Gert van der Hoek
In Memoriam - Editor, Senior Moderator
Sweden reports a patient with antibiotic resistant Q-fever
may 14, 2012
Sweden reports a patient with antibiotic resistant Q-fever.
The first choice antibiotic for most Q-fever patients is doxycycline, which has to be adminstrated during many months, up to 2 years.
Fortunately antibiotic resistance is very rare, however this is something to watch.
Probably the patient was infected in Southeast Europe.
In the end the Swedish patient died, after autopsy the PCR test for the Q-fever bacteria was negative. However this is not unusual with chronic Q-fever patients.
computer translation
PCR postitivitet in flap vascular grafts and unusual resistance to doxycycklin
Because of failure of highly persistent fever (> 1 year), rising splenomegaly, rising liver function tests and progressive signs of infection around the flap kärlgraftet the aorta with the onset of lung involvement, an extensive re-operation in autumn 2011.
Excised tissue was sent for diagnosis of SMI and to a reference laboratory in Marseille. PCR for Coxiella burnetii precipitated positive at the SMI and the reference laboratory in Marseille.
In the latter laboratory also succeeded in cultivating and determine the resistant strain of doxycycline, which is the most well-documented treatment option. MIC of doxycycline was 8 mg / L, which was previously only reported in one subject in the world and carries high risk of treatment failure.
Despite continued treatment with high-dose doxycycline and chloroquine plus ciprofloxacin when MICs obtained, the patient died 6 months postoperatively after a course with multiple complications. PCR from autopsy material precipitated, however, negative for Coxiella burnetii.
/ Ulrika Stylish-Martin, Infectious Diseases, Sahlgrenska University Hospital, Gothenburg
More: http://www.smittskyddsinstitutet.se/nyhetsarkiv/2012/ovanlig-form-av-q-feber-i-sverige/
may 14, 2012
Sweden reports a patient with antibiotic resistant Q-fever.
The first choice antibiotic for most Q-fever patients is doxycycline, which has to be adminstrated during many months, up to 2 years.
Fortunately antibiotic resistance is very rare, however this is something to watch.
Probably the patient was infected in Southeast Europe.
In the end the Swedish patient died, after autopsy the PCR test for the Q-fever bacteria was negative. However this is not unusual with chronic Q-fever patients.
computer translation
PCR postitivitet in flap vascular grafts and unusual resistance to doxycycklin
Because of failure of highly persistent fever (> 1 year), rising splenomegaly, rising liver function tests and progressive signs of infection around the flap kärlgraftet the aorta with the onset of lung involvement, an extensive re-operation in autumn 2011.
Excised tissue was sent for diagnosis of SMI and to a reference laboratory in Marseille. PCR for Coxiella burnetii precipitated positive at the SMI and the reference laboratory in Marseille.
In the latter laboratory also succeeded in cultivating and determine the resistant strain of doxycycline, which is the most well-documented treatment option. MIC of doxycycline was 8 mg / L, which was previously only reported in one subject in the world and carries high risk of treatment failure.
Despite continued treatment with high-dose doxycycline and chloroquine plus ciprofloxacin when MICs obtained, the patient died 6 months postoperatively after a course with multiple complications. PCR from autopsy material precipitated, however, negative for Coxiella burnetii.
/ Ulrika Stylish-Martin, Infectious Diseases, Sahlgrenska University Hospital, Gothenburg
More: http://www.smittskyddsinstitutet.se/nyhetsarkiv/2012/ovanlig-form-av-q-feber-i-sverige/