Successful ceftazidime‐avibactam treatment of post‐surgery Burkholderia multivorans genomovar II bacteremia and brain abscesses in a young lung transplanted woman with cystic fibrosis. Issue 3 (3rd April 2019)

• Record Type: Journal Article
• Authors: Daccò, Valeria; Claut, Laura; Piconi, Stefania; Castellazzi, Luca; Garbarino, Francesca; Teri, Antonio; Colombo, Carla
• Is Part Of: Transplant infectious disease. Volume 21:Issue 3(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-04-03
• Subjects: brain abscesses -- Burkholderia cepacia complex -- Burkholderia multivorans -- ceftazidime‐avibactam -- cystic fibrosis; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.13082
• Languages: English
• ISSNs: 1398-2273

Abstract

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.