Combination of aztreonam, ceftazidime–avibactam and amikacin in the treatment of VIM-1 Pseudomonas aeruginosa ST235 osteomyelitis. (July 2021)

• Record Type: Journal Article
• Authors: Mularoni, Alessandra; Mezzatesta, Maria Lina; Pilato, Michele; Medaglia, Alice Annalisa; Cervo, Adriana; Bongiorno, Dafne; Aprile, Ausilia; Luca, Angelo; Stefani, Stefania; Grossi, Paolo
• Is Part Of: International journal of infectious diseases. Volume 108(2021)
• Page Start: 510
• Page End: 512
• Publication Date: 2021-07
• Subjects: Pseudomonas aeruginosa -- ST235 -- VIM-1 -- Ceftazidime–avibactam -- Aztreonam -- Osteomyelitis; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.05.085
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Metallo-beta-lactamase-producing Pseudomonas aeruginosa osteomyelitis is hard to treat. Aztreonam/ceftazidime–avibactam combined with amikacin was strongly synergic. Time-kill curves showed that triple combination achieved 99.9% killing until 48 h. Antipseudomonal synergistic agents plus debridement resolved the infection. Abstract: We describe a challenging case of patient with metallo-beta-lactamase-producing Pseudomonas aeruginosa sternal osteomyelitis following aortic valve replacement with biological prosthesis. The strain exhibited a multidrug-resistance phenotype carrying the bla VIM-1 gene and belonged to the high-risk clone sequence type ST235. The patient was successfully treated with surgical debridement plus antibiotic therapy with ceftazidime/avibactam, aztreonam, and amikacin. Time-kill curves showed that this triple antibiotic combination at 1 × MIC was strongly synergic after 8 h, achieving 99.9% killing and maintaining this until 48 h.