Multiresistant Stenotrophomonas maltophilia tunneled CVC-related sepsis, treated with systemic and lock therapy

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Oncology

Background:

• Rising incidence of nosocomial Gram-negative infections poses a significant clinical challenge.
• High antibiotic resistance profiles of common Gram-negative pathogens complicate treatment strategies.
• Multiresistant Gram-negative rods, such as Acinetobacter spp., Pseudomonas aeruginosa, and Burkholderia cepacia, are common causes of severe infections like ventilator-associated pneumonia (VAP).

Observation:

• A case of central venous catheter (CVC)-related Stenotrophomonas maltophilia sepsis in a solid tumor patient is presented.
• The patient had a serious infection requiring immediate and effective intervention to allow continued cancer treatment.
• The presence of a CVC complicated the management of the sepsis, necessitating strategies to preserve its function if possible.

Findings:

• Successful treatment of Stenotrophomonas maltophilia sepsis was achieved using a combination of systemic antibiotic therapy and "lock therapy".
• This dual approach effectively eradicated the infection while preserving the indwelling central venous catheter (CVC).
• The patient was able to continue their essential chemotherapy regimen without interruption due to the CVC salvage.

Implications:

• Combined antibiotic and lock therapy offers a viable strategy for managing CVC-related Stenotrophomonas maltophilia sepsis, particularly in immunocompromised patients.
• Preserving CVC function is crucial for ongoing treatments like chemotherapy, improving patient outcomes and quality of life.
• Robust surveillance of CVCs, adherence to protocols, and good clinical practice are essential for preventing nosocomial infections.