Aortic Prosthesis-Associated MDR Pseudomonas Infections as a Diagnostic and Therapeutic Challenge

Rita Filipe,Margarida Tavares,Filipa Ceia,António Sarmento,António P O Carvalho ,José Fernando Teixeira

doi:10.3390/idr12030012

Rita Filipe, Margarida Tavares + Show 4 more

Open Access

https://doi.org/10.3390/idr12030012

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Abstract

Endovascular prostheses are used to treat life-threatening conditions such as ruptured aortic aneurysms. Prosthetic infection cause significant morbidity and mortality, posing important diagnostic and therapeutic challenges. It is particularly difficult to diagnose and, in the era of multidrug resistance (MDR), these type of infections may become even more difficult to treat. Herein, we reported a case of a secondary prosthetic endovascular infection following repeated bacteremia episodes from a urinary source. This case illustrates an MDR Pseudomonas aeruginosa aortic infection that was difficult to diagnose with no oral antibiotic treatment options.

Highlights

Endovascular prostheses are used to treat life-threatening conditions such as ruptured aortic aneurysms
multidrug resistance (MDR) P. aeruginosa was again isolated in urine and and blood urine blood cultures
The reported rate of Aortic graft infections (AGIs) is below 1% in most series, and it is significantly associated with hematogenous spread and surgical site infection [2,3]

Summary

Case Report

In 2015, a 59-year-old man underwent emergency surgery to repair a ruptured abdominal aortic aneurysm. He had several episodes of catheter-associated pyelonephritis with repeated isolation of multidrug resistance (MDR), Pseudomonas aeruginosa in urine, and, on one occasion, blood cultures. (CT) showed showed that that there there was was aa fluid to the the left left psoas psoas muscle muscle with with contrast contrast uptake uptake in in the the collection collection walls, walls, apparently apparently in in continuity continuity of of the the to bypass bifurcation region. This had previously been detected in a post-operatory exam with similar bypass bifurcation region. The patient was discharged after completing 10 weeks of antibiotic therapy and remained free infection for the 18 months of follow-up.

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