title: Liver abscess caused by multidrug-resistant Pseudomonas aeruginosa treated with colistin; a case report and review of the literature.
abstract: A 77-year-old man had undergone left-lobe liver resection and a choledochojejunostomy six years previously, and thereafter he suffered from a postoperative relapse of cholangitis. He was admitted to our hospital due to liver abscesses and bacteremia caused by multidrug-resistant Pseudomonas aeruginosa. Empirical treatment with piperacillin/tazobactam was started, and the patient initially recovered. However, he developed a second case of sepsis caused by piperacillin/tazobactam-resistant P. aeruginosa bacteremia originating from a new liver abscess. We changed the piperacillin/tazobactam to colistin and flomoxef and continued the two antibiotics for one month. During the antibiotic therapy, the patient successfully underwent bile duct stent placement.
authors.affiliation: Division of Infectious Diseases, Kenwakai Otemachi Hospital, Japan. kyaita81@gmail.com
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yaita
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sameshima
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takeyama
authors.forename: Shinpei
authors.initials: S
authors.lastname: Matsuyama
authors.forename: Chie
authors.initials: C
authors.lastname: Nagahara
authors.forename: Ryo
authors.initials: R
authors.lastname: Hashiguchi
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Moronaga
authors.forename: Nami
authors.initials: N
authors.lastname: Tottori
authors.forename: Masanari
authors.initials: M
authors.lastname: Komatsu
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Oshiro
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy; D002511:Cephalosporins / Q000627:therapeutic use; D002761:Cholangitis / Q000150:complications / Q000628:therapy; D003091:Colistin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007668:Kidney / Q000187:drug effects; D046290:Liver Abscess, Pyogenic / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D000077725:Piperacillin, Tazobactam Drug Combination; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000209:etiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; C045693:flomoxef; D010878:Piperacillin; D003091:Colistin