Successful combination therapy by meropenem and colistin for multi-drug-resistant Pseudomonas aeruginosa infection after allogeneic bone marrow transplantation

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  • KANDA Masatoshi
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • SHIGEMATSU Akio
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • OKADA Kohei
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • KASAHARA Ikumi
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • IWASAKI Junko
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • YAMAGUCHI Keisuke
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • ONOZAWA Masahiro
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • ENDO Tomoyuki
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • AKIZAWA Koji
    Department of Clinical Laboratory and Transfusion, Hokkaido University Hospital
  • ISHIGURO Nobuhiro
    Infection Control Team, Hokkaido University Hospital
  • HASHINO Satoshi
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital
  • IMAMURA Masahiro
    Hematopoietic Stem Cell Transplantation Center, Hokkaido University Hospital

Bibliographic Information

Other Title
  • メロペネム・コリスチン併用療法が奏効した同種骨髄移植後の多剤耐性緑膿菌感染症
  • 症例報告 メロペネム・コリスチン併用療法が奏効した同種骨髄移植後の多剤耐性緑膿菌感染症
  • ショウレイ ホウコク メロペネム コリスチン ヘイヨウ リョウホウ ガ ソウコウ シタ ドウシュ コツズイ イショク ゴ ノ タザイ タイセイ リョクノウキン カンセンショウ

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Abstract

A 66-year-old male with acute type adult T-cell leukemia that was refractory to chemotherapy underwent unrelated allogeneic bone marrow transplantation after non-myeloablative conditioning with fludarabine, busulfan and total body irradiation. During an episode of neutropenia on day 12 after transplantation, pneumonia and sepsis due to multi-drug resistant Pseudomonas aeruginosa developed. Drug susceptibility tests demonstrated resistance to all kinds of intravenous antibiotics available for P. aeruginosa in Japan. Multi-drug susceptibility tests by the breakpoint-checkerboard plate method were then performed and combination therapy with meropenem hydrate and colistin was started based on the test results. After starting treatment, clinical symptoms and laboratory data immediately improved and engraftment of neutrophils was achieved on day 18. Infections with multi-drug-resistant P. aeruginosa are often critical for patients after hematopoietic stem cell transplantation and are difficult to control. In this paper, we report a case of severe multi-drug-resistant P. aeruginosa infection that was successfully treated by combination therapy selected using the breakpoint-checkerboard plate method.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 52 (3), 118-123, 2011

    The Japanese Society of Hematology

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