title: Ventilator-associated pneumonia with Col-S strains: a successful comeback of colistin!
abstract: Emergence of multi and pan-drug resistant Gram-negative bacteria causing nosocomial infections in intensive care settings has become a challenge for clinicians. The mortality rate of ventilator-associated pneumonia (VAP) is known to increase when the initial microbiological diagnosis and antimicrobial therapy are inappropriate. We present a case of a 18-year-old man, who after being admitted following an accident, had developed VAP due to multi-drug resistant Pseudomonas aeruginosa and Acinetobacter spp. and had a downhill clinical course despite broad-spectrum antibiotic treatment. The strains were found to be Col-S, as the susceptibility was tested. Colistin was instituted, with remarkable recovery. It is imperative to diagnose VAP with multi-drug resistant strains as early as possible; colistin, the 'last resort' antibiotic, if instituted with proper monitoring at the right time, can be life saving.
authors.affiliation: Department of Microbiology, Kasturba Medical College, Manipal, Karnataka, India. chiranjay@yahoo.co.in
authors.forename: C
authors.initials: C
authors.lastname: Mukhopadhyay
authors.forename: S
authors.initials: S
authors.lastname: Krishna
authors.forename: K E
authors.initials: KE
authors.lastname: Vandana
authors.forename: A
authors.initials: A
authors.lastname: Shenoy
authors.forename: I
authors.initials: I
authors.lastname: Bairy
mesh_terms: D000151:Acinetobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003091:Colistin / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin