M. Michele , M. Lugara , M.G. Coppola, C. P. Petrosino, R. Boccia, C. Rainone, B. Tartaglia B, C. Fierarossa, V. Gammaldi, F. Lacava, P. Madonna
Postgraduate Specialization School of Internal Medicine, University of Naples Federico II, Naples, Italy Internal Medicine Unit, Ospedale del Mare, ASL Napoli 1 Centro, Naples, Italy Postgraduate Specialization School in Geriatrics, University of Naples Federico II, Naples, Italy
Scientific Tracks Abstracts: Health Sci J
Background Multi drug resistant germs are a problem of increasing importance given the prevalence of these pathogens. Acinetobacter baumanii MDR accounts for 15% of all causes of sepsis in ICU in Italy, with a mortality rate from 28% to 43%. The use of antibiotic carriers makes it possible to overcome the challenges posed by antibiotic penetration into poorly vascularized sites and the need to use potentially toxic drugs to treat resistant microorganisms. Case history A 68-years-old female presents to ED with fever and confusional state. In her medical history she had right hip arthroplasty surgery 2 months earlier. Physical examination reveals two fistulae with purulent drainage from the site of the surgical wound. Wound swabbing shows positivity for MRSA and Acinetobacter MDR. Increased metabolic index in the prosthetic-periprosthetic site in the FDG-PET scan corroborates the hypothesis of a prosthetic joint infection. Systemic therapy with Linezolid 1200 mg die and Cefiderocol 6 mg die is started and the decision is made for surgical reduction and spacer placement. It is also decided to place antibiotic carrier (Stimulan) loaded with Cefiderocol 1 gr during surgery. Two weeks after surgery, the patient is transferred to a rehabilitation facility for the continuation of the rehabilitation process. Discussion The use of Stimulan loaded with Cefiderocol was safe and effective in the treatment of prosthetic joint infection of the hip sustained by Acinetobacter baumannii MDR.
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