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Multidrug-resistant Acinetobacter baumannii prosthetic joint infection treated with colistin

Abstract number: 1733_842

Rodríguez Guardado A., Asensi V., Lantero M., Castillo M., Cartón J.

Background: Description of the characteristics of the prosthetic joint infection by A. baumannii treated with colistin emphasizing the factors influencing their outcome

Methods: All the episodes of prosthetic joint infection by multidrug-resistant A. baumannii diagnosed between 2004–2006 treated with colistin were retrospectively reviewed. The Acinetobacter isolate was defined as MDR if it was resistant to ≥ 3classes of antimicrobial agents as tested by commercial system. The dose of parenteral colistin was 160 mg/8 h.

Results: Eight cases were reviewed. All the patients had underwent surgery. Five patients were carriers of a knee prosthesis and the rest hip prosthesis. The mean time between the surgery and the onset of the infection was 26.5 days. Five patients had deep wound cultures and the rest had bone tissue cultures. Three patients had mixed infections [methicillin-resistant Staphylococcus aureus (two cases), E. faecium (one case)] coccus aureus (and case each). All the patients had received previous antibiotic treatment which were inadequate in all cases Four patients received IV colistin (160 mg/8 hours) monotherapy. Three received a combined IV therapy with colistin and vancomycin. One patient development a infection by a A. baumannii resistant to colistin and he was treated with a combination of IV colistin 160 mg/8 hours, IV rifampicin (600 mg/day) and IV imipenem (1 g/8 hours) with good evolution. In 3 cases the treatment was associated with removal of the prosthesis and in the rest a surgical drainage was performed. The mean of treatment was 59.7 days. The follow-up period was 9 months (range 6–18 months). Only one patient died a consequence of the infection and the rest cured. The renal function was normal in all the cases.

Conclusions: The use of intravenous colistin is safe and effective treatment for prosthetic joint infection due to multiresistant A. baumannii.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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