Meropenem 단독요법에 반응하지 않았으나, ceftazidime과 trimethoprim- sulfamethoxazole 병합투여로 치료한 Burkholderia 균 혈증 및 감염성 척추염 1례 = A Case of Burkholderia cepacia Bacteremia and Infective Spondylitis, Treated with Ceftazidime and Trimethoprim-Sulfamethoxazole Combination Therapy, which did not Respond to Carbapenem Monotherapy

다국어 초록 (Multilingual Abstract)

Burkholderia cepacia is an aerobic gram-negative rod that causes healthcareassociated 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.

참고문헌 (Reference)

1 MacGregor RR, "pharmacokinetics and body fluid concentrations in patients receiving high-dose treatment for serious infections" 29 : 188-192, 1986

2 양병혁, "Pyogenic Spondylitis in a Healthy Adult Caused by Burkholderia cepacia" 대한감염학회 40 (40): 233-236, 2008

3 Leigh DA, "Pharmacokinetic study of ceftazidime in bone and serum of patients undergoing hip and knee arthroplasty" 16 : 637-642, 1985

4 Wertheim WA, "Osteomyelitis and intervertebral discitis caused by Pseudomonas pickettii" 30 : 2506-2508, 1992

5 Held MR, "Life-threatening sepsis caused by Burkholderia cepacia from contaminated intravenous flush solutions prepared by a compounding pharmacy in another state" 118 : e212-e215, 2006

6 Alfonso Olmos M, "Infected vertebroplasty due to uncommon bacteria solved surgically: a rare and threatening life complication of a common procedure: report of a case and a review of the literature" 31 : E770-E773, 2006

7 Lewin C, "In vitro activities of meropenem, PD 127391, PD 131628, ceftazidime, chloramphenicol, cotrimoxazole, and ciprofloxacin against Pseudomonas cepacia" 37 : 123-125, 1993

8 Lu DC, "In vitro activities of antimicrobial agents, alone and in combinations, against Burkholderia cepacia isolated from blood" 28 : 187-191, 1997

9 Bonacorsi S, "Comparative in vitro activities of meropenem, imipenem, temocillin, piperacillin, and ceftazidime in combination with tobramycin, rifampin, or ciprofloxacin against Burkholderia cepacia isolates from patients with cystic fibrosis" 43 : 213-217, 1999

10 Zimmerli W, "Clinical practice. Vertebral osteomyelitis" 362 : 1022-1029, 2010

11 Huang CH, "Characteristics of patients with Burkholderia cepacia bacteremia" 34 : 215-219, 2001

12 Smith MA, "Cervical osteomyelitis caused by Pseudomonas cepacia in an intravenous-drug abuser" 21 : 445-446, 1985

13 Weinstein L, "Cervical osteomyelitis caused by Burkholderia cepacia after rhinoplasty" 2 : 76-77, 2008

14 Marioni G, "Cervical necrotizing fasciitis: a novel clinical presentation of Burkholderia cepacia infection" 53 : e219-e222, 2006

15 Mohr CD, "Cellular aspects of Burkholderia cepacia infection" 3 : 425-435, 2001

16 Sudo H, "Burkholderia pickettii spondylitis" 43 : 499-502, 2005

17 Saux MC, "Bone diffusion of trimethoprim and sulfamethoxazole high pressure liquid chromatography(HPLC)" 30 : 385-388, 1982

18 Sader HS, "Antimicrobial susceptibility of uncommonly isolated non-enteric Gram-negative bacilli" 25 : 95-109, 2005

19 Speert DP, "Advances in Burkholderia cepacia complex" 3 : 230-235, 2002