Infection with an Extended-Spectrum β-Lactamase-Producing Strain of Serratia marcescens following Tongue Reconstruction

Author:

Dhawan Benu1,Bonnet Richard2,Shukla N. K.3,Mathur Purva1,Das Bimal K.1,Kapil Arti1

Affiliation:

1. Department of Microbiology

2. Faculté de Médecine, Service de Bactériologie-Virologie, 63001 Clermont-Ferrand Cedex, France

3. Department of Surgical Oncology, Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi-29, India

Abstract

ABSTRACT We report a case of postsurgical wound infection of polymicrobial etiology caused by Serratia marcescens and Pseudomonas aeruginosa following the use of a radial forearm free flap for oncological tongue reconstruction. S. marcescens was a producer of SHV-12 extended-spectrum β-lactamase (ESBL). This is the first report from India of this ESBL. S. marcescens and P. aeruginosa were resistant to the empirical perioperative antibiotics administered. Delay in the recognition of the type of infection and in the institution of appropriate therapy resulted in total loss of the free flap.

Publisher

American Society for Microbiology

Subject

Microbiology (medical)

Reference11 articles.

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3. Johnson, J. T., R. L. Wagner, D. E. Schuller, J. Gluckman, J. Y. Suen, and N. L. Snyderman. 1992. Prophylactic antibiotics for head and neck surgery with flap reconstruction. Arch. Otolaryngol. Head Neck Surg.118:488-490.

4. Johnson, J. T., V. L. Yu, E. N. Myers, and R. L. Wagner. 1987. An assessment of the need for gram-negative bacterial coverage in antibiotic prophylaxis for oncologic head and neck surgery. J. Infect. Dis.155:331-333.

5. Karim, A., L. Poirel, S. Nagarajan, and P. Nordmann. 2001. Plasmid-mediated extended-spectrum beta-lactamase (CTX-M-3 like) from India and gene association with insertion sequence ISEcp1. FEMS Microbiol. Lett.201:237-241.

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