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.
Zain I AlamaratJessica BabicTruc T TranSusan H WoottonAn Q DinhWilliam R MillerBlake M HansonAudrey WangerJoshua L GaryCesar A AriasNorma PérezPublished in: Antimicrobial agents and chemotherapy (2020)
We report a 15 year-old Nigerian adolescent male with chronic osteomyelitis caused by an extensively drug-resistant (XDR) Pseudomonas aeruginosa strain of sequence type 773 (ST773) carrying bla NDM-1 and an extended spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae 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.
Keyphrases
- klebsiella pneumoniae
- multidrug resistant
- drug resistant
- gram negative
- acinetobacter baumannii
- pseudomonas aeruginosa
- cystic fibrosis
- biofilm formation
- young adults
- mental health
- escherichia coli
- magnetic resonance imaging
- bone mineral density
- staphylococcus aureus
- lower limb
- drug induced
- magnetic resonance
- bone regeneration
- gestational age
- smoking cessation