Nilgün ALTIN, S. Fehmi KATIRCIOĞLU, Göknur TOROS YAPAR, Mehmet S. BAYRAKTAROĞLU, İrfan ŞENCAN, Salih CESUR

Kombine Antibiyotik Tedavisi İle Düzelen Çok İlaca Dirençli Acinetobacter Baumannii Mediastiniti Olgusu

Acinetobacter baumannii (A. baumannii) çoklu ilaç direnci göstermesi nedeniyle tedavisinde sorunlar yaşananve mortalite oranı yüksek hastane enfeksiyonlarına neden olabilen gram negatif nonfermentatif kokobasildir. Sonyıllarda A.baumannii suşlarında karbapenemler dahil birçok antibiyotik grubuna karşı direnç görülmesi tedavideönemli sorunlara yol açmaktadır. Çoklu ilaca dirençli A. baumanniinin neden olduğu enfeksiyonların tedavisindeçeşitli antibiyotik kombinasyonları önerilmektedir. Postoperatif mediastinit nadir görülen bir komplikasyon olupmortalite oranı yüksektir. Çok ilaca dirençli Acinetobacter baumanniinin neden olduğu mediastinitin tedavisinderifampisin ve kolistin kombinasyonu uygun bir tedavi seçeneğidir. Bu yazıda koroner arter bypass ameliyatı sonrası Acinetobacter baumannii mediastiniti gelişen, kolistin ve rifampisinkombinasyonu ile tedavi başarısı sağlanan bir olgu sunuldu.

A Case of Mediastinitis Due To Multidrug Resistant Acinetobacter Baumannii Recovered With Combined Antibiotic Therapy

(A. baumannii) is a non fermantative gram negative coccobacillus that may cause hospital infections with difficultiesin treatment high mortality rates due to its ability to have multiple drug resistance. During recent years, resistanceto a lot of antimicrobials including carbapenems in A.baumannii strains results in problems in treatment. Antibioticcombinations are suggested in the treatment of infections caused by multi-drug resistant A. baumannii strains. Postoperative mediastinitis is a rare condition with a high mortality rate. The combination of rifampicin and colistin is anappropriate treatment choice in case of mediastinitis caused by multi-drug resistant A. baumannii. In this case report,we describe a patient who experienced mediastinitis due to A. baumannii infection after coronary artery bypass surgery that was successfully treated with rifampicin and colistin combination.

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