Successful Treatment of Bloodstream Infection Due to Metallo-β-Lactamase-Producing Stenotrophomonas maltophilia in a Renal Transplant Patient

Maria F Mojica; Christopher P Ouellette; Amy Leber; M Brian Becknell; Monica I Ardura; Federico Perez; Masako Shimamura; Robert A Bonomo; Samuel L Aitken; Samuel A Shelburne

doi:10.1128/AAC.00264-16

Successful Treatment of Bloodstream Infection Due to Metallo-β-Lactamase-Producing Stenotrophomonas maltophilia in a Renal Transplant Patient

Antimicrob Agents Chemother. 2016 Aug 22;60(9):5130-4. doi: 10.1128/AAC.00264-16. Print 2016 Sep.

Authors

Affiliations

¹ Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
² Department of Pediatrics, Division of Pediatric Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
³ Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
⁴ Department of Pediatrics, Division of Pediatric Nephrology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
⁵ Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Medical Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA.
⁶ Department of Pediatrics, Division of Pediatric Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA masako.shimamura@nationwidechildrens.org robert.bonomo@va.gov sshelburne@mdanderson.org.
⁷ Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Medical Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA masako.shimamura@nationwidechildrens.org robert.bonomo@va.gov sshelburne@mdanderson.org.
⁸ Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
⁹ Department of Infectious Diseases, Infection Control, and Employee Health, and Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA masako.shimamura@nationwidechildrens.org robert.bonomo@va.gov sshelburne@mdanderson.org.

Abstract

Stenotrophomonas maltophilia is an emerging multidrug-resistant (MDR) opportunistic pathogen for which new antibiotic options are urgently needed. We report our clinical experience treating a 19-year-old renal transplant recipient who developed prolonged bacteremia due to metallo-β-lactamase-producing S. maltophilia refractory to conventional treatment. The infection recurred despite a prolonged course of colistimethate sodium (colistin) but resolved with the use of a novel drug combination with clinical efficacy against the patient's S. maltophilia isolate.

Publication types

Case Reports

MeSH terms

Anti-Bacterial Agents / therapeutic use
Azabicyclo Compounds / therapeutic use*
Aztreonam / therapeutic use*
Bacteremia / drug therapy*
Bacteremia / microbiology
Bacteremia / pathology
Ceftazidime / therapeutic use*
Colistin / therapeutic use
Drug Combinations
Drug Resistance, Multiple, Bacterial
Drug Substitution
Gene Expression
Gram-Negative Bacterial Infections / drug therapy*
Gram-Negative Bacterial Infections / microbiology
Gram-Negative Bacterial Infections / pathology
Humans
Kidney Transplantation*
Male
Polycystic Kidney Diseases / pathology
Polycystic Kidney Diseases / surgery
Stenotrophomonas maltophilia / drug effects*
Stenotrophomonas maltophilia / genetics
Stenotrophomonas maltophilia / growth & development
Stenotrophomonas maltophilia / pathogenicity
Young Adult
beta-Lactamases / genetics
beta-Lactamases / metabolism

Substances

Anti-Bacterial Agents
Azabicyclo Compounds
Drug Combinations
avibactam, ceftazidime drug combination
Ceftazidime
beta-Lactamases
Aztreonam
Colistin

Abstract

Publication types

MeSH terms

Substances

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