Management of a Multidrug-Resistant Pseudomonas Aeruginosa Infected Total Knee Arthroplasty Using Colistin. A Case Report and Review of the Literature
Papagelopoulos, Panayiotis J; Mavrogenis, Andreas F; Giannitsioti, Efthymia; Kikilas, Athanasios; Kanellakopoulou, Kyriaki; Soucacos, Panayotis NKnee
Multidrug-resistant infections present a serious clinical and therapeutical problem. Colistin is an old-used polymyxin with rather poor pharmacokinetic profile and a remarkable nephrotoxicity. However, the emergence of multidrug-resistant bacteria has recently led to the increased use of colistin as a potentially available therapy. This article presents a 75-year-old diabetic woman with an early onset total knee arthroplasty infection by a multidrug-resistant Pseudomonas aeruginosa bacterial isolate that was managed successfully with surgical removal of the knee prosthesis, antibiotic impregnated cement and intravenous administration of colistin for 6 weeks, and second stage revision knee surgery. Two years later, laboratory and imaging studies showed no evidence of recurrence of infection.
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