Successful ceftazidime-avibactam treatment of post-surgery Burkholderia multivorans genomovar II bacteremia and brain abscesses in a young lung transplanted woman with cystic fibrosis

Valeria Daccò, Laura Claut, Stefania Piconi, Luca Castellazzi, Francesca Garbarino, Antonio Teri, Carla Colombo

Research output: Contribution to journalArticle

Abstract

Burkholderia cepacia complex (Bcc) includes several phenotypically similar but genotypically distinct gram-negative bacteria (GNB) that can colonize the respiratory tract of Cystic Fibrosis (CF) patients. Pathogens are difficult to treat due to intrinsic resistance to multiple antibiotics and are associated to a more rapid decline in lung function and to increased mortality, particularly after lung transplantation. For all these reasons, chronic infection by Burkholderia (B) cenocepacia is presently considered a relative or absolute contraindication in almost all lung transplant centres. We report the case of a young adult CF patient chronically colonized by B multivorans genomovar II, with diabetes and end-stage renal disease treated with renal replacement therapy: a few months after lung transplantation, she developed post-surgery B multivorans bacteremia and multiple brain abscesses. This severe infection did not improve despite multiple standard antibiotic regimen. The introduction of ceftazidime-avibactam, a new β-lactam/ β-lactamase inhibitor combination resulted in clinical recovery and in radiological and biochemical improvement.

Original languageEnglish
Article numbere13082
JournalTransplant Infectious Disease
Volume21
Issue number3
DOIs
Publication statusPublished - Jan 1 2019

Keywords

  • brain abscesses
  • Burkholderia cepacia complex
  • Burkholderia multivorans
  • ceftazidime-avibactam
  • cystic fibrosis

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

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