Abstract：
OBJECTIVE: Fracture-related infections (FRI) pose a difficult management problem, as they require numerous surgical interventions and extended antibiotic treatments, especially when a multidrug-resistant organism is involved, with a paucity of available literature that provides guidance.
RESULTS: A 42 year-old male presents an open diaphyseal tibia and fibula fracture, complicated by soft tissue necrosis and infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-Ab). Initially treated with a damage control external fixator, the patient underwent multiple surgical procedures, including radical debridement, negative pressure wound therapy, external fixator revisions and reconstructive surgery using a latissimus dorsi free flap. The emergence of colistin resistance in the Acinetobacter baumannii strain led to the compassionate use of cefiderocol, finally achieving clinical cure.
CONCLUSIONS: This case report is one of the firsts that highlights the potential efficacy of cefiderocol in treating challenging bone and joint infections sustained by XDR-Ab. The successful outcome also emphasizes the importance of a comprehensive, multidisciplinary approach in achieving favorable results in complex FRI.
RESULTS: A 42 year-old male presents an open diaphyseal tibia and fibula fracture, complicated by soft tissue necrosis and infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-Ab). Initially treated with a damage control external fixator, the patient underwent multiple surgical procedures, including radical debridement, negative pressure wound therapy, external fixator revisions and reconstructive surgery using a latissimus dorsi free flap. The emergence of colistin resistance in the Acinetobacter baumannii strain led to the compassionate use of cefiderocol, finally achieving clinical cure.
CONCLUSIONS: This case report is one of the firsts that highlights the potential efficacy of cefiderocol in treating challenging bone and joint infections sustained by XDR-Ab. The successful outcome also emphasizes the importance of a comprehensive, multidisciplinary approach in achieving favorable results in complex FRI.
摘要：
目的：骨折相关感染（FRI）是一个管理困难的问题，因为它们需要大量的外科手术和长期的抗生素治疗，尤其是当涉及多重耐药生物时，缺乏提供指导的可用文献。
结果：一名42岁男性表现为胫骨和腓骨开放性骨干骨折，由广泛耐药鲍曼不动杆菌（XDR-Ab）引起的软组织坏死和感染。最初用损伤控制外固定器治疗，病人接受了多次手术,包括彻底清创术,负压伤口治疗,使用背阔肌游离皮瓣进行外固定器修正和重建手术。鲍曼不动杆菌菌株中粘菌素耐药性的出现导致了对头孢地洛的同情使用，最终实现临床治愈。
结论：本病例报告是首次强调头孢地洛治疗XDR-Ab引起的具有挑战性的骨和关节感染的潜在疗效的病例之一。成功的结果还强调了全面，在复杂的FRI中取得良好成果的多学科方法。
结果：一名42岁男性表现为胫骨和腓骨开放性骨干骨折，由广泛耐药鲍曼不动杆菌（XDR-Ab）引起的软组织坏死和感染。最初用损伤控制外固定器治疗，病人接受了多次手术,包括彻底清创术,负压伤口治疗,使用背阔肌游离皮瓣进行外固定器修正和重建手术。鲍曼不动杆菌菌株中粘菌素耐药性的出现导致了对头孢地洛的同情使用，最终实现临床治愈。
结论：本病例报告是首次强调头孢地洛治疗XDR-Ab引起的具有挑战性的骨和关节感染的潜在疗效的病例之一。成功的结果还强调了全面，在复杂的FRI中取得良好成果的多学科方法。
