Burkholderia cepacia complex (Bcc) includes several phenotypically similar but genotypically distinct gram-negative bacteria (GNB) that can colonize the respiratory tract of Cystic Fibrosis (CF) patients. Pathogens are difficult to treat due to intrinsic resistance to multiple antibiotics and are associated to a more rapid decline in lung function and to increased mortality, particularly after lung transplantation. For all these reasons, chronic infection by Burkholderia (B) cenocepacia is presently considered a relative or absolute contraindication in almost all lung transplant centres. We report the case of a young adult CF patient chronically colonized by B multivorans genomovar II, with diabetes and end-stage renal disease treated with renal replacement therapy: a few months after lung transplantation, she developed post-surgery B multivorans bacteremia and multiple brain abscesses. This severe infection did not improve despite multiple standard antibiotic regimen. The introduction of ceftazidime-avibactam, a new β-lactam/ β-lactamase inhibitor combination resulted in clinical recovery and in radiological and biochemical improvement.
|Titolo:||Successful ceftazidime-avibactam treatment of post-surgery Burkholderia multivorans genomovar II bacteremia and brain abscesses in a young lung transplanted woman with cystic fibrosis|
COLOMBO, CARLA (Corresponding)
|Parole Chiave:||brain abscesses; Burkholderia cepacia complex; Burkholderia multivorans; ceftazidime-avibactam; cystic fibrosis; Adult; Anti-Bacterial Agents; Azabicyclo Compounds; Bacteremia; Brain Abscess; Burkholderia Infections; Burkholderia cepacia complex; Ceftazidime; Cystic Fibrosis; Diabetes Complications; Drug Combinations; Drug Therapy, Combination; Female; Humans; Kidney Failure, Chronic; Lung; Lung Transplantation; Treatment Outcome|
|Settore Scientifico Disciplinare:||Settore MED/38 - Pediatria Generale e Specialistica|
|Data di pubblicazione:||giu-2019|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1111/tid.13082|
|Appare nelle tipologie:||01 - Articolo su periodico|