Citrobacter freundii and Acinetobacter baumanii infection in a patient with neoplastic lung disease - Case report

• Published in: Annals of Agricultural and Environmental Medicine Vol. 28; no. 4; pp. 724 - 728
• Main Authors: Lewicki, Marcin, Kozioł, Małgorzata, Lorenc, Karol, Kozioł, Magdalena, Pawlicki, Mateusz, Smoleń, Agata
• Format: Journal Article
• Language: English
• Published: Poland Institute of Rural Health 01.01.2021
• Subjects: Acinetobacter baumannii; Aged, 80 and over; Amoxicillin; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacterial Proteins; beta-Lactamases; Blood; Blood culture; Carbapenemase; Case reports; Ciprofloxacin; Citrobacter freundii; Colistin; Defibrillators; Etiology; Fluoroquinolones; Gentamicin; Humans; Lung; Lung Diseases; Male; Microbial Sensitivity Tests; Neoplasms; Sepsis; Sputum; Tumors; β Lactamase; β-Lactam antibiotics; alert pathogen; antibiotic resistance; antibiotic therapy
• ISSN: 1232-1966; 1898-2263
• DOI: 10.26444/aaem/140111

An 85-year-old male with a tumour in his right lung was admitted to Internal Diseases Ward to continue treatment after suffering a sudden cardiac arrest. An empiric antibiotic therapy with amoxycillin was introduced due to increased inflammation markers. Blood and sputum were collected. An abundant growth of AmpC β-lactamase-producing Citrobacter freundii was observed in culture grown from the sputum. The antibiogram showed retained sensitivity to fluoroquinolones. The therapy was modified by replacing β-lactam with ciprofloxacin. Neither clinical nor laboratory improvement were observed. Blood culture indicated sepsis of Acinetobacter baumannii etiology. The strain was suspected of producing OXA carbapenemase (CARBA test positive), KPC (-), MBL (-). Antibiogram illustrated retained sensitivity to gentamicin and colistin with complete resistance to ciprofloxacin. Another modification in treatment was implemented and ciprofloxacin was replaced with colistin.