A case of pan-resistant Burkholderia cepacia complex bacteremic pneumonia, after lung transplantation treated with a targeted combination therapy

Transpl Infect Dis. 2019 Apr;21(2):e13034. doi: 10.1111/tid.13034. Epub 2019 Jan 1.

Abstract

We describe a case of one patient with cystic fibrosis who developed a pan-resistant Burkholderia cepacia complex rapidly progressive bacteraemic pneunonia, following bilateral lung transplantation. The patient was treated with a targeted combination antibiotic therapy (meropenem plus ceftazidime/avibactam plus high doses of nebulized colistimethate sodium). Evolution of the disease was complicated by multiple organ system dysfunction. Finally, clinical improvement and microbiological cure was achieved.

Keywords: bacteraemic pneumonia; lung transplantation; pan-resistant Burkholderia Cepacia complex.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / microbiology*
  • Burkholderia Infections / diagnosis*
  • Burkholderia Infections / drug therapy
  • Burkholderia Infections / etiology
  • Burkholderia cepacia complex
  • Colistin / analogs & derivatives
  • Colistin / therapeutic use
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / microbiology
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Lung Transplantation / adverse effects*
  • Male
  • Pneumonia, Bacterial / diagnostic imaging*
  • Pneumonia, Bacterial / drug therapy
  • Treatment Outcome
  • X-Rays

Substances

  • Anti-Bacterial Agents
  • colistinmethanesulfonic acid
  • Colistin