Sepsis and pneumonia caused by Enterococcus faecium following liver transplantation treated with contezolid as the first-line therapy

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES Journal of global antimicrobial resistance Pub Date : 2024-05-21 DOI:10.1016/j.jgar.2024.05.005
Xiangyan Liu, Zhuoyi Wang, Weilin Wu, Shusen Zheng
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Abstract

Background

Enterococcus faecium (E. faecium) stands as a prominent pathogen contributing to Gram-positive bacterial infections in individuals who have undergone liver transplantation.

Case presentation

A 66-year-old male with a three-year history of treated anxiety disorder was admitted to our hospital due to recurrent abdominal distension and oliguria. He was diagnosed with hepatic veno-occlusive disease (HVOD), hepatic failure, pneumonia, renal insufficiency and abdominal ascites. A liver transplantation procedure was performed, but the patient's infection index increased on the first day after surgery. Empirical antibiotic therapy with ceftriaxone and meropenem and preventive antifungal therapy were applied. Sputum culture, blood culture, ascites culture and bronchoalveolar lavage fluid (BALF) next-generation sequencing (NGS), revealed the presence of E. faecium. Given the application of various nephrotoxic immunosuppressive agents after liver transplantation, pre-existing renal insufficiency, severe bone marrow suppression, and a history of anxiety disorder treated with sertraline, contezolid was added for the treatment of the Gram-positive bacterial infection. Sixteen days after surgery, cultures from ascites and sputum yielded negative results for fungi and bacteria. Contezolid was subsequently discontinued without any reported adverse events during follow-up.

Conclusion

Treatment with contezolid as the first-line therapy for sepsis and pneumonia caused by E. faecium following liver transplantation has shown satisfactory efficacy and safety. Therefore, contezolid may hold great promise for managing this life-threatening condition.

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肝移植术后粪肠球菌引发的败血症和肺炎,康特唑胺作为一线疗法进行治疗。
背景:粪肠球菌(E. faecium)是导致肝移植患者发生革兰氏阳性细菌感染的主要病原体:一名 66 岁的男性因反复腹胀和少尿被送入我院,他曾有三年的焦虑症治疗史。他被诊断为肝静脉闭塞症(HVOD)、肝功能衰竭、肺炎、肾功能不全和腹水。虽然进行了肝移植手术,但术后第一天患者的感染指数就升高了。患者接受了头孢曲松和美罗培南的经验性抗生素治疗和预防性抗真菌治疗。痰培养、血培养、腹水培养和支气管肺泡灌洗液(BALF)新一代测序(NGS)结果显示存在粪肠球菌。鉴于该患者在肝移植后使用了多种肾毒性免疫抑制剂、原有肾功能不全、严重骨髓抑制以及使用舍曲林治疗焦虑症的病史,因此在治疗革兰氏阳性菌感染时加入了康替佐利。术后 16 天,腹水和痰培养结果显示真菌和细菌均为阴性。随后停用了康替佐利,随访期间未报告任何不良反应:结论:肝移植术后粪肠球菌引起的败血症和肺炎的一线治疗方案--康替唑烷的疗效和安全性均令人满意。因此,在治疗这种危及生命的疾病方面,康替唑烷可能大有可为。
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来源期刊
Journal of global antimicrobial resistance
Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
8.70
自引率
2.20%
发文量
285
审稿时长
34 weeks
期刊介绍: The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
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