title: Successful Treatment of Bloodstream Infection Due to Metallo-β-Lactamase-Producing Stenotrophomonas maltophilia in a Renal Transplant Patient.
abstract: Stenotrophomonas maltophilia is an emerging multidrug-resistant (MDR) opportunistic pathogen for which new antibiotic options are urgently needed. We report our clinical experience treating a 19-year-old renal transplant recipient who developed prolonged bacteremia due to metallo-β-lactamase-producing S. maltophilia refractory to conventional treatment. The infection recurred despite a prolonged course of colistimethate sodium (colistin) but resolved with the use of a novel drug combination with clinical efficacy against the patient's S. maltophilia isolate.
authors.affiliation: Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Mojica
authors.affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Ouellette
authors.affiliation: Department of Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Leber
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
authors.forename: M Brian
authors.initials: MB
authors.lastname: Becknell
authors.affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
authors.forename: Monica I
authors.initials: MI
authors.lastname: Ardura
authors.affiliation: Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Medical Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA.
authors.forename: Federico
authors.initials: F
authors.lastname: Perez
authors.affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA Center for Vaccines and Immunity, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA masako.shimamura@nationwidechildrens.org robert.bonomo@va.gov sshelburne@mdanderson.org.
authors.forename: Masako
authors.initials: M
authors.lastname: Shimamura
authors.affiliation: Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA Medical Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, USA masako.shimamura@nationwidechildrens.org robert.bonomo@va.gov sshelburne@mdanderson.org.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bonomo
authors.affiliation: Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Samuel L
authors.initials: SL
authors.lastname: Aitken
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, and Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA masako.shimamura@nationwidechildrens.org robert.bonomo@va.gov sshelburne@mdanderson.org.
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Shelburne
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D053961:Azabicyclo Compounds / Q000627:therapeutic use*; D001398:Aztreonam / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D002442:Ceftazidime / Q000627:therapeutic use*; D003091:Colistin / Q000627:therapeutic use; D004338:Drug Combinations; D024901:Drug Resistance, Multiple, Bacterial; D057915:Drug Substitution; D015870:Gene Expression; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D007690:Polycystic Kidney Diseases / Q000473:pathology / Q000601:surgery; D020615:Stenotrophomonas maltophilia / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development / Q000472:pathogenicity; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D053961:Azabicyclo Compounds; D004338:Drug Combinations; C000595613:avibactam, ceftazidime drug combination; D002442:Ceftazidime; D001618:beta-Lactamases; D001398:Aztreonam; D003091:Colistin