance and development of new treatments for extensively drug-resistant (XDR) Gram-positive pathogens.
- Effective management of XDR E. faecium infections requires a thorough understanding of resistance mechanisms and alternative therapeutic approaches.
- The rise of XDR organisms necessitates a global strategy to combat antimicrobial resistance and improve patient outcomes.
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