Cefiderocol for the Treatment of Nosocomial Bloodstream Infections Caused by Stenotrophomonas maltophilia: A Case Series and Literature Review.

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES
Infectious Diseases and Therapy Pub Date : 2025-03-01 Epub Date: 2025-03-04 DOI:10.1007/s40121-025-01117-2
Antonio Vena, Laura Mezzogori, Nadia Castaldo, Silvia Corcione, Renato Pascale, Maddalena Giannella, Simone Mornese Pinna, Daniele Roberto Giacobbe, Davide Fiore Bavaro, Vincenzo Scaglione, Benedetta Fumarola, Gabriele Pagani, Francesco Giuseppe De Rosa, Michele Bartoletti, Matteo Bassetti
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引用次数: 0

Abstract

Introduction: The treatment of Stenotrophomonas maltophilia bloodstream infections (BSI) remains challenging due to the organism's intrinsic multidrug resistance and the potential side effects of commonly used first-line antibiotics.

Methods: Here, we describe four cases of S. maltophilia BSI treated with cefiderocol (≥ 72 h) in different Italian hospitals. Additionally, we conducted a PubMed search to identify other studies reporting cases of S. maltophilia BSI managed with cefiderocol.

Results: We reviewed a total of 8 cases of S. maltophilia BSI [median age 52.5 years (Q1-Q3 27.5-61.0), 50% males] treated with cefiderocol, including ours. BSI sources were mainly central venous catheters (62.5%) and the lower respiratory tract (25.0%). Cefiderocol was used as first-line therapy in 87.5% of patients (7/8), with a median treatment duration of 14 days (IQR 6.2-16.0). Combination therapy was administered in 62.5% of cases. Infection source control was required in 75.0% and achieved in 40.0%. Clinical success was observed in 62.5% of patients, with microbiological eradication in 87.5%. In-hospital mortality occurred in 37.5% of cases, with one death directly attributable to S. maltophilia. No significant differences were observed in terms of outcomes between cefiderocol monotherapy and combination therapy.

Conclusions: Based on our findings and a review of the literature, cefiderocol-based regimens show promise as an effective treatment option for S. maltophilia BSI, warranting further investigation in larger studies.

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来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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