piperacillin--tazobactam-drug-combination and Femoral-Neck-Fractures

Herein we report two cases of infections caused by Tissierella praeacuta and a review of the literature. The first case was a septic pseudarthrosis of the left femur after multiple fractures. Two per-operative samples were positive with T. praeacuta. The patient was successfully treated by piperacillin - tazobactam and metronidazole. The second case was a bacteremia in a patient suffering from pyonephrosis and a hepatic abscess. The treatment was meropenem. No relapses were observed in both cases. Identification of the strains using MALDI-TOF coupled to mass spectrometry (MS) (Beckman coulter, France) was inconclusive in the two cases. Identification by 16S rRNA sequencing was then performed. This bacterium was susceptible to beta-lactams, chloramphenicol, rifampicine and metronidazole.

Topics: Adult; Aged; Anti-Bacterial Agents; Bacteremia; Bacterial Typing Techniques; Femoral Neck Fractures; Femur; Firmicutes; Humans; Liver Abscess; Meropenem; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Polymerase Chain Reaction; Pseudarthrosis; Pyonephrosis; RNA, Ribosomal, 16S; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Thienamycins; Treatment Outcome

Electrolytes imbalance has been reported with the use of several antimicrobials. We report a case of severe hypokalemia secondary to piperacillin/tazobactam in a patient with normal renal function and normal serum potassium level who had presented with a fractured neck of femur. The electrolytes abnormality was corrected once piperacillin/tazobactam was stopped. To our knowledge, this is the first case to describe an early severe hypokalemia induced by piperacillin/ tazobactam therapy in an otherwise healthy individual.

Topics: Aged; Anti-Bacterial Agents; Female; Femoral Neck Fractures; Humans; Hypokalemia; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Respiratory Tract Infections