Lung transplantation in two cystic fibrosis patients infected with previously pandrug-resistant Burkholderia cepacia complex treated with ceftazidime–avibactam
We describe two cystic fibrosis patients infected with pandrug-resistant Burkholderia cepacia complex, with the exception of ceftazidime–avibactam, who received prophylaxis with this antibiotic during lung transplantation. Although both patients had a post-operative relapse of respiratory infection, one with positive blood cultures, ceftazidime–avibactam treatment yielded a favourable outcome. 12 months after transplantation, one patient presented an excellent clinical outcome. However, the other patient died 10 months later due to severe B. cepacia sinusitis with intracranial invasion.
KeywordsMulti-drug resistance Respiratory tract infection Lung transplantation Cystic fibrosis Ceftazidime–avibactam Burkholderia cepacia complex
Ibai Los-Arcos received a Rio Hortega contract through the 2016 call for Strategic Action in Health from Instituto de Salud Carlos III of the Spanish Health Ministry for the years 2017–2018. The authors thank Celine Cavallo for English language support.
This research received no specific Grant from any funding agency in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
I.L. has been a speaker for Pfizer and has received travel support from Gilead, Merck and Novartis. O.L. has received a research grant from Pfizer and has been speaker for Pfizer, Astellas, Novartis and Merck. The rest of the authors declare that they have no conflicts of interest related to this study.
- 3.Papp-Wallace KM, Becka SA, Zeiser ET, Ohuchi N, Mojica MF, Gatta JA, et al. Overcoming an extremely drug resistant (XDR) pathogen: avibactam restores susceptibility to ceftazidime for Burkholderia cepacia complex isolates from cystic fibrosis patients. ACS Infect Dis. 2017;3:502–11.CrossRefGoogle Scholar
- 4.Weill D, Benden C, Corris PA, Dark JH, Davis RD, Keshavjee S, et al. A consensus document for the selection of lung transplant candidates: 2014—an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2015;34:1–15.CrossRefGoogle Scholar
- 20.Shields RK, Chen L, Cheng S, Chavda KD, Press EG, Snyder A, et al. Emergence of ceftazidime–avibactam resistance due to plasmid-borne bla KPC-3 mutations during treatment of carbapenem-resistant Klebsiella pneumoniae infections. Antimicrob Agents Chemother. 2017;61:e02097–16.PubMedPubMedCentralGoogle Scholar