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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 12, Issue.: 8

Case Study

Multidrug-resistant Bacteroides fragilis Isolated from a Case of Pyopneumothorax


B. G. Viswanath1*, G. Jyothi Lakshmi1, K. Nagamani1 and Abhijeet M. Dashetwar2

1Department of Microbiology, Gandhi Medical College & Hospital, Secunderabad, Telangana, India.

2Department of Cardiothoracic Surgery, Gandhi Medical College & Hospital, Secunderabad, Telangana, India.

Article Information
(1) Faris Q. B. Alenzi, Department of Medical Laboratories, College of Applied Medical Sciences Salman bin Abdulaziz University (Al-Kharj), Saudi Arabia.
(1) Ana Cláudia Correia Coelho, University of Trás-os-Montes and Alto Douro, Portugal.
(2) Anonymous, Nagoya City University, Japan.
(3) Ronald Bartzatt, University of Nebraska, USA.
Complete Peer review History: http://sciencedomain.org/review-history/12467


Aim: The aim of this case report is to present an unusual case of multidrug- resistant Bacteroides fragilis from a patient with pyopneumothorax who had a blunt injury to the thorax and got admitted in a tertiary care hospital, South India.

Presentation of Case: The patient developed pyopneumothorax after a blunt injury and on admission was treated empirically with piperacillin-tazobactam and metronidazole. Following antibiotic sensitivity testing the B. fragilis strain isolated showed multidrug resistance including metronidazole. Imipenem was initiated replacing empiric therapy with a successful clinical outcome.

Discussion: Bacteroides species are obligate anaerobic bacteria that are usually found in the gastrointestinal tract of the human body. Bacteroides species are the most commonly isolated anaerobic organisms from intra-abdominal lesions and rarely from intrathoracic disease conditions like pyopneumothorax. Pyopneumothorax caused by Bacteroides species is associated with high treatment failure and mortality rates in antibiotic-resistant cases. Though metronidazole is the mainstay of treating anaerobic infections, attention has to be given to the possibility of multidrug resistance when treating critical diseases.

Conclusion: This case report summarizes the multidrug- resistance in Bacteroides fragilis strain isolated from a case of pyopneumothorax. The situation calls attention to the possibility of multidrug-resistance being underestimated when given as empirical therapy and institution of appropriate and timely antibiotic policy measures to prevent mortality.

Keywords :

Pyopneumothorax; Bacteroides fragilis; multidrug-resistance.

Full Article - PDF    Page 1-6

DOI : 10.9734/BJMMR/2016/22648

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