title: [Case of sepsis caused by multidrug-resistant neutropenic-phase Pseudomonas aeruginosa treated successfully with antibiotic combination therapy].
abstract: Multidrug-resistant Pseudomonas aeruginosa (MDRP), defined as Pseudomonas aeruginosa resistant to aminoglycosides, carbapenems, and fluoroquinolones, has emerged as an increasingly problematic cause of hospital-acquired infection. With parenteral colistin unavailable in Japan, effective antimicrobial options are severely limited. We report a case of MDRP bacteremia successfully treated with antibiotic combination therapy screened by a 'Break-point Checkerboard Plate'. A 54-year-old man with malignant lymphoma who became febrile 9 days after a recent course of chemotherapy had a neutrophil count of 176/microL. Treatment with meropenem and vancomycin was ineffective and high fever persisted. Methicillin-resistant Staphylococcus aureus (MRSA) and MDRP were isolated from blood culture and combination therapy with aztreonam and amikacin was selected for MDRP based on 'Break-point Checkerboard Plate' results. Linezolid was used for MRSA. The patient recovered successfully from MDRP and MRSA sepsis.
authors.affiliation: Department of Infectious Disease, Toranomon hospital,.
authors.forename: Hideki
authors.initials: H
authors.lastname: Araoka
authors.forename: Masaru
authors.initials: M
authors.lastname: Baba
authors.forename: Keita
authors.initials: K
authors.lastname: Tatsushima
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Takagi
authors.forename: Naofumi
authors.initials: N
authors.lastname: Matsuno
authors.forename: Atsushi
authors.initials: A
authors.lastname: Wake
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Akiko
authors.initials: A
authors.lastname: Yoneyama
mesh_terms: D000583:Amikacin / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001398:Aztreonam / Q000008:administration & dosage*; D018432:Drug Resistance, Multiple; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin; D001398:Aztreonam