Fever in a Patient with a Central Venous Catheter Colonized by 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.

An efflux pump in genomic island GI-M202a mediates the transfer of polymyxin B resistance in Pandoraea pnomenusa M202

“…MDR organisms have emerged not only in the hospital environment but also in community settings, suggesting that reservoirs of antibiotic-resistant bacteria are present around hospitals (Youlden et al 2022 ). Pandoraea species is a newly emerging multidrug-resistant pathogen usually isolated from a variety of clinical samples (See-Too et al 2019 ; Gawalkar et al 2021 ; Singh et al 2021 ; Cubides-Diaz et al 2022 ; Ramos Oliveira et al 2023 ) with antibiotic resistance (Schneider et al 2006 ). In this study, we isolated the MDR gram-negative strain P. pnomenusa M202 from hospital sewage.…”