Fever in a Patient with a Central Venous Catheter Colonized by Pandoraea pnomenusa

Authors

  • Susana Ramos Oliveira Serviço de Doenças Infecciosas. Hospital Pedro Hispano. Matosinhos. Unidade Local de Saúde de Matosinhos.
  • Isabel Costa Monteiro Serviço de Medicina Interna. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos.
  • Cristina Rodrigues Serviço de Medicina Interna. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos.
  • Maria João Soares Sector de Microbiologia. Serviço de Patologia Clínica. Hospital Pedro Hispano. Unidade Local de Saúde de Matosinhos. Matosinhos.

DOI:

https://doi.org/10.20344/amp.16176

Keywords:

Catheter-Related Infections, Central Venous Catheters/adverse effects, Fever, Pandoraea pnomenusa

Abstract

Pandoraea species are a newly described genus of multidrug-resistant, non-fermentative Gram-negative bacilli, mainly isolated from sputum samples of cystic fibrosis patients. In immunocompromised patients or with high antibiotic selective pressure, these pathogens are generally opportunistic and invasive. Although Pandoraea spp. are rare, the true incidence of these infections may be underestimated due to difficulties in microbial identification by phenotypic methods. We present the case of a 51-year-old woman, with new-onset fever after a prolonged hospitalization and multiple courses of antibiotics. Mass spectrometry assays identified Pandoraea pnomenusa in the blood cultures taken from the central venous catheter and in the catheter tip. Fever cessation after catheter removal suggests a catheter-related bloodstream infection. To the best of our knowledge, this is the first isolation of a Pandoraea spp. in Portugal, which should raise awareness to the emergence of these opportunistic and multidrug-resistant microorganisms, and the importance of its prompt identification.

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References

Coenye T, Falsen E, Hoste B, Ohlen M, Goris J, Govan JR, et al. Description of Pandoraea gen. nov. with Pandoraea apista sp. nov., Pandoraea pulmonicola sp. nov., Pandoraea pnomenusa sp. nov., Pandoraea sputorum sp. nov. and Pandoraea norimbergensis comb. nov. Int J Syst Evol Microbiol. 2000;50:887-99.

Daneshvar MI, Hollis DG, Steigerwalt AG, Whitney AM, Spangler L, Douglas MP, et al. Assignment of CDC weak oxidizer group 2 (WO-2) to the genus Pandoraea and characterization of three new Pandoraea genomospecies. J Clin Microbiol. 2001;39:1819-26.

Monzón T, Valga F, Reichert J, López C. Hemodialysis catheter colonised by Pandoraea spotorum. Nefrología. 2018;38:662-4.

Tabatabaei M, Dastbarsar M, Moslehi MA. Isolation and identification of Pandoraea spp. from bronchoalveolar lavage of cystic fibrosis patients in Iran. Ital J Pediatr. 2019;45:1-8.

Lin C, Luo N, Xu Q, Zhang J, Cai M, Zheng G, et al. Pneumonia due to Pandoraea Apista after evacuation of traumatic intracranial hematomas: a case report and literature review. BMC Infect Dis. 2019;19:869.

See-too WS, Ambrose M, Malley R, Robson E, Mulcahy E, Manche E, et al. Pandoraea fibrosis sp. nov., a novel Pandoraea species isolated from clinical respiratory samples. Int J Syst Evol Microbiol. 2019;69:645-51.

Schneider I, Bauernfeind A. Intrinsic carbapenem-hydrolyzing oxacillinases from members of the genus pandoraea. Antimicrob Agents Chemother. 2015;59:7136-41.

Stryjewski ME, LiPuma JJ, Messier RH, Reller LB, Alexander BD. Sepsis, multiple organ failure, and death due to Pandoraea pnomenusa infection after lung transplantation. J Clin Microbiol. 2003;41:2255-7.

Pimentel JD, Macleod C. Misidentification of Pandoraea sputorum Isolated from sputum of a patient with cystic fibrosis and review of Pandoraea species infections in transplant patients. J Clin Microbiol. 2008;46:3165-8.

Xiao X, Tian H, Cheng X, Li G, Zhou J, Peng Z, et al. Pandoraea sputorum bacteremia in a patient who had undergone allogeneic liver transplantation plus immunosuppressive therapy: a case report. Infect Drug Resist. 2019;12:3359-64.

Johnson LN, Han JY, Moskowitz SM, Burns JL, Qin X, Englund A. Pandoraea bacteriemia in a cystic fibrosis patient with associated systemic illness. Pediatr Infect Dis J. 2004;23:881-2.

Falces-Romero I, Gutiérrez-Arroyo A, Romero-Gómez MP. Catheterassociated bacteremia by Pandoraea pnomenusa in an infant with acute lymphoblastic leukaemia. Med Clin. 2016;147:132.

Fernández-Olmos A, García-Castillo M, Morosini MI, Lamas A, Máiz L, Cantón R. MALDI-TOF MS improves routine identification of nonfermenting Gram negative isolates from cystic fibrosis patients. J Cyst Fibros. 2012;11:59-62.

Fernández-Olmos A, Morosini MI, Lamas A, Garcia-Castillo M, Garcia-Garcia L, Cantón R, et al. Clinical and microbiological features of a cystic fibrosis patient chronically colonized with Pandoraea sputorum identified by combining 16S rRNA sequencing and matrix-assisted laser desorption ionization - time of flight mass spectrometry. J Clin Microbiol. 2012;50:1096-8.

The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 11.0, 2021. [cited 2021 Feb 15]. Available from: https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_11.0_Breakpoint_Tables.pdf.

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Published

2022-05-23

How to Cite

1.
Ramos Oliveira S, Costa Monteiro I, Rodrigues C, Soares MJ. Fever in a Patient with a Central Venous Catheter Colonized by Pandoraea pnomenusa. Acta Med Port [Internet]. 2022 May 23 [cited 2023 Mar. 27];36(2):127-30. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/16176

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Section

Case Report