Abstract
Background: Pseudomonas aeruginosa is a Gram-negative opportunistic bacterium with wide distribution around the world capable of both aerobic and anaerobic growth that may become Multidrug Resistant (MDR). It is typically associated with nosocomial infections in patients with serious underlying conditions and most notably in immunocompromised individuals, though; it is not a common infectious agent in central venous catheters (CVC) of patients receiving hemodialysis treatment, however, infection of CVC is a well-known complication in patients with end stage chronic kidney disease. Case Study: The current article is a retrospective study that presents a case of a 63-year-old male patient with KDIGO V chronic kidney disease that presented multidrug resistant Pseudomonas aeruginosa infection of CVC; exposing evaluation of transmission and treatment and making mention of American, Spanish and Mexican guidelines regarded to vascular acceses management for prevention of bacteremia an infection. Result: Patient is currently asymptomatic, with remission of the infection and after catheter removal receiving his usual hemodialysis therapy with a functional Cimino-Brescia fistula. Conclusion: MDR microorganisms such as Pseudomonas aeruginosa are a public health problem secondary to antibiotic resistance, it is necessary to implement the strict care of vascular accesses following the recommendations of national and international guidelines to reduce the morbidity and mortality generated by infection of CVC.
Highlights
Pseudomonas aeruginosa is a gram-negative opportunistic bacterium with wide distribution around the world capable of both aerobic and anaerobic growth that makes it capable of becoming Multidrug Resistant (MDR) [1-8]. It is typically associated with nosocomial infections in patients with serious underlying conditions and most notably in immunocompromised individuals, though it is not a common infectious agent in central venous catheters (CVC) of patients in hemodialysis treatment [2]
Infections related to CVC are a serious public health problem due to their high morbidity and mortality, and most importantly because they are potentially preventable with proper protocols and aseptic techniques as well as management strategies for care and use of the catheters [4,22]
A temporal left jugular catheter was placed for hemodialysis, patient received 3 renal replacement therapies without bacteremia data and new blood cultures were performed after one and a half week intravenous treatment, reporting Pseudomonas aeruginosa and Staphylococcus epidermidis infection, this last one with high sensitivity for usual antibiotics, multiresistance for Pseudomonas aeruginosa persisted, in consequence, an alternative therapy was establish with intravenous carbapenem and gentamicin, extending IV antibiotic therapy for 21 days during treatment patient presented bacteremia in two more ocations
Summary
Multidrug resistant microorganisms such as Pseudomonas aeruginosa are a public health problem secondary to antibiotic resistance, it is necessary to implement the strict care of vascular accesses following the recommendations of national and international guidelines in order to reduce the morbidity and mortality generated by infection of CVC and education of the patient, reduction of comorbidities and usual asepsia of the catheter before manipulation is imperative for preventing bacteremia and catheter infections
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