Treatment of a septic shock due to multiresistant Acinetobacter baumannii with tigecycline in combination

We report a case of pulmonary and bloodstream infection due to multiresistant Acinetobacter baumannii six days after a severe trauma. Clinical condition transiently improved following antimicrobial treatment with ticarcillin-clavulanate and rifampicin. However, a septic shock developed on the fourth day due to the emergence of a strain only sensible to cotrimoxazole, colistin and tigecycline. Cure was achieved after a two week treatment with piperacillin-tazobactam, cotrimoxazole and tigecycline. This case shows that combined antimicrobial therapy including tigecycline can be relevant in some severe pulmonary infections due to multiresistant A. baumannii. (C) 2007 Elsevier Masson SAS. Tous droits reserves.