RESUMEN
Coagulase-negative Staphylococci, including Staphylococcus epidermidis, are common pathogens in orthopedic prosthesis infections. Operation and prolonged treatment with rifampicin in combination with another antibiotic is often required. Coagulase-negative Staph-ylococci are frequently multi-resistant, but resistance to vancomycin is rare in Sweden. Linezolid is an alternative, however it is only recommended for up to 4 weeks treatment due to risk of hematological side effects. We have successfully used prolonged treatment with linezolid and rifampicin in a patient suffering from a complicated prosthetic joint infection caused by a vancomycin resistant Staphyloccous epidermidis strain.
Asunto(s)
Antibacterianos , Infecciones Relacionadas con Prótesis/tratamiento farmacológico , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus epidermidis/efectos de los fármacos , Resistencia a la Vancomicina , Acetamidas/administración & dosificación , Acetamidas/farmacología , Acetamidas/uso terapéutico , Antibacterianos/administración & dosificación , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Humanos , Prótesis de la Rodilla/efectos adversos , Linezolid , Masculino , Persona de Mediana Edad , Oxazolidinonas/administración & dosificación , Oxazolidinonas/farmacología , Oxazolidinonas/uso terapéutico , Infecciones Relacionadas con Prótesis/microbiología , Rifampin/administración & dosificación , Rifampin/farmacología , Rifampin/uso terapéutico , Staphylococcus epidermidis/aislamiento & purificación , Resultado del Tratamiento , Vancomicina/administración & dosificación , Vancomicina/farmacología , Vancomicina/uso terapéuticoRESUMEN
Clostridium difficile-associated disease (CDAD) with frequent watery stools, sometimes with painful bowel movements, fever and sickness, is probably the major known cause of antibiotic-associated diarrhea and colitis, most probably depending on a disruption of the normal intestinal balance in the microbiome. In this study, we have inoculated a mixture of fecal microbes--as an enema--originating from a healthy Scandinavian middle-aged donor, regularly re-cultivated under strict anaerobic conditions for more than 10 years, to 32 patients. Twenty-two patients (69%) were durably cured. In those patients receiving the transplant by colonoscopy, four out of five were cured. To the best of our knowledge, this is the first time a fecal culture of microbes has retained the possibility for years to cure a substantial number of patients with CDAD.