Applying local vancomycin with vacuum-assisted closure on decubitus isolated Corynebacterium striatum: a case report

• Main Authors: Ali Ramazan Benli, Didem Adahan
• Format: Article
• Language: English
• Published: SERNEV 2018-04-01
• Series: Family Practice and Palliative Care
• Subjects: decubitus; corynebacterium striatum; local treatment; vancomycin; negative-pressure wound therapy; dekübit ülseri; lokal tedavi; vankomisin; negatif basınçlı yara tedavisi
• Online Access: https://dergipark.org.tr/en/pub/fppc/issue/36461/338928

Introduction:  The infections of decubitus are generally polymicrobial. infection. After  debridement and control of infection, decubitus treatment continues with regeneration of tissue loss. Vacuum assisted closing (VAC) is a treatment option in these situations. We aimed to reveal local antibiotic treatment of decubitus infection with C. Striatum which was resistant to first generation antibiotics, with vancomycin instillated in VAC device, in this case.Case Presentation:  77 years old patient with Alzheimer, Parkinson and diabetes mellitus residented in was hospitalized in palliative care unit for decubitus and nutrition disorder. Decubitus with necrosis was present in sacral region.  The Ampirical antibiotherapy with ciprofloxacin for decubitus infection was given to the patient whose hematologic parameters detected during hospitalization were normal. VAC application was performed after debridement of necrotic tissues. C. Striatum resistant 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 normal skin flora. Ciprofloxacin was stopped as C. Striatum was isolated again in the culture taken from the middle of wound and was determined sensitive to linezoid and vancomycin and resistant to other antibiotics.   Treatment was continued with vancomycin added to VAC device. No bacteria was detected in control cultures. Conclusion:  Decubitus wound infections are generally polymicrobial and treated with systemic or local treatments.  Multi resistant C. Striatum reproduction as in this case is usually isolated in immunosupressive patients with long hospitalization period, patients using prolonged large spectrum antibiotics and in intensive care units. It was presented with this case that successfull resuIts could be achieved  by local performing of advanced antibiotic that the microorganism is sensitive in the treatment of seconder infection developed in decubitus ulcer of the patient who had no sepsis signs.