Multidrug Resistant Case Study

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Community acquired multi drug resistant (MDR) Pseudomonas aeruginosa and extended-spectrum beta-lactamase (ESBL) Escherichia Coli to ceftolozane-tazobactam in a patient with a liver abscess.

Mohamed Teleb M.D., Enrique Soto-Ruiz Pharm.D., Suresh Antony M.D
Section of Infectious Diseases, Department of Medicine
Texas Tech University School of Medicine, El Paso, Texas

Correspondence and Reprints:
Suresh Antony M.D
1205 N-Oregon
El Paso, Texas 79902
Tel: 9155334900
Fax 915 5334902
Email. Suresh.antony@att.net

Abstract
Multidrug resistant P.aeruginosa and extended-spectrum β-lactamase (ESBL) enterobactericae is becoming an increasing difficult clinical problem. De novo resistance to some of the new antimicrobials such as ceftolozane/tazobactam is unusual and is due to a variety of …show more content…
Post operatively she developed persistent abdominal pain with nausea and vomiting. She was evaluated in Mexico where she was noted to have a liver abscess and a percutaneous drainage catheter was placed. She then moved to the United States where she was admitted to the hospital for further …show more content…
aeruginosa and other gram-negative pathogens, including ESBL producing Enterobactericae [nccl]. Ceftolozane/tazobactam seemed to be an appropriate antimicrobial for our patient as it potentially provided coverage for both strains of pseudomonas as well as the ESBL-producing E. Coli. In addition, a regimen consisting of a single antimicrobial seemed more appropriate in the setting of C. difficle. After susceptibility testing and much to our surprise ceftolozane/tazobactam was not a viable option, as it did not inhibit any in vitro
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