title: Fatal multidrug-resistant Acinetobacter baumannii sepsis in a patient with travel history and recent onset of systemic lupus erythematosus: a case report.
abstract: Severe infections are a common cause of death in patients suffering from systemic lupus erythematosus (SLE). We here report on a fatal multidrug-resistant Acinetobacter baumannii sepsis in a patient with newly diagnosed SLE, who had to be treated with immunosuppressants due to lupus nephritis. Detailed analysis of the patient's history revealed that colonisation probably had occurred during a recent hospitalisation of the patient in the Mediterranean region. E-test analysis indicated that resistance to carbapenems was mediated by a plasmid-encoded metallo-beta-lactamase. We conclude that travel history including previously visited health care facilities always should be carefully considered for decisions on anti-infective therapy, as travel activities increasingly facilitate spread of antimicrobial resistances.
authors.affiliation: Department of Internal Medicine; University Hospital of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Weyrich
authors.forename: S
authors.initials: S
authors.lastname: Borgmann
authors.forename: F
authors.initials: F
authors.lastname: Mayer
authors.forename: P
authors.initials: P
authors.lastname: Heeg
authors.forename: R
authors.initials: R
authors.lastname: Riessen
authors.forename: I
authors.initials: I
authors.lastname: Kötter
mesh_terms: D000151:Acinetobacter Infections / Q000382:microbiology*; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D017809:Fatal Outcome; D005260:Female; D006115:Greece; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D018805:Sepsis / Q000382:microbiology*; D014195:Travel; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases