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
{"title":"Cefiderocol for the Treatment of Nosocomial Bloodstream Infections Caused by Stenotrophomonas maltophilia: A Case Series and Literature Review.","authors":"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","doi":"10.1007/s40121-025-01117-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":13592,"journal":{"name":"Infectious Diseases and Therapy","volume":" ","pages":"657-669"},"PeriodicalIF":4.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933503/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infectious Diseases and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40121-025-01117-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
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.

头孢地罗治疗嗜麦芽窄养单胞菌引起的医院血液感染:病例系列和文献综述。
导读:嗜麦芽窄养单胞菌血液感染(BSI)的治疗仍然具有挑战性,因为该生物固有的多药耐药和常用一线抗生素的潜在副作用。方法:我们对意大利不同医院的4例嗜麦芽链球菌BSI患者进行头孢地罗治疗(≥72 h)。此外,我们进行了PubMed检索,以确定其他报告用头孢地罗治疗嗜麦芽链球菌BSI病例的研究。结果:我们回顾了8例接受头孢地罗治疗的嗜麦芽链球菌BSI[中位年龄52.5岁(Q1-Q3 27.5-61.0), 50%男性],包括我们的病例。BSI来源主要为中心静脉导管(62.5%)和下呼吸道(25.0%)。87.5%(7/8)的患者使用头孢地罗作为一线治疗,中位治疗时间为14天(IQR为6.2-16.0)。62.5%的病例采用联合治疗。需要控制传染源的占75.0%,控制传染源的占40.0%。临床成功率为62.5%,微生物根除率为87.5%。37.5%的病例发生院内死亡,其中1例死亡直接归因于嗜麦芽链球菌。头孢地罗单药治疗和联合治疗的结果无显著差异。结论:根据我们的研究结果和文献回顾,头孢地冷为基础的方案显示出希望作为嗜麦芽链球菌BSI的有效治疗选择,值得在更大规模的研究中进一步调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信