Abstract
Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infections are rare but associated with very high mortality rates. We report the case of a 14-year-old patient with Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus infection and Influenza B pneumonia requiring veno-arterial extra-corporeal membrane oxygenator for refractory shock. In the absence of response to conventional therapy, we have inserted a Cytosorb® cartridge within the extra-corporeal membrane oxygenator circuit. A spectacular decrease in vasopressor requirements followed. Since clindamycin, a key component of Panton-Valentine leucocidin producing methicillin-resistant Staphylococcus aureus treatment, might be removed by Cytosorb® hemoadsorption, we have performed serial plasma concentrations measurements of the drug. Based on these measurements, we were able to develop a pharmacokinetic model incorporating variable plasma clearance. Patient's exposure was estimated before, during and after Cytosorb® hemoadsorption. According to this model, Cytosorb® hemoadsorption did not seem to result in significant clindamycin removal. Cytosorb® hemoadsorption during Panton-Valentine leucocidin producing methicilli...Continue Reading
References
Oct 19, 1999·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·G LinaJ Etienne
Mar 13, 2002·Lancet·Yves GilletJerome Etienne
Sep 16, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Robin L TrotmanWilliam L Salzer
Dec 28, 2006·The Journal of Infectious Diseases·Dennis L StevensAmy E Bryant
Jan 15, 2010·PLoS Pathogens·Bettina LöfflerGeorg Peters
Mar 17, 2010·Proceedings of the National Academy of Sciences of the United States of America·Binh An DiepHenry F Chambers
Jun 2, 2015·The Journal of Infection·Claire E Turner, Shiranee Sriskandan
Jul 21, 2016·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·N J LeesA F Popov
Jan 28, 2017·Journal of Intensive Care·Sascha DavidJan T Kielstein
Feb 1, 2017·Antimicrobial Agents and Chemotherapy·Michael J SmithUNKNOWN Best Pharmaceuticals for Children Act—Pediatric Trials Network Steering Committee
Aug 1, 2015·Journal of the Intensive Care Society·Craig MorrisMarco Giovannelli
Jan 26, 2018·PloS One·Maryann C GrudaPhillip P Chan
May 8, 2018·Intensive Care Medicine Experimental·Benjamin MalardJohn A Kellum
Nov 18, 2018·Intensive Care Medicine·Elettra C PoliAntoine G Schneider
Citations
Apr 29, 2020·The International Journal of Artificial Organs·Thomas DimskiDetlef Kindgen-Milles
May 16, 2019·Annals of Intensive Care·Patrick M HonoreLui G Forni
Mar 10, 2021·Artificial Organs·Anna Mara ScandroglioFederico Pappalardo
May 20, 2021·Scientific Reports·Antoine G SchneiderDetlef Kindgen-Milles
Dec 1, 2021·Clinical Pharmacokinetics·Samuel DubinskyAndrea Edginton