Table 1.
Clinical milestones during patient treatment in Ecuador. Antibiotic treatment was initiated according to the Hospital de los Valles scheme of susceptibility. Acinetobacter baumannii infection started on day 15 after hospitalization (bold)
| Historical record | Date | Clinical manifestations | Location | Antibiotic treatment | Comments |
|---|---|---|---|---|---|
| Day 1 | 15 May | Psychomotor agitation with deterioration of the state of consciousness | Airport, Emergency room, ICU |
Diagnosis of ischaemic stroke requiring mechanical ventilation, tracheostomy and gastrostomy | |
| Day 3 | 17 May | Suspected diagnosis of ventilator-associated pneumonia (VAP). Empirical antibiotic treatment initiated | ICU | Ampicillin/sulbactam (3 g i.v. every 6 h) | Tracheal aspirate and blood samples sent to laboratory |
| Day 7 | 21 May | Serratia marcescens isolated from tracheal aspirate culture | ICU | Piperacillin/tazobactam (4.5 g i.v. every 6 h) | |
| Day 12 | 26 May |
Pseudomonas aeruginosa isolated from blood culture. Same antibiotic regimen |
ICU | Piperacillin/tazobactam (4.5 g i.v. every 6 h) | |
| Day 15 | 29 May | The patient developed fever (37.9°C), white blood cells = 11,400 cells/μL, procalcitonin = 0.48 ng/mL (ascending) | ICU | Meropenem (1 g i.v. every 8 h) | Peripheral, central venous catheter, catheter tip, blood and urine samples sent to laboratory |
| Day 18 | 1 June | A. baumannii isolated from blood samples | ICU | Meropenem (1 g i.v. every 8 h) Colistin (100 mg i.v. every 8 h) |
Absence of urinary or respiratory reinfections |
| Day 27 | 10 June | Patient's clinical condition improved | Meropenem (1 g i.v. every 8 h) Colistin (100 mg i.v. every 8 h) |
Patient transferred to London |