Long-Term Compassionate Use of Cefiderocol To Treat Chronic Osteomyelitis Caused by Extensively Drug-Resistant Pseudomonas aeruginosa and Extended-Spectrum-β-Lactamase-Producing Klebsiella pneumoniae in a Pediatric Patient

We report a 15 year-old Nigerian adolescent male with chronic osteomyelitis caused by an extensively drug-resistant (XDR) strain of sequence type 773 (ST773) carrying and an extended spectrum β-lactamase (ESBL)-producing strain. The patient developed neurological side effects in the form of circumor...

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Veröffentlicht in:	Antimicrobial agents and chemotherapy 2020-03, Vol.64 (4)
Hauptverfasser:	Alamarat, Zain I, Babic, Jessica, Tran, Truc T, Wootton, Susan H, Dinh, An Q, Miller, William R, Hanson, Blake, Wanger, Audrey, Gary, Joshua L, Arias, Cesar A, Pérez, Norma
Format:	Artikel
Sprache:	eng
Schlagworte:	Adolescent Anti-Bacterial Agents - therapeutic use beta-Lactam Resistance - genetics beta-Lactamases - genetics Cefiderocol Cephalosporins - therapeutic use Challenging Clinical Case in Antimicrobial Resistance Comment On Compassionate Use Trials - methods Drug Resistance, Multiple, Bacterial - genetics Humans Klebsiella pneumoniae - drug effects Male Microbial Sensitivity Tests Nigeria Osteomyelitis - drug therapy Osteomyelitis - microbiology Pseudomonas aeruginosa - drug effects Surgical Wound Infection - drug therapy Surgical Wound Infection - microbiology
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Zusammenfassung:	We report a 15 year-old Nigerian adolescent male with chronic osteomyelitis caused by an extensively drug-resistant (XDR) strain of sequence type 773 (ST773) carrying and an extended spectrum β-lactamase (ESBL)-producing strain. The patient developed neurological side effects in the form of circumoral paresthesia with polymyxin B and asymptomatic elevation of transaminases with aztreonam (used in combination with ceftazidime-avibactam). Cefiderocol treatment for 14 weeks plus bone implantation resulted in apparent cure and avoided amputation.
ISSN:	0066-4804 1098-6596
DOI:	10.1128/AAC.01872-19