Delftia Acidovorans Sepsis In An Immunodeficient Child With Congenital Heart Disease

Yıl 2020, Cilt: 8 Sayı: 2, 46 - 49, 31.08.2020

Kübra Ertan , Resul Yılmaz

Öz

Delftia acidovorans is an aerobic, non-fermented Gram-negative bacillus. After PDA ligation and pulmonary banding operation, a 4-month-old female patient who was followed up in the cardiovascular surgery intensive care unit had a general status deterioration and fever on the 22nd postoperative day. Blood cultures were taken from the patient who was evaluated as nosocomial sepsis, and K. Pneumonia and D. Acidovorans were detected in the blood culture of the patient who was given cefepime treatment for 5 days. Colistin and meropenem treatment was started with the diagnosis of septicemia due to K. Pneumonia and D. Acidovorans. Despite the use of multiple antibiotherapy, since resistant microorganism growth was detected, immunological examinations were performed and intravenous immunoglobulin treatment was given due to immune deficiency, but the patient died on the 33rd day of follow-up. Since there is no case of D. Acidovorans-associated bacteremia in pediatric immunodeficiency patients in the literature, a case of D. Acidovorans-associated nosocomial sepsis developed in an immunocompromised pediatric patient after pulmonary banding and PDA ligation is presented.

Anahtar Kelimeler

Delftia acidovorans, immunocompromised host, child, sepsis, congenital heart disease

İmmün Yetmezliği ve Konjenital Kalp Hastalığı Olan Çocukta Delftia Acidovorans Sepsisi

Öz

Delftia acidovorans aerobik, non-fermente bir Gram-negatif basildir. PDA ligasyonu ve pulmoner banding operasyonu sonrasında kardiyovasküler cerrahi yoğun bakım ünitesinde takip edilen 4 aylık kız hastanın postoperatif 22. gününde genel durum bozukluğu ve ateşi mevcuttu. Nozokomial sepsis lehine değerlendirilen hastadan kan kültürleri gönderilmiş, 5 gün süre ile sefepim tedavisi verilen hastanın kan kültüründe K. Pneumonia ve D. Acidovorans üremesi saptanmıştır. K. Pneumonia ve D. Acidovorans’a bağlı septisemi tanısıyla kolistin ve meropenem tedavisine geçilmiştir. Çoklu antibiyoterapi kullanımına rağmen dirençli mikroorganizma üremeleri saptandığı için immünolojik tetkikleri yapılmış, intravenöz immunglobulin tedavisi verilmiştir, ancak hasta takibinin 33. gününde kaybedilmiştir. Literatürde pediatrik immun yetmezlik hastalarında D. Acidovorans ilişkili bakteriyemi olgusu bildirilmediğinden, pulmoner banding ve PDA ligasyonu sonrasında immün yetmezlikli pediatrik bir hastada gelişen D. Acidovorans ilişkili nozokomiyal sepsis olgusu sunulmuştur.

Anahtar Kelimeler

Delftia acidovorans, immün sistemi baskılanmış konak, çocuk, sepsis, konjenital kalp hastalığı

Kaynakça

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