Tropea Fabrizio, Fraulino David, Aeschlimann Jeffrey, LaSala P Rocco, Magano Sonia
University of Connecticut Health Center, Farmington, CT, United States.
University of Connecticut School of Pharmacy, Storrs, CT, United States.
IDCases. 2025 May 7;40:e02248. doi: 10.1016/j.idcr.2025.e02248. eCollection 2025.
is a Gram-negative bacillus that was previously thought to rarely infect humans but recently has been identified as an emerging pathogen in both community and nosocomial settings. Typically found in the environment, this organism has been shown to infect predisposed hosts with an immunocompromised status and/or a prolonged exposure to healthcare settings. Herein, we report a case of a 78-year-old male with newly diagnosed myelodysplastic syndrome initially admitted to the hospital with pneumonia and then re-admitted after discharge with septic shock and evidence of bacteremia isolated from blood cultures. Treatment with piperacillin-tazobactam was initiated and later escalated to dual-therapy with the addition of levofloxacin. After hemodynamic stability was achieved, the patient was discharged on oral levofloxacin to complete a 21-day course of therapy. displays a unique multi-drug resistant profile that often makes initial antimicrobial selection challenging. This case illustrates the importance of early detection and use of in vitro susceptibility testing to guide therapeutic decision-making in infections; a pathogen known to have both high morbidity and mortality particularly in the immunocompromised.
是一种革兰氏阴性杆菌,以前被认为很少感染人类,但最近已被确认为社区和医院环境中的一种新兴病原体。这种微生物通常存在于环境中,已被证明会感染免疫功能低下和/或长期暴露于医疗环境中的易感宿主。在此,我们报告一例78岁男性,新诊断为骨髓增生异常综合征,最初因肺炎入院,出院后因感染性休克再次入院,血培养分离出菌血症证据。开始使用哌拉西林-他唑巴坦治疗,后来升级为联合左氧氟沙星的双联治疗。血流动力学稳定后,患者口服左氧氟沙星出院,完成21天疗程的治疗。表现出独特的多重耐药谱,这常常使初始抗菌药物选择具有挑战性。该病例说明了早期检测和使用体外药敏试验以指导感染治疗决策的重要性;这种病原体已知具有高发病率和死亡率,尤其是在免疫功能低下的患者中。