Scaglione Vincenzo, Stefanelli Lucia Federica, Mazzitelli Maria, Cattarin Leda, De Giorgi Loreta, Naso Elena, Maraolo Alberto Enrico, Cattelan Annamaria, Nalesso Federico
Infectious and Tropical Diseases Unit, Padua University Hospital, 35128 Padua, Italy.
Nephrology, Dialysis and Transplantation Unit, Padua University Hospital, 35128 Padua, Italy.
Antibiotics (Basel). 2025 Apr 1;14(4):365. doi: 10.3390/antibiotics14040365.
() is a non-fermentative, aerobic, Gram-negative bacillus typically found in environmental sources such as soil and water. Although considered an opportunistic pathogen, it has been implicated in both immunocompromised and immunocompetent individuals. This study presents a case of persistent cathether-related bacteraemia in a 61-year-old haemodialysis patient and offers a systematic literature review of similar cases. The patient, affected by end-stage kidney disease and dependent on a central venous catheter (CVC), presented with septic shock. Blood cultures confirmed , resistant to aminoglycosides but sensitive to cephalosporins, piperacillin/tazobactam, and fluoroquinolones. Despite appropriate antibiotic therapy, bacteraemia persisted, prompting the use of taurolidine lock therapy when catheter removal was initially unfeasible. Blood cultures cleared after nine days, and the catheter was later replaced. A systematic review following PRISMA guidelines identified 21 additional cases of bacteraemia. Most (76.2%) occurred in immunocompromised patients, particularly those with malignancies, chronic haemodialysis, or indwelling devices. Infections in immunocompetent individuals were typically associated with intravenous drug use or environmental exposure. Mortality was approximately 19%. Aminoglycoside resistance was consistent across most cases, while susceptibility to piperacillin/tazobactam, cephalosporins, and carbapenems was generally preserved. Given its resistance profile and ability to form biofilms, D. acidovorans poses a management challenge, particularly in catheter-associated infections. Rapid identification and targeted antimicrobial therapy are crucial. Adjunctive measures such as taurolidine lock therapy can be beneficial when device removal is not immediately possible.
（某菌）是一种非发酵、需氧的革兰氏阴性杆菌，通常存在于土壤和水等环境来源中。尽管被认为是一种机会性病原体，但它已在免疫功能低下和免疫功能正常的个体中均有涉及。本研究报告了一例61岁血液透析患者持续性导管相关菌血症病例，并对类似病例进行了系统的文献综述。该患者患有终末期肾病，依赖中心静脉导管（CVC），出现感染性休克。血培养证实（某菌），对氨基糖苷类耐药，但对头孢菌素、哌拉西林/他唑巴坦和氟喹诺酮敏感。尽管进行了适当的抗生素治疗，菌血症仍持续存在，在最初无法拔除导管时促使使用多粘菌素E甲磺酸钠封管治疗。九天后血培养转阴，导管随后被更换。按照PRISMA指南进行的系统综述又确定了另外21例（某菌）菌血症病例。大多数（76.2%）发生在免疫功能低下的患者中，特别是那些患有恶性肿瘤、慢性血液透析或留置装置的患者。免疫功能正常个体的感染通常与静脉吸毒或环境暴露有关。死亡率约为19%。大多数病例中对氨基糖苷类的耐药性是一致的，而对哌拉西林/他唑巴坦、头孢菌素和碳青霉烯类的敏感性通常得以保留。鉴于其耐药谱和形成生物膜的能力，食酸戴尔福特菌带来了管理挑战，特别是在导管相关感染方面。快速识别和针对性抗菌治疗至关重要。当无法立即拔除装置时，多粘菌素E甲磺酸钠封管治疗等辅助措施可能有益。
