Open Conversion after Aortic Endograft Infection Caused by Colistin-Resistant, Carbapenemase-Producing Klebsiella pneumoniae

Montelione, Nunzio; Menna, Danilo; Sirignano, Pasqualino; Capoccia, Laura; Mansour, Wassim; Speziale, Francesco

doi:10.14503/thij-15-5265

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…Aortic endograft is an efficacious option of treatment for aortic aneurysm burdened with several ischemic and vascular complications (8). However, only partial and limited information is available on graft-associated infective complications, as that they occur infrequently (with an estimated incidence of 6.2/1,000 person-years), are difficult to manage and have high mortality rates (9)(10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

First case of aorto‑bi‑iliac endograft thrombotic infection by Listeria monocytogenes: A case report

et al. 2022

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Listeria monocytogenes may cause serious vascular and graft infections. In the present case report, a 71-year-old man underwent partial prosthetic endograft replacement due to high-flow endoleak and limb occlusion. Following surgery, a multiple empiric antibiotic regime was initiated due to fever, malaise, abdominal tenderness and signs of an acute abdomen; however, in spite of this, the clinical condition of the patient worsened. An aorto-enteric fistula was discovered, and duodenal resection with duodeno-jejunal anastomosis packaging was performed. Gastrointestinal bleeding originating from this anastomosis both complicated and prolonged the clinical course, necessitating appropriate parenteral support and endoscopic hemostasis. The growth of Candida lusitanae in the drained abdominal and pleural effusion, and the isolation of L. monocytogenes from the thrombus inside the removed abdominal aorto-bi-iliac endograft allowed for establishment of a specific antibiotic treatment. After a suitable period of clinical improvement, the patient was transferred to a clinical rehabilitation center. At the present time, the patient maintains a good condition. To the best of our knowledge, the present study represents the first described case of thrombotic infection of an aorto-bi-iliac endograft by L. monocytogenes. In the event of graft thrombotic occlusion, L. monocytogenes infection should be considered as a potential cause. In case of complications requiring open conversion, even if not suspected from the medical history of the patient, the possibility of an underlying and occult infection should always be excluded with an in-depth preoperative work-up.

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Section: Discussionmentioning

confidence: 99%

First case of aorto‑bi‑iliac endograft thrombotic infection by Listeria monocytogenes: A case report

et al. 2022

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“…To date, the only two studies that report of VGEIs due to KPC-Kp, describe respectively a case series (including 3 patients) and a case report [13,14].…”

Section: N Literature Reviewmentioning

confidence: 99%

“…Finally, the kidney recipients experienced rupture of renal artery anastomosis and underwent graft nephrectomy and haemodialysis, pending for a new transplantation. Montelione et al described a case of a patient with a late VGEI caused by CR-Kp, treated with endograft removal and in situ aortic reconstruction and a double carbapenem-regimen for 4 weeks, with no recurrence of infection after three years [14].…”

Section: N Literature Reviewmentioning

confidence: 99%

Thoracic aorta graft infection by avibactam-resistant KPC-producing K. pneumoniae treated with meropenem/vaborbactam: a case report and literature review

2022

Infez Med

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“…Overall, 28 studies were selected for fulltext review, and 21 studies met our inclusion criteria. For these 21 studies, three trials [33][34][35] were cohort or casecontrol studies, and 18 reports [26,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] were case series or case reports. The flow diagram (Fig.…”

Section: Study Identificationmentioning

confidence: 99%

Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis

Wang

et al. 2020

BMC Infect Dis

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Background: To compare the efficacy and safety of double-carbapenem therapy (DCT) with other antibiotics for the treatment of multidrug resistant (MDR) Gram-negative bacterial infections. Methods: Cochrane Library, PubMed, Embase and Web of Science as well as Chinese databases were searched from database establishment to February 2019. All types of studies were included if they had evaluated efficacy and safety of DCT regimens in patients with MDR Gram-negative bacterial infections. Clinical response, microbiological response, adverse events and mortality were the main outcomes. The protocol was registered with PROSPERO No. CRD42019129979. Results: Three cohort or case-control studies consisting of 235 patients and 18 case series or case reports consisting of 90 patients were included. The clinical and microbiological responses were similar between DCT and other regimens in patients with carbapenem-resistant Enterobacteriaceae (CRE) infection. DCT achieved a lower mortality than comparators in patients with CRE infection (OR = 0.44, 95% CI = 0.24-0.82, P = 0.009). Ertapenem was the most reported antibiotic in DCT regimens in case series or case reports. Moreover, clinical and microbiological improvements were found in 59 (65.6%) and 63 (70%) in total 90 cases, respectively. Conclusions: DCT was as effective as other antibiotics in treating MDR Gram-negative bacterial infections, with similar efficacy response and lower mortality. DCT could be an alternative therapeutic option in the treatment of MDR Gram-negative bacterial infections. High-quality randomized controlled trials were required to confirm the beneficial effects of DCT.

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Open Conversion after Aortic Endograft Infection Caused by Colistin-Resistant, Carbapenemase-Producing Klebsiella pneumoniae

Cited by 6 publications

References 33 publications

First case of aorto‑bi‑iliac endograft thrombotic infection by Listeria monocytogenes: A case report

First case of aorto‑bi‑iliac endograft thrombotic infection by Listeria monocytogenes: A case report

Thoracic aorta graft infection by avibactam-resistant KPC-producing K. pneumoniae treated with meropenem/vaborbactam: a case report and literature review

Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis

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