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Case of recurrent bacteraemia and PICC (peripherally-inserted central catheter) line infection in an immunocompromised patient.

dc.contributor.authorHoulihan, Elaine
dc.contributor.authorLucey, Mary
dc.contributor.authorPandian, Aruna
dc.contributor.authorHanahoe, Belinda
dc.contributor.authorHiggins, Frances
dc.contributor.authorDeLappe, Niall
dc.contributor.authorKrawczyk, Janusz
dc.contributor.authorKeady, Deirbhile
dc.date.accessioned2024-10-02T14:40:55Z
dc.date.available2024-10-02T14:40:55Z
dc.date.issued2022-01-21
dc.identifier.pmid35198965
dc.identifier.doi10.1016/j.infpip.2022.100202
dc.identifier.urihttp://hdl.handle.net/10147/643012
dc.descriptionBackground: This report describes recurrent A. xylosoxidans bloodstream and PICC (peripherally-inserted central catheter) line infection in an immunocompromised patient. Presentation of case: A 64-year-old female with acute promyelocytic leukaemia presented during a non-neutropenic febrile episode, and A. xylosoxidans was isolated from multiple PICC and peripheral blood cultures, and from the tip of the line on removal. The patient was treated with meropenem and a new PICC line was inserted after sterile blood cultures. Six weeks later, she represented with A. xylosoxidans from multiple cultures from the line. She was treated with piperacillin-tazobactam and the line was removed. There was no evidence of deep-seated infection. Further discussion revealed that the patient was using a sponge to clean, and a sleeve to cover her PICC-line while bathing. A. xylosoxidans was cultured from both the sponge and the swab. Whole Genome Sequencing performed on two blood culture isolated and both environmental isolates confirmed all four isolates were indistinguishable. The patient was advised not to use the sponge/sleeve in future and we have incorporated specific advice in this regard into our patient information. Discussion: Achromobacter xylosoxidans is an aerobic, non-lactose fermenting gram-negative bacillus usually considered an opportunistic pathogen. It is associated with infection in immunocompromised patients, and is an emerging pathogen in catheter-related infections, sometimes associated with contaminated water. Conclusion: This case of recurrent A. xylosoxidans line infection highlights diagnostic and management challenges associated with catheter-related infections. Treatment is challenging because of intrinsic and acquired resistance mechanisms. Empiric treatment with anti-pseudomonal penicillins or carbapenems with line removal is typically required.en_US
dc.language.isoenen_US
dc.rights© 2022 The Authors.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAIDS, acquired immune deficiency syndromeen_US
dc.subjectANC, absolute neutrophil counten_US
dc.subjectAPML, Acute promyelocytic leukaemiaen_US
dc.subjectATRA, All-trans-retinoic aciden_US
dc.subjectAchromobacter xylosoxidansen_US
dc.subjectCF, cystic fibrosisen_US
dc.subjectCLED, cystine-lactose-electrolyte deficienten_US
dc.subjectCLSI, Clinical Laboratory Standards Instituteen_US
dc.subjectCRP, C-reactive proteinen_US
dc.subjectESBL, extended-spectrum beta-lactamaseen_US
dc.subjectEUCAST, European Committee on Antimicrobial Susceptibility Testingen_US
dc.subjectMALDI-TOF, matrix-assisted laser desorption/ionization time-of-flighten_US
dc.subjectMIC, minimum inhibitory concentrationen_US
dc.subjectMLST, multilocus sequence typingen_US
dc.subjectOpportunistic infectionen_US
dc.subjectPICC, Peripherally-inserted central catheteren_US
dc.subjectPeripheral-inserted central catheter infectionen_US
dc.subjectRecurrent bacteraemiaen_US
dc.subjectSNP, single nucleotide polymorphismsen_US
dc.subjectWCC, white cell counten_US
dc.subjectWGS, Whole genome sequencingen_US
dc.subjectWater-borne pathogenen_US
dc.subjectrMLST, Ribosomal multi-locus sequence typingen_US
dc.subjectrRNA, ribosomal ribonucleic aciden_US
dc.titleCase of recurrent bacteraemia and PICC (peripherally-inserted central catheter) line infection in an immunocompromised patient.en_US
dc.typeArticleen_US
dc.identifier.eissn2590-0889
dc.identifier.journalInfection prevention in practiceen_US
dc.source.journaltitleInfection prevention in practice
dc.source.volume4
dc.source.issue1
dc.source.beginpage100202
dc.source.endpage
refterms.dateFOA2024-10-02T14:40:56Z
dc.source.countryEngland


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Except where otherwise noted, this item's license is described as © 2022 The Authors.