Mediastinitis caused by an NDM-1 Escherichia coli in a child with Dacron Sano shunt after pulmonary atresia with ventricular septal defect surgery treated with combination of aztreonam-avibactam

Vladimir L Cousin; Jordi Miatello; Roberto Sierra; Tornike Sologashvili; Julie Wacker; Diego O Andrey; Arnaud G L'Huillier

doi:10.1016/j.ijantimicag.2024.107295

Mediastinitis caused by an NDM-1 Escherichia coli in a child with Dacron Sano shunt after pulmonary atresia with ventricular septal defect surgery treated with combination of aztreonam-avibactam

Int J Antimicrob Agents. 2024 Oct;64(4):107295. doi: 10.1016/j.ijantimicag.2024.107295. Epub 2024 Aug 2.

Authors

Vladimir L Cousin¹, Jordi Miatello², Roberto Sierra³, Tornike Sologashvili⁴, Julie Wacker⁵, Diego O Andrey³, Arnaud G L'Huillier⁶

Affiliations

¹ Paediatric Intensive Care Unit, Women, Child and Adolescent Department, Geneva University Hospital, Geneva, Switzerland; Paediatric Cardiology Unit, Women, Child and Adolescent Department, Geneva University Hospital, Geneva, Switzerland. Electronic address: [email protected].
² Paediatric Intensive Care Unit, Women, Child and Adolescent Department, Geneva University Hospital, Geneva, Switzerland.
³ Infectious Diseases Division, Department of Medicine, Geneva University Hospital, Geneva, Switzerland; Division of Laboratory Medicine, Department of Diagnostics, Geneva University Hospital, Geneva, Switzerland.
⁴ Paediatric Cardiac Surgery Unit, Women, Child and Adolescent Department, Geneva University Hospital, Geneva, Switzerland.
⁵ Paediatric Cardiology Unit, Women, Child and Adolescent Department, Geneva University Hospital, Geneva, Switzerland.
⁶ Paediatric Infectious Disease Unit, Department of Woman, Child and Adolescent Health, Geneva University Hospitals, and Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

PMID: 39096941
DOI: 10.1016/j.ijantimicag.2024.107295

Abstract

Carbapenem-resistant Enterobacterales are being reported increasingly and cause nosocomial infections, which may include postoperative mediastinitis. This paper reports a case of postoperative mediastinitis caused by an Escherichia coli NDM-1 carbapenemase producer in a 13-month-old boy with DiGeorge syndrome. The infection was managed with surgical debridement and antibiotherapy with aztreonam, ceftazidime-avibactam and IV fosfomycin for 6 weeks. The evolution was favourable, without relapse over 10 weeks of follow-up.

Keywords: Aztreonam; Carbapenem-resistant Enterobacterales; Ceftazidime-avibactam; Mediastinitis; Paediatric; Postsurgical infection.

Publication types

Case Reports

MeSH terms

Anti-Bacterial Agents* / therapeutic use
Azabicyclo Compounds* / therapeutic use
Aztreonam* / therapeutic use
Ceftazidime / therapeutic use
Drug Combinations*
Escherichia coli Infections* / drug therapy
Escherichia coli Infections* / microbiology
Escherichia coli* / drug effects
Escherichia coli* / genetics
Escherichia coli* / isolation & purification
Heart Septal Defects, Ventricular / surgery
Humans
Infant
Male
Mediastinitis* / drug therapy
Mediastinitis* / microbiology
Pulmonary Atresia / surgery
Treatment Outcome
beta-Lactamases* / genetics

Substances

Aztreonam
beta-Lactamases
Anti-Bacterial Agents
Azabicyclo Compounds
Drug Combinations
beta-lactamase NDM-1
Ceftazidime
avibactam