9-month old baby after liver transplantation, with multi organ dysfunction, treated already with trimethoprim-sulfamethoxazole
We have used colistin in an immunosuppressed patient with Stenotrophomonas.
What is the site of infection (trachea, blood, wound)? Do you have antimicrobial sensitivities showing resistance to trimethoprim-sulfa?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1578578/
The doctors used also targocid (teicoplanin), ambisome (amphotercin), colistin, levofloxacin (fluorochinolon). We tried to get in contact with phage therapy specialists but it looks like that it is not possible to use it in this particular case.
Check these out,
Stenotrophomonas maltophilia infections in a general hospital: patient characteristics, antimicrobial susceptibility, and treatment outcome.Samonis G, Karageorgopoulos DE, Maraki S, Levis P, Dimopoulou D, Spernovasilis NA, Kofteridis DP, Falagas ME.PLoS One. 2012;7(5):e37375. doi: 10.1371/journal.pone.0037375. Epub 2012 May 18.
Therapeutic options for Stenotrophomonas maltophilia infections beyond co-trimoxazole: a systematic review. Falagas ME, Valkimadi PE, Huang YT, Matthaiou DK, Hsueh PR. J Antimicrob Chemother. 2008 Nov;62(5):889-94. doi: 10.1093/jac/dkn301. Epub 2008 Jul 28. Review. PMID: 18662945 [PubMed - indexed for MEDLINE]
They are both open access. Professor Falagas is a worldwide known infectious diseases specialist with cutting edge knowledge. His research is always appreciated
Thank you. I will forward it to clinicians and perhaps also try to contact Prof. Falagas.
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