Multiresistant Stenotrophomonas maltophilia Tunneled CVC-Related Sepsis, Treated with Systemic and Lock Therapy

Abstract

In the last decade, a remarkable increase in the incidence of nosocomial Gram-negative infections has been observed. These pathogens represent a substantial problem in clinical practice, due to the high resistance profile of most commonly used antibiotics. This phenomenon is surely a co-factor that exposes these susceptible patients to infections caused by selected pathogens like multiresistant Gram-negative rods. A typical example is represented by VAP (ventilator- associated pneumonia) sustained by Acinetobacter spp.Pseudomonas aeruginosa Bulkolderia cepacia. The Authors describe a case of a central venous cather (CVC)-related Stenotrophomonas maltophilia sepsis in a patient affected by solid tumor, successfully treated with systemic antibiotic therapy associated with “lock therapy”. This combination was able to cure the infection, allowing the patient to continue chemotherapy and saving the in situ CVC. The surveillance of CVCs, good adherence to the protocols and guidelines and “good practice” are the cornerstones for the prevention of nosocomial infections.

Keywords:

• Stenotrophomonas maltophilia
• sepsis
• lock therapy
• fluoroquinolones
• Gram-negative bacterial infection