Stent-associated urosepsis, personalized bacteriophage therapy

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Abstract

In the era of antibiotic resistance, strict control of foci of infection (for example, a long-term stent) and adherence to the timing of drainage removal are necessary.

The spread of pan-resistant pathogens requires the development of effective alternative antimicrobial measures, in particular, bacteriophage therapy.

A clinical case of a 42-year-old patient with a closed spinal cord injury, lower paraplegia, pelvic organs dysfunction, post-traumatic right ureteral stricture, and right kidney stones is presented in the article.

The patient developed stent-associated urosepsis due to pan-resistant Klebsiella pneumonia after endoscopic removal of a long-term right ureteral stent (over 3 months) with endotoxic shock, disseminated intravascular coagulation syndrome and wound sepsis, which was treated using personalized local bacteriophage therapy.

About the authors

T. S. Perepanova

N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center

Author for correspondence.
Email: perepanova2003@mail.ru

PhD, MD, Professor, Head of Infectious and Inflammatory Diseases and Clinical Pharmacology Panel of the Department of General and Reconstructive Urology

Russian Federation, Moscow

A. V. Kazachenko

N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center

Email: avknii@mail.ru
ORCID iD: 0000-0003-3198-5933

PhD, MD, Deputy Director of Clinical Work

Russian Federation, Moscow

S. A. Mesropyan

N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center

Email: perepanova2003@mail.ru

Acting Head of the Department of Anesthesiology and Resuscitation

Russian Federation, Moscow

V. E. Antonova

N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center

Email: perepanova2003@mail.ru

PhD, Head of the Transfusiology Department

Russian Federation, Moscow

M. R. Nazirov

N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center

Email: nazirov84@mail.ru

Head of the Clinical and Diagnostic Laboratory

Russian Federation, Moscow

Yu. A. Malova

N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center

Email: perepanova2003@mail.ru

Specialist of Organizational and Methodological Department

Russian Federation, Moscow

L. N. Lyubchenko

N.A. Lopatkin Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center

Email: perepanova2003@mail.ru

PhD, MD, Professor, Head of the Department of Molecular Genetics and Cellular Technologies

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Disturbance of microcirculation of extremities: A - both feet and B - both hands and arms

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3. Fig. 2. Necrosis of the patient's toes (60 days of hospital stay)

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4. Fig. 3. Fingers and hands of the patient were saved (60 days of hospital stay)

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