title: Management of a multidrug-resistant Pseudomonas aeruginosa infected total knee arthroplasty using colistin. A case report and review of the literature.
abstract: Multidrug-resistant infections present a serious clinical and therapeutical problem. Colistin is an old-used polymyxin with rather poor pharmacokinetic profile and a remarkable nephrotoxicity. However, the emergence of multidrug-resistant bacteria has recently led to the increased use of colistin as a potentially available therapy. This article presents a 75-year-old diabetic woman with an early onset total knee arthroplasty infection by a multidrug-resistant Pseudomonas aeruginosa bacterial isolate that was managed successfully with surgical removal of the knee prosthesis, antibiotic impregnated cement and intravenous administration of colistin for 6 weeks, and second stage revision knee surgery. Two years later, laboratory and imaging studies showed no evidence of recurrence of infection.
authors.affiliation: First Department of Orthopaedics, Athens University Medical School, Athens, Greece.
authors.forename: Panayiotis J
authors.initials: PJ
authors.lastname: Papagelopoulos
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Mavrogenis
authors.forename: Efthymia
authors.initials: E
authors.lastname: Giannitsioti
authors.forename: Athanasios
authors.initials: A
authors.lastname: Kikilas
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Kanellakopoulou
authors.forename: Panayotis N
authors.initials: PN
authors.lastname: Soucacos
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee; D001843:Bone Cements; D003091:Colistin / Q000008:administration & dosage / Q000627:therapeutic use*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005264:Femoral Fractures / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000453:epidemiology; D011552:Pseudomonas Infections / Q000188:drug therapy*; D012086:Reoperation
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D003091:Colistin