One case of extensively drug-resistant (XDR) infection

Author G.Kiliptari
DOI

Country : Georgia
Subject : critical care

Keywords : XDR infection. Multidrug resistant. Cavitation

Abstract

Infections due to multidrug resistance of the infected organism have become more common in clinical settings. The non-fermenter, gram-negative bacilli cause severe hospital infections. The main non-fermenter, gram-negative bacilli (BNF) microorganisms, that cause disease in humans are Pseudomonas aeruginosa, Acinetobacterbaumannii, Burkholderia cepacia, Stenotrophomonas., Alcaligenes, Moraxella, The family of enzymes carbapenemase – KPC, NDM-1, IMP, VIM, OXA-48 – is one of the most significant health challenges. For microorganisms: Klebsiella pneumoniae, Acinetobacter baumanni, and Pseudomonas aeruginosa was launched the terms: extensively drug-resistant (XDR) and pan drug-resistant (PDR) Gram-negative microorganisms. New antibiotics is targeting some of the current most problematic Gram-negative pathogens, namely Klebsiella pneumoniae carbapenemase (KPC) - producing Enterobacteriaceae and multi-drug-resistant (MDR) P. aeruginosa. We presented case, when sputem microbiological analysis in patient with bilateral pnumoniae and respiratory distress syndrome, revealed extensively drug-resistant (XDR) gram-negative microorganism. Also chest computer tomography diagnosed lung cavitation,For antibacterial treatment was used new class of antibiotics, named Ceftazidime-Avibactam,a novel non-β-lactam, β-lactamase inhibitor( restores the activity of ceftazidime against the majority of β- lactamases,ESBLs and carbapenemases, including KPCs– Ambler Class A, AmpC —Class C and oxacillinase OXA-48—Class D).Patient state was improuved and discharged with suitable recommendations.

Conclusion: in the therapy of XDR Gram-negative bacteria, colistin was continued to be considered as a companion drug with novel agents es ceftazidim/avibactam for the treatment of carbapenem-resistant Enterobacteriaceae, also fosfomycin as part of combination treatment for CRE and XDR Pseudomonas aeruginosa infections.

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