Providencia rettgeri infection complicating cranial surgery: illustrative cases
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Published on: May 19, 2022
Shabal Sapkota1, Mitesh Karn2, Sanjib Mani Regmi3
1Department of Neurosurgery.
Background:
Providencia rettgeri is a rare cause of nosocomial infection in humans. These organisms are capable of biofilm production and are intrinsically resistant to commonly used antibiotics, leading to high rates of morbidity and mortality. P. rettgeri may very rarely cause postneurosurgical infection.
Observations:
In this report, the authors describe two patients in whom P. rettgeri infection complicated the postoperative course. Both the patients underwent craniotomy at approximately the same time under similar environments. The organism isolated was resistant to most of the commonly used antibiotics, and therapy tailored to the results of susceptibility testing led to resolution of infection in both cases.
Lessons:
P. rettgeri is a rare cause of postneurosurgical nosocomial infection. Timely identification and early tailoring of antibiotic therapy based on susceptibility testing is the key to treatment. Every effort should be made to identify the source of infection and rectify it so that mortality, morbidity, and financial burden are reduced. Contact isolation and use of sterile gloves after each patient contact are effective in preventing its spread, as in most cases of nosocomial infection.
Insights
Providencia rettgeri is a rare cause of postneurosurgical infections. Prompt antibiotic therapy guided by susceptibility testing is crucial for successful treatment and preventing complications.
Area of Science:
- Infectious Diseases
- Microbiology
- Neurosurgery
Background:
- Providencia rettgeri is an opportunistic pathogen causing rare nosocomial infections.
- This bacterium exhibits intrinsic antibiotic resistance and biofilm formation, contributing to severe patient outcomes.
- P. rettgeri infections are infrequently associated with postneurosurgical complications.
Observation:
- This report details two cases of P. rettgeri infection following craniotomy.
- Both patients underwent similar surgical procedures in comparable environments.
- The isolated P. rettgeri strains demonstrated resistance to multiple antibiotics.
Findings:
- Tailored antibiotic therapy, based on antimicrobial susceptibility testing, successfully resolved infections in both patients.
- Early identification and targeted treatment are critical for managing P. rettgeri infections.
- Addressing the infection source is vital to minimize patient morbidity, mortality, and healthcare costs.
Implications:
- Highlights the importance of vigilance for P. rettgeri in postneurosurgical settings.
- Emphasizes the necessity of antibiotic stewardship and susceptibility-guided treatment strategies.
- Reinforces standard infection control measures, such as contact isolation and sterile technique, to prevent pathogen transmission.
