Development of multidrug-resistant Mycobacterium tuberculosis in the biofilm of a peritoneal-venous shunt

Publication Title

IDCases

Authors

Romany M Redman
Timothy D Maughan, Infectious Diseases Clinic, Providence Sacred Heart Hospital, 101 West 8th Avenue, Spokane, WA 99204, USAFollow
Charles B Smith
Peter F Crossno
Donald L Granger

Document Type

Article

Publication Date

1-1-2023

Keywords

washington; spokane; pshmc; Biofilm; Denver catheter; Foreign body; Multi-drug resistance; Relapse; Tuberculosis

Abstract

A patient with ascites received a peritoneal-venous shunt for presumed cirrhosis, however surgical specimens grew Mycobacterium tuberculosis (MTb) sensitive to all anti-tuberculous drugs. Directly-Observed-Therapy (DOT) led to improvement followed by relapse with multidrug resistant MTb (MDRTB). We discuss pathways for selection of MDRTB within mycobacterial biofilm. This case illustrates the potential for development of MDRTB in patients with long-term indwelling catheters. We emphasize catheter removal and if not possible continuing follow-up for symptoms and signs of relapse.

Specialty/Research Institute

Infectious Diseases

Specialty/Research Institute

Pharmacy

Specialty/Research Institute

Internal Medicine

DOI

10.1016/j.idcr.2023.e01801