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Introduction <p>The treatment of <i>Stenotrophomonas maltophilia</i> 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> Methods <p>Here, we describe four cases of <i>S. maltophilia</i> BSI treated with cefiderocol (≥&#xa0;72&#xa0;h) in different Italian hospitals. Additionally, we conducted a PubMed search to identify other studies reporting cases of <i>S. maltophilia</i> BSI managed with cefiderocol.</p> Results <p>We reviewed a total of 8 cases of <i>S. maltophilia</i> BSI [median age 52.5 years (Q1–Q3&#xa0;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&#xa0;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 <i>S. maltophilia</i>. No significant differences were observed in terms of outcomes between cefiderocol monotherapy and combination therapy.</p> Conclusions <p>Based on our findings and a review of the literature, cefiderocol-based regimens show promise as an effective treatment option for <i>S. maltophilia</i> BSI, warranting further investigation in larger studies.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月4日

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  • 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,
  • Giuseppe Accurso,
  • Davide Fiore Bavaro,
  • Stefania Chiappetta,
  • Domenico Faliero,
  • Benedetta Fumarola,
  • Nicholas Geremia,
  • Francesca Giovannenze,
  • Angelo Maccaro,
  • Andrea Marino,
  • Marco Merli,
  • Gabriele Pagani,
  • Alessia Sardanelli,
  • Vincenzo Scaglione,
  • Monica Tontodonati,
  • Veronica Vassia

摘要

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.