Mediastinitis due to Acinetobacter baumannii is rare.
Methods:
We report a case of mediastinitis caused by pan-resistant A. baumannii in a patient with multiple comorbidities who underwent cardiopulmonary bypass and we also present a literature review.
Results:
Successful treatment consisted of surgical debridement plus drainage, and tigecycline administration for three weeks.
Conclusion:
Surgical source control along with effective antibiotics is essential in the treatment of mediastinitis. Tigecycline has the potential to be an option for pan-resistant A. baumannii mediastinitis.
Get full access to this article
View all access options for this article.
References
1.
SunenshineRH, WrightMO, MaragakisLLet al.Multidrug-resistant Acinetobacter infection mortality rate and length of hospitalization. Emerg Infect Dis, 2007; 13:97–103.
2.
LiJ, NationRL, OwenRJet al.Antibiograms of multidrug-resistant clinical Acinetobacter baumannii: Promising therapeutic options for treatment of infection with colistin-resistant strains. Clin Infect Dis, 2007; 45:594–598.
MerrillWH, AkhterSA, WolfRKet al.Simplified treatment of postoperative mediastinitis. Ann Thorac Surg, 2004; 78:608–612.
5.
AbidQ, NkereUU, HasanAet al.Mediastinitis in heart and lung transplantation: 15 years experience. Ann Thorac Surg, 2003; 75:1565–1571.
6.
LachanasE, TomosP, SfyrasNet al.Acinetobacter baumannii mediastinitis after cardiopulmonary bypass: Case report and literature review. Surg Infect (Larchmt), 2008; 9:201–204.
7.
GeorgeRS, BirksEJ, Haj-YahiaSet al.Acinetobacter mediastinitis in a heart transplant patient. Ann Thorac Surg, 2006; 82:715–716.
8.
GiamarellouH, AntoniadouA, KanellakopoulouK. Acinetobacter baumannii: A universal threat to public health?Int J Antimicrob Agents, 2008; 32:106–119.
9.
GarrisonMW, MuttersR, DowzickyMJ. In vitro activity of tigecycline and comparator agents against a global collection of gram negative and gram positive organisms: Tigecycline evaluation and surveillance trial 2004 to 2007. Diagn Microbiol Infect Dis, 2009; 65:288–299.
10.
CasalM, RodriguezF, JohnsonBet al.Influence of testing methodology on the tigecycline activity profile against presumably tigecycline non-susceptible Acinetobacter spp. J Antimicrob Chemother, 2009; 64:69–72.
11.
ScheinM, MarshallJ. Source control for surgical infections. World J Surg, 2004; 28:638–645.
12.
AnthonyKB, FishmanNO, LinkinDRet al.Clinical and microbiological outcomes of serious infections with multidrug-resistant gram-negative organisms treated with tigecycline. Clin Infect Dis, 2008; 46:567–570.
