A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine
Anatomical barriers for antibiotic penetration can pose a particular challenge in the clinical setting. <em>Stenotrophomonas maltophilia</em> (SM) and <em>Pseudomonas aeruginosa</em> (PA) are two pathogens capable of developing multiple drug-resistance (MDR) mechanisms. We re...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2014-05-01
|
| Series: | Infectious Disease Reports |
| Subjects: | |
| Online Access: | http://www.pagepress.org/journals/index.php/idr/article/view/5147 |
| _version_ | 1818865127622967296 |
|---|---|
| author | Pablo N. Pérez María A. Ramírez José A. Fernández Laura Ladrón de Guevara |
| author_facet | Pablo N. Pérez María A. Ramírez José A. Fernández Laura Ladrón de Guevara |
| author_sort | Pablo N. Pérez |
| collection | DOAJ |
| description | Anatomical barriers for antibiotic penetration can pose a particular challenge in the clinical setting. <em>Stenotrophomonas maltophilia</em> (SM) and <em>Pseudomonas aeruginosa</em> (PA) are two pathogens capable of developing multiple drug-resistance (MDR) mechanisms. We report the case of a 56-year-old female patient with a permanent percutaneous transhepatic biliary drainage (PTBD), who was admitted to our hospital with a cholangitis due to a MDR <em>Escherichia coli</em> strain. Upon admission, culture-guided antimicrobial therapy was conducted and the biliary catheter was replaced, with poor clinical response. Subsequently, SM and PA were detected. Treatment with fosfomycin and colistine was initiated, again without adequate response. Systemic colistine and tigecycline along with an intrabiliary infusion of colistine for 5 days was then used, followed by parenteral fosfomycin and tigecycline for 7 days. The patient was then successfully discharged. This is the first case report we are aware of on the use of intrabiliary colistine. It describes a new approach to treating cholangitis by MDR bacteria in patients with a PTBD. |
| first_indexed | 2024-12-19T10:42:37Z |
| format | Article |
| id | doaj.art-c5791b672990410d8a6820029f2186e3 |
| institution | Directory Open Access Journal |
| issn | 2036-7430 2036-7449 |
| language | English |
| last_indexed | 2024-12-19T10:42:37Z |
| publishDate | 2014-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Infectious Disease Reports |
| spelling | doaj.art-c5791b672990410d8a6820029f2186e32022-12-21T20:25:24ZengMDPI AGInfectious Disease Reports2036-74302036-74492014-05-016210.4081/idr.2014.51472808A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistinePablo N. Pérez0María A. Ramírez1José A. Fernández2Laura Ladrón de Guevara3Department of Internal Medicine, Hospital Ángeles Clínica Londres, Mexico CityDepartment of Epidemiology, Instituto Nacional de Neurología y Neurocirugía, Mexico CityDepartment of Internal Medicine, Hospital Ángeles Clínica Londres, Mexico CityDepartment of Gastroenterology and Hepatology, Centro Médico Nacional 20 de Noviembre, Mexico CityAnatomical barriers for antibiotic penetration can pose a particular challenge in the clinical setting. <em>Stenotrophomonas maltophilia</em> (SM) and <em>Pseudomonas aeruginosa</em> (PA) are two pathogens capable of developing multiple drug-resistance (MDR) mechanisms. We report the case of a 56-year-old female patient with a permanent percutaneous transhepatic biliary drainage (PTBD), who was admitted to our hospital with a cholangitis due to a MDR <em>Escherichia coli</em> strain. Upon admission, culture-guided antimicrobial therapy was conducted and the biliary catheter was replaced, with poor clinical response. Subsequently, SM and PA were detected. Treatment with fosfomycin and colistine was initiated, again without adequate response. Systemic colistine and tigecycline along with an intrabiliary infusion of colistine for 5 days was then used, followed by parenteral fosfomycin and tigecycline for 7 days. The patient was then successfully discharged. This is the first case report we are aware of on the use of intrabiliary colistine. It describes a new approach to treating cholangitis by MDR bacteria in patients with a PTBD.http://www.pagepress.org/journals/index.php/idr/article/view/5147cholangitis, colistine, Pseudomonas, Stenotrophomonas |
| spellingShingle | Pablo N. Pérez María A. Ramírez José A. Fernández Laura Ladrón de Guevara A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine Infectious Disease Reports cholangitis, colistine, Pseudomonas, Stenotrophomonas |
| title | A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine |
| title_full | A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine |
| title_fullStr | A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine |
| title_full_unstemmed | A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine |
| title_short | A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine |
| title_sort | patient presenting with cholangitis due to stenotrophomonas maltophilia and pseudomonas aeruginosa successfully treated with intrabiliary colistine |
| topic | cholangitis, colistine, Pseudomonas, Stenotrophomonas |
| url | http://www.pagepress.org/journals/index.php/idr/article/view/5147 |
| work_keys_str_mv | AT pablonperez apatientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine AT mariaaramirez apatientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine AT joseafernandez apatientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine AT lauraladrondeguevara apatientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine AT pablonperez patientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine AT mariaaramirez patientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine AT joseafernandez patientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine AT lauraladrondeguevara patientpresentingwithcholangitisduetostenotrophomonasmaltophiliaandpseudomonasaeruginosasuccessfullytreatedwithintrabiliarycolistine |