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dc.contributor.authorMusil, Ian
dc.contributor.authorJensen, Vanessa
dc.contributor.authorSchilling, Jolyon
dc.contributor.authorAshdown, Boyd
dc.contributor.authorKent, Tyler
dc.date.accessioned2016-05-20T09:00:36Z
dc.date.available2016-05-20T09:00:36Z
dc.date.issued2010en
dc.identifier.citationMusil et al. Journal of Medical Case Reports 2010, 4:131 http://www.jmedicalcasereports.com/content/4/1/131en
dc.identifier.doi10.1186/1752-1947-4-131en
dc.identifier.urihttp://hdl.handle.net/10150/610188
dc.description.abstractINTRODUCTION:Enterobacter cloacae infections are common among burn victims, immunocompromised patients, and patients with malignancy. Most commonly these infections are manifested as nosocomial urinary tract or pulmonary infections. Nosocomial outbreaks have also been associated with colonization of certain surgical equipment and operative cleaning solutions. Infections of an aortobifemoral prosthesis, an aortic graft, and arteriovenous fistulae are noted in the literature. To our knowledge, this is the first isolated account of an E. cloacae infection of a femoral-popliteal expanded polytetrafluoroethylene bypass graft.CASE PRESENTATION:A 68-year-old Caucasian man presented with fever and rest pain in the right lower extremity five months after the placement of a vascular expanded polytetrafluoroethylene graft for femoral-popliteal bypass. Computed tomography angiography demonstrated peri-graft fluid that was aspirated percutaneously with image guidance and cultured to reveal E. cloacae. The graft was revised and then removed. The patient completed a six-week course of ceftazidime and is currently without signs of infection. There were no other reports of E. cloacae graft infections in any patients receiving treatment in the same surgical suite within a month of this report.CONCLUSION:Isolated cases of E. cloacae infection of surgical bypass grafts are rare (unique in this setting). Clinicians should have a high index of suspicion for device contamination in such cases and should consider testing for possible microbial reservoirs. Graft removal is required due to the formation of biofilm and the recent emergence of Enterobacteriaceae producing extended-spectrum beta-lactamase in community acquired infections.
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.jmedicalcasereports.com/content/4/1/131en
dc.rights© 2010 Musil et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.titleEnterobacter cloacae infection of an expanded polytetrafluoroethylene femoral-popliteal bypass graft: a case reporten
dc.typeArticleen
dc.identifier.eissn1752-1947en
dc.contributor.departmentCollege of Medicine, University of Arizona, 1501 N Campbell Avenue, Tucson AZ 85724, USAen
dc.contributor.departmentDepartment of Surgery, University of Arizona, 1501 N. Campbell Avenue, PO Box 245066 Tucson, Arizona 85724-5066, USAen
dc.contributor.departmentTucson Hospitals Medical Education Program, 1501 N. Campbell Avenue, PO Box 245066, Tucson, Arizona 85724-5066, USAen
dc.identifier.journalJournal of Medical Case Reportsen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
refterms.dateFOA2018-06-24T00:27:26Z
html.description.abstractINTRODUCTION:Enterobacter cloacae infections are common among burn victims, immunocompromised patients, and patients with malignancy. Most commonly these infections are manifested as nosocomial urinary tract or pulmonary infections. Nosocomial outbreaks have also been associated with colonization of certain surgical equipment and operative cleaning solutions. Infections of an aortobifemoral prosthesis, an aortic graft, and arteriovenous fistulae are noted in the literature. To our knowledge, this is the first isolated account of an E. cloacae infection of a femoral-popliteal expanded polytetrafluoroethylene bypass graft.CASE PRESENTATION:A 68-year-old Caucasian man presented with fever and rest pain in the right lower extremity five months after the placement of a vascular expanded polytetrafluoroethylene graft for femoral-popliteal bypass. Computed tomography angiography demonstrated peri-graft fluid that was aspirated percutaneously with image guidance and cultured to reveal E. cloacae. The graft was revised and then removed. The patient completed a six-week course of ceftazidime and is currently without signs of infection. There were no other reports of E. cloacae graft infections in any patients receiving treatment in the same surgical suite within a month of this report.CONCLUSION:Isolated cases of E. cloacae infection of surgical bypass grafts are rare (unique in this setting). Clinicians should have a high index of suspicion for device contamination in such cases and should consider testing for possible microbial reservoirs. Graft removal is required due to the formation of biofilm and the recent emergence of Enterobacteriaceae producing extended-spectrum beta-lactamase in community acquired infections.


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