Pandoraea sputorum Bacteremia In A Patient Who Had Undergone Allogeneic Liver Transplantation Plus Immunosuppressive Therapy: A Case Report

Abstract Pandoraea sputorum (P. sputorum), an emerging pathogen, is able to trigger a pronounced pro-inflammatory response that results in lung dysfunction in cystic fibrosis (CF) patients. All previous P. sputorum isolates have been obtained from the respiratory samples of CF patients, with no reported cases of P. sputorum bacteremia. For the first time, we report P. sputorum isolates recovered twice from the blood cultures of a patient with liver cancer who had undergone allogeneic liver transplantation. These isolates were successfully identified by combining mass spectrometry and molecular techniques based on 16S rRNA sequencing methods. At the onset of the P. sputorum bacteremia, the patient’s peripheral T, B and NK cell counts were 181.68/μL, 59.57/μL and 70.66/μL, respectively. The serum procalcitonin level, C-reactive protein level and peripheral neutrophil granulocyte percentage were 0.56 ng/mL, 61.00 mg/L and 96.8%, respectively. We found these isolates to be susceptible to ciprofloxacin and piperacillin/tazobactam and to be intermediate to amikacin. Previous studies have found P. sputorum isolates to be resistant. All of the data combined showed that compromised immune function from allogeneic liver transplantation plus immunosuppressive therapy contributes to the occurrence of P. sputorum bacteremia. Furthermore, the P. sputorum isolates demonstrated characteristic resistance profiles.