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

Publication Title

IDCases

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

Infectious Diseases

Specialty

Pharmacy

Specialty

Internal Medicine

DOI

10.1016/j.idcr.2023.e01801

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