An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

Spencer, Hannah K.; Spitznogle, Sarah L; Borjan, Jovan; Aitken, Samuel L

doi:10.1002/phar.2447

Cited by 31 publications

(27 citation statements)

References 70 publications

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“…Alternative treatment approaches include minocycline, ceftazidime-avibactam, and ceftazidime-avibactam-piperacillin-tazobactam. [5][6][7][8] Double and triple combinations of these agents are commonly used. For instance, a two-drug combination of parenteral trimethoprim-sulfamethoxazole (5 mg/kg trimethoprim component given every 6-12 h) plus a β-lactam (such as ceftazidime, piperacillin, and meropenem) or a fluoroquinolone is recommended for cases presenting with severe infections from susceptible strains.…”

Section: Discussionmentioning

confidence: 99%

Burkholderia cepacia—A rare but important cause of refractory peritonitis in patients with continuous ambulatory peritoneal dialysis: A case report and literature review

Huang

Yang

et al. 2021

Seminars in Dialysis

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Refractory peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) caused by Burkholderia cepacia is very rare. Herein, we describe a case of B. cepacia-related refractory peritonitis and present a literature review of similar cases. A 62-year-old male patient presented with diffuse abdominal pain, bloating, and turbid peritoneal effluent. Initial dialysis effluent culture was negative for any microorganism. The patient initially underwent treatment with piperacillinsulbactam. The second dialysis effluent culture was positive for gram stain and later tested positive for B. cepacia. Peritoneal dialysis (PD) catheter removal was recommended, and the patient agreed to undergo regular hemodialysis. To the best of our knowledge, this is the first case of B. cepacia-related refractory peritonitis in a patient undergoing CAPD with no history of a recent hospitalization. B. cepacia infections can result in death in some areas. Therefore, timely catheter removal and switching treatment to hemodialysis is recommended for patients with B. cepacia-related refractory peritonitis. | INTRODUCTIONPeritonitis is a common and serious infection-related complication in patients undergoing peritoneal dialysis (PD) and a cause of mortality in about 16% of all patients receiving PD. 1 Previous studies have shown that gram-positive bacteria (mainly coagulase-negative staphylococcus, enterococcus species, and streptococcal species) are the most common bacteria causing peritonitis. Gram-negative bacteria (mainly Corynebacterium and Pseudomonas) account for 15%-35%. 2Burkholderia cepacia is a gram-negative bacteria that has become increasingly recognized as an important nosocomial pathogen responsible for hospital outbreaks. However, B. cepacia-related peritonitis in CAPD is a very rare occurrence in clinical practice. One possible reason is that B. cepacia is often misdiagnosed as non-lactose-fermenting bacillus, especially of Pseudomonas spp. in most developing countries. 3 To the best of our knowledge, this is the first report of a patient undergoing CAPD who developed refractory peritonitis due to B. cepacia infection with no history of recent hospitalization.

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Section: Discussionmentioning

confidence: 99%

Burkholderia cepacia—A rare but important cause of refractory peritonitis in patients with continuous ambulatory peritoneal dialysis: A case report and literature review

Huang

Yang

et al. 2021

Seminars in Dialysis

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“…The strain was involved in documented patient-to-patient transmission episodes, resulting in several deaths among CF patients [25], and its genome sequence is publicly available [43]. Bcc species are intrinsically resistant to currently available antibiotics including penicillins, narrow-spectrum cephalosporins, aminoglycosides, and polymyxins, and effective strategies for eradicating chronic Bcc infections are lacking [44]. In this context, the development of protective vaccines against Bcc infections becomes highly attractive.…”

Section: Discussionmentioning

confidence: 99%

Characterization of the Burkholderia cenocepacia J2315 Surface-Exposed Immunoproteome

et al. 2020

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Infections by the Burkholderia cepacia complex (Bcc) remain seriously life threatening to cystic fibrosis (CF) patients, and no effective eradication is available. A vaccine to protect patients against Bcc infections is a highly attractive therapeutic option, but none is available. A strategy combining the bioinformatics identification of putative surface-exposed proteins with an experimental approach encompassing the “shaving” of surface-exposed proteins with trypsin followed by peptide identification by liquid chromatography and mass spectrometry is here reported. The methodology allowed the bioinformatics identification of 263 potentially surface-exposed proteins, 16 of them also experimentally identified by the “shaving” approach. Of the proteins identified, 143 have a high probability of containing B-cell epitopes that are surface-exposed. The immunogenicity of three of these proteins was demonstrated using serum samples from Bcc-infected CF patients and Western blotting, validating the usefulness of this methodology in identifying potentially immunogenic surface-exposed proteins that might be used for the development of Bcc-protective vaccines.

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“…Unusual Gram-negative (GN) pathogens, including Achromobacter spp., Alcaligenes spp., Aeromonas spp., Burkholderia spp., and other genera, are primarily opportunistic pathogens that can cause serious infections ( 1 – 3 ). Achromobacter spp., particularly A. xylosoxidans , have been isolated from cystic fibrosis (CF) patients, and the incidence has increased recently ( 4 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

Minocycline Activity against Unusual Clinically Significant Gram-Negative Pathogens

Shortridge

Arends

Streit

et al. 2021

Antimicrob Agents Chemother

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The minocycline susceptibility of 3,856 isolates including Burkholderia , Achromobacter , Alcaligenes, Aeromonas , and Stenotrophomonas maltophilia from the SENTRY surveillance (2014-2019) were analyzed. The susceptibilities of these species (number; %S) were Achromobacter spp. (n=411; 92.6%), Burkholderia cepacia species complex (n=199; 85.9%), Aeromonas spp. (n=127; 99.2%), Chryseobacterium spp (n=59; 94.9%), Alcaligenes faecalis (n=42; 88.1%) and S. maltophilia (n=2,287; 99.5%). These data suggest that minocycline may be a useful treatment option for infections caused by unusual gram-negative pathogens.

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An Overview of the Treatment of Less Common Non–Lactose‐Fermenting Gram‐Negative Bacteria

Cited by 31 publications

References 70 publications

Burkholderia cepacia—A rare but important cause of refractory peritonitis in patients with continuous ambulatory peritoneal dialysis: A case report and literature review

Burkholderia cepacia—A rare but important cause of refractory peritonitis in patients with continuous ambulatory peritoneal dialysis: A case report and literature review

Characterization of the Burkholderia cenocepacia J2315 Surface-Exposed Immunoproteome

Minocycline Activity against Unusual Clinically Significant Gram-Negative Pathogens

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