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Meropenem-Responsive Pandoraea apista Pneumonia Despite High-Level In Vitro Resistance: A Rare Case in an Older
Mohamed Abdelgalil1, Abdalla Diyab1
1Critical Care Medicine, Salma Rehabilitation Hospital, Abu Dhabi, ARE.
Abstract:
Pandoraea apista is a rare, non-fermenting, gram-negative bacillus mainly seen in cystic fibrosis (CF) patients. It is now increasingly being isolated in non-CF patients, mostly those who are critically ill or have multiple comorbidities. We describe a patient with no history of CF who was admitted with hospital-acquired pneumonia. The sputum culture grew P. apista, which was resistant to many antibiotics, including meropenem. Despite the in vitro resistance, the patient improved when kept on meropenem after the culture result was available. This was mostly due to optimized dosing and favorable exposure above the minimum inhibitory concentration. Our case highlights these diagnostic challenges and variable resistance patterns. It also emphasizes the important role of personalized therapy tailored to each patient and their condition.
Insights
Pandoraea apista, a rare bacterium, is increasingly found in non-cystic fibrosis (CF) patients. This case shows successful treatment of P. apista infection with meropenem, despite in vitro resistance, highlighting personalized therapy.
Area of Science:
- Medical microbiology
- Infectious diseases
- Pulmonology
Background:
- Pandoraea apista is a rare, non-fermenting, gram-negative bacillus.
- Primarily associated with cystic fibrosis (CF) patients, it's increasingly isolated in critically ill non-CF patients with comorbidities.
- Hospital-acquired pneumonia is a common severe infection in hospitalized patients.
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