Tailoring antimicrobials in febrile neutropenia: using faster diagnostic and communication tools to improve treatment in the era of extensively resistant pathogens
Braz. j. infect. dis; 22 (3), 2018
Publication year: 2018
ABSTRACT Febrile Neutropenia represents a medical emergency and the use of appropriate antimicrobial therapy is essential for a better outcome. Although being time-consuming, conventional cultures and antimicrobial susceptibility tests remain the golden standard practices for microbiology identification. Final reports are typically available within several days. Faster diagnostic tools, such as species identification trough Matrix Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) and molecular techniques might help to shorten time to diagnostic and also guide definitive therapy in this scenario. Here we present a case in which the use of a diagnostic molecular workflow combining MALDI-TOF and real-time PCR for relevant genes codifying antibiotic resistant integrated with instant communication report, led to a tailored and more appropriate treatment in a patient presenting with febrile neutropenia.
Compuestos de Azabiciclo/administración & dosificación, Ceftazidima/administración & dosificación, Combinación de Medicamentos, Farmacorresistencia Bacteriana Múltiple, Neutropenia Febril/tratamiento farmacológico, Neutropenia Febril/microbiología, Klebsiella pneumoniae/efectos de los fármacos, Klebsiella pneumoniae/aislamiento & purificación, Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones, Reacción en Cadena de la Polimerasa de Transcriptasa Inversa, Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción, Inhibidores de beta-Lactamasas/administración & dosificación