Family Practice and Palliative Care (Apr 2018)
Applying local vancomycin with vacuum-assisted closure on decubitus isolated Corynebacterium striatum: a case report
Abstract
Introduction: The infections of decubitus are generally polymicrobial. infection.After debridement and control ofinfection, decubitus treatment continues with regeneration of tissue loss.Vacuum assisted closing (VAC) is a treatment option in these situations. Weaimed to reveal local antibiotic treatment of decubitus infection with C.Striatum which was resistant to first generation antibiotics, with vancomycininstillated in VAC device, in this case.Case Presentation: 77 years old patient with Alzheimer, Parkinson and diabetes mellitusresidented in was hospitalized in palliative care unit for decubitus andnutrition disorder. Decubitus with necrosis was present in sacral region. The Ampirical antibiotherapy withciprofloxacin for decubitus infection was given to the patient whosehematologic parameters detected during hospitalization were normal. VACapplication was performed after debridement of necrotic tissues. C. Striatumresistant to first generation antibiotics was identified in wound culture.Contamination was suspected cause the patient’s general status was good,inflamation marker levels were moderate and C. Striatumun is existing in normalskin flora. Ciprofloxacin was stopped as C. Striatum was isolated again in theculture taken from the middle of wound and was determined sensitive to linezoidand vancomycin and resistant to other antibiotics. Treatment was continued with vancomycinadded to VAC device. No bacteria was detected in control cultures. Conclusion: Decubitus wound infections are generally polymicrobial and treated withsystemic or local treatments. Multiresistant C. Striatum reproduction as in this case is usually isolated inimmunosupressive patients with long hospitalization period, patients usingprolonged large spectrum antibiotics and in intensive care units. It waspresented with this case that successfull resuIts could be achieved by local performing of advanced antibioticthat the microorganism is sensitive in the treatment of seconder infectiondeveloped in decubitus ulcer of the patient who had no sepsis signs.
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