Failure of ceftriaxone in an intravenous drug user with invasive infection due to Ralstonia pickettii.
We report a case of septic arthritis due to Ralstonia pickettii in an intravenous drug user with unfavorable clinical course under antibiotic therapy with ceftriaxone despite in vitro susceptibility to the drug. The treatment failure may have been due to a discrepancy between in vitro and in vivo susceptibility of R. pickettii, or to resistance development mediated by a recently described inducible beta-lactamase.
Division of Infectious Diseases, University Hospital, Inselspital PKT2 B, CH-3010 Bern, Switzerland. claudine.zellweger@insel.ch
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C
Zellweger
T
T
Bodmer
M G
MG
Täuber
K
K
Mühlemann
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000473:pathology; D002443:Ceftriaxone / Q000494:pharmacology* / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008826:Microbial Sensitivity Tests; D043367:Ralstonia / Q000472:pathogenicity*; D015203:Reproducibility of Results; D015819:Substance Abuse, Intravenous
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone