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Multidisciplinary Approach to Multiple Multiresistant Agent Infection of Instrumented Spine Surgery: A Case Report
Francisco Xará-Leite1,2,3, Ana Ribau1,2, Mário Diogo Lopes Guerra4
1Spinal Unit (UVM), Department of Orthopaedics, Centro Hospitalar Universitário do Porto, Porto, Portugal.
JBJS Case Connector
|January 26, 2022
Summary
This case study highlights a challenging surgical wound infection caused by multidrug-resistant organisms, including carbapenem-resistant Klebsiella pneumoniae. Novel antibiotics like ceftazidime-avibactam in combination therapy proved successful in treatment.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Surgical Site Infections
Background:
- Multidrug resistance (MDR) poses a significant global health threat, complicating treatment of bacterial infections.
- Surgical site infections (SSIs) are a common complication following invasive procedures, with MDR pathogens presenting a particular challenge.
- Lumbar spine fusion surgery carries a risk of SSIs, which can be severe and difficult to manage if caused by resistant bacteria.
Observation:
- A patient developed a complex surgical wound infection after lumbar spine fusion.
- The infection involved consecutive infections with multiple multidrug-resistant organisms (MDROs).
- Key pathogens identified included carbapenem-resistant strains of Klebsiella pneumoniae.
Findings:
- Standard antibiotic regimens were ineffective against the spectrum of MDROs.
- Successful treatment was achieved through combination therapy utilizing novel antibiotics, specifically ceftazidime-avibactam.
- This case underscores the critical need for advanced therapeutic options when facing highly resistant infections.
Implications:
- The successful use of ceftazidime-avibactam highlights its potential role in managing challenging MDR infections.
- A multidisciplinary approach and consideration of novel antibiotic combinations are essential for optimizing treatment strategies.
- This case emphasizes the ongoing battle against antimicrobial resistance and the importance of developing and utilizing new antimicrobial agents.
