Evolving antimicrobial resistance in a patient receiving palliative OPAT for a vascular graft infection: a case report

Irvine, J. W.D., Chapman, A. L.N., Lopez, C. V., Reid, K., Spittal, M., McCormick, S. and Dundas, S. (2019) Evolving antimicrobial resistance in a patient receiving palliative OPAT for a vascular graft infection: a case report. Clinical Infection in Practice, 1, 100002. (doi: 10.1016/j.clinpr.2019.100002)

Abstract

Prosthetic vascular graft infection is devastating and frequently fatal. Cure requires removal of the graft and reperfusion by placement of a new graft. However, no evidence based guidelines exist for management where removal of the graft is not possible. We describe a patient who lived in a state of chronic infection suppression through outpatient parenteral antimicrobial therapy (OPAT) over a period of 32 months, and outline the challenges experienced and strategies used to suppress infection in the face of escalating antimicrobial resistance. To date there have been very few reports of OPAT used in the palliative context and this case illustrates the microbiological issues that can arise and the importance of the full OPAT multi-disciplinary team in managing these issues and optimising the patient's quality and length of life.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Chapman, Dr Ann
• Authors: Irvine, J. W.D., Chapman, A. L.N., Lopez, C. V., Reid, K., Spittal, M., McCormick, S., and Dundas, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Clinical Infection in Practice
• Publisher: Elsevier
• ISSN: 2590-1702
• ISSN (Online): 2590-1702
• Published Online: 09 October 2019
• Copyright Holders: Copyright © 2019 The Authors
• First Published: First published in Clinical Infection in Practice 1:100002
• Publisher Policy: Reproduced under a Creative Commons License