A Case of Burkholderia cepacia Bacteremia and Infective Spondylitis, Treated with Ceftazidime and Trimethoprim-Sulfamethoxazole Combination Therapy, which did not Respond to Carbapenem Monotherapy

Mi Ok Jang; Hyun Wook Kang; Seong Eun Kim; Seung-Ji Kang; Hee-Chang Jang; Sook-In Jung; Jong Hee Shin; Kyung Hwa Park

doi:10.3947/ic.2011.43.6.490

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Jang, Kang, Kim, Kang, Jang, Jung, Shin, and Park: A Case of Burkholderia cepacia Bacteremia and Infective Spondylitis, Treated with Ceftazidime and Trimethoprim-Sulfamethoxazole Combination Therapy, which did not Respond to Carbapenem Monotherapy

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2011; 43(6): 490-493.

Published online: 30 December 2011

DOI: https://doi.org/10.3947/ic.2011.43.6.490

A Case of Burkholderia cepacia Bacteremia and Infective Spondylitis, Treated with Ceftazidime and Trimethoprim-Sulfamethoxazole Combination Therapy, which did not Respond to Carbapenem Monotherapy

Mi Ok Jang¹, Hyun Wook Kang¹, Seong Eun Kim¹, Seung-Ji Kang¹, Hee-Chang Jang¹, Sook-In Jung¹, Jong Hee Shin², Kyung Hwa Park¹

¹Department of Internal Medicine, Chonnam National University Medical School, Gwang-ju, Korea.

²Department of Laboratory Medicine, Chonnam National University Medical School, Gwang-ju, Korea.

Correspondence to Kyung Hwa Park, M.D. Department of Infectious disease, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju 501-757, Korea. Tel: +82-62-220-6483, Fax: +82-62-225-8578, medkid@dreamwiz.com

Received 21 June 2011 Revised 20 September 2011 Accepted 26 September 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Burkholderia cepacia is an aerobic gram-negative rod that causes healthcare-associated infections through contaminated disinfectants, fluids, and medical equipment. This bacterium shows resistance to various antibiotics. For this reason, available therapeutic antimicrobial agents are limited, and the optimal antimicrobial therapeutic regimen was still not well-determined in the case of infective spondylitis. We experienced a case of B. cepacia bacteremia with infective spondylitis and paraspinal abscesses which did not respond to carbapenem monotherapy, but was did respond to ceftazidime and sulfamethoxzaole/trimethoprim combination therapy.

Keywords: Burkholderia cepacia, Spondylitis

Figures and Tables

Figure 1

Magnetic resonance imaging of the lumbar spine. Infective spondylitis involving L3-4, small paraspinal abscess pockets, and epidural and paraspinal soft tissue thickening was evident.

Figure 2

Course of the patient's hospital stay. On hospital day 13, meropenem was changed to ceftazidime plus sulfamethoxazole/trimethoprim. Then WBC count, CRP level, and fever of the patient was improved.

WBC, white blood cell; CRP, c-reactive protein; BT, body temperature; CFZOL, cefazolin; MRPN, meropenem; CFTAZ, ceftazidime; SMX/TMP, sulfamethoxazole/trimethoprim.

Table 1

Clinical Findings and Management in Previous Case Reports of Spondylitis by Burkholderia species Infection

HTN, hypertension; DM, diabetes mellitus; CRF, chronic renal failure; LC, liver cirrhosis; P. cepacia, Pseudomonas cepacia; B. pickettii, Burkholderia pickettii; S. marcescens, Serratia marcescens; S. maltophilia, Stenotrophomonas maltophilia; SMX/TMP, sulfamethoxzaole/trimethoprim

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