RESUMO
Staphylococcus lugdunensis is a coagulase-negative Staphylococcus that causes skin and soft tissue infections and occasionally life threatening endocarditis of native valves. Prosthetic valve infection due to this pathogen is very rare and has not been described in HIV infected individuals. We report on the first case of early prosthetic valve endocarditis in an HIV-1 positive individual.
Assuntos
Valva Aórtica/microbiologia , Endocardite Bacteriana/microbiologia , Soropositividade para HIV/complicações , Próteses Valvulares Cardíacas/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Staphylococcus/isolamento & purificação , Adulto , Humanos , Masculino , Infecções Estafilocócicas/microbiologia , Staphylococcus/classificaçãoRESUMO
The prospective case series study presented here was conducted to assess the outcome of patients with infections caused by polymyxin-only-susceptible (POS) gram-negative bacteria managed with intravenous colistin. Between July 2003 and April 2005 a total of 27 patients were infected with a POS gram-negative bacterium and received intravenous colistin at a dose of 2 million international units (MIU) (160 mg or 66.7 mg colistin base) every 8 h for a mean (+/-SD) duration of 13.9 (+/-7.5) days. Nine patients had ventilator-associated pneumonia and received, in addition to the intravenous colistin therapy, 1 MIU (80 mg or 33.3 mg colistin base) aerosolized colistin every 12 h for a mean (+/-SD) duration of 13 (+/-6.5) days. The predominant pathogens were Pseudomonas aeruginosa (n = 17) and Acinetobacter baumannii (n = 12); in two patients both pathogens were isolated from one clinical specimen. In-hospital mortality and clinical response were 15% and 85%, respectively. Colistin-associated nephrotoxicity was observed in two of the 27 patients. POS gram-negative pathogens represent a major threat for hospitalized patients. Colistin appears to be an effective and safe treatment, even in patients with severe underlying diseases.
