title: Successful salvage therapy with tigecycline after linezolid failure in a liver transplant recipient with MRSA pneumonia.
abstract: Pulmonary infections are a significant cause of morbidity and mortality after liver transplantation. Infections with methicillin-resistant Staphylococcus aureus (MRSA) have increased in the last 10 years. Mortality may exceed 80% in liver transplant recipients who develop MRSA pneumonia. A 57-year-old male following living-donor liver transplantation developed a right-sided MRSA pneumonia 6 weeks after transplantation, which required artificial ventilation for 14 weeks. Initially, pneumonia was treated with linezolid. However, after 12 days under current therapy, the infection spread out to both lungs. At that time. we initiated the treatment with tigecycline. Under this therapy, the patient could be cured from MRSA pneumonia and was extubated. We detected no tigecycline related hepatotoxic effect. In conclusion, this case suggests that tigecycline may be useful in the salvage therapy of pneumonia due to MRSA after linezolid failure.
authors.affiliation: Department of General Surgery and Transplantation, University Essen, Germany. fuat.saner@uni-essen.de
authors.forename: Fuat H
authors.initials: FH
authors.lastname: Saner
authors.forename: Matthias
authors.initials: M
authors.lastname: Heuer
authors.forename: Peter-Michael
authors.initials: PM
authors.lastname: Rath
authors.forename: Julia
authors.initials: J
authors.lastname: Gensicke
authors.forename: Arnold
authors.initials: A
authors.lastname: Radtke
authors.forename: Nina
authors.initials: N
authors.lastname: Drühe
authors.forename: Eva-Marija
authors.initials: EM
authors.lastname: Rüngeler
authors.forename: Silvio
authors.initials: S
authors.lastname: Nadalin
authors.forename: Massimo
authors.initials: M
authors.lastname: Malagó
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D006801:Humans; D000069349:Linezolid; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D023303:Oxazolidinones / Q000627:therapeutic use*; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D016879:Salvage Therapy; D013211:Staphylococcus aureus / Q000502:physiology; D000078304:Tigecycline; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000078304:Tigecycline; D008911:Minocycline; D000069349:Linezolid