A Case of Pandoraea apista Bacteremia in an Immunosuppressed Ventriculoperitoneal (VP) Shunt Patient in Dubai Hospital, UAE.
Abstract
Pandoraea species are multidrug-resistant (MDR) Gram-negative bacteria increasingly recognized as opportunistic pathogens beyond cystic fibrosis (CF). To our knowledge, we report the first documented case of Pandoraea apista bacteremia in the Middle East, occurring in a 41-year-old non-CF woman with post-revision ventriculoperitoneal (VP) shunt hydrocephalus, metastatic cervical carcinoma, and renal failure. Presenting with fever, hematuria, and obstructive uropathy, the patient developed catheter-related bloodstream infection (CRBSI) and urinary tract infection. P. apista was identified via MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry) from blood and urine cultures, displaying resistance to ceftazidime and meropenem but susceptibility to ciprofloxacin, which led to clinical improvement. This case highlights the emerging threat of P. apista in immunocompromised, non-CF patients with indwelling devices, emphasizing the critical role of precise microbiological identification and susceptibility-guided therapy in managing such infections.
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