Clinical characteristics, antibiotic susceptibilities, treatment characteristics and outcomes in pediatric patients with Sfingomonas paucimobilis bacteremia

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Abstract
Objective: This study aimed to examine the clinical and laboratory features, antibiotic susceptibilities, treatment characteristics, and outcomes of pediatric patients with Sphingomonas paucimobilis bacteremia. Material and Methods: This single-center, retrospective study included patients aged between 1 month and 18 years who were treated for Sphingomonas paucimobilis bacteremia between September 2019 and December 2022. Results: The study population included 12 pediatric patients with S. paucimobilis bacteremia. The median age of the patients was 28.5 months (range 7-215 months) and 50% were male. All patients had hospital-acquired infections (HAIs). The presence of comorbidities such as hematological-oncological malignancies, neurological disorders, burns and immunological disorders, the presence of a central venous catheter and a history of hospitalization within the last 12 months were prominent risk factors. Bacterial isolates were susceptible at different rates to antibiotics used as follows: piperacillin-tazobactam (83.3%), ceftazidime (91.7%), cefepime (91.7%) and meropenem (100%). The patients were treated with meropenem, cefepime, ceftazidime and piperacillin-tazobactam and the median duration of systemic antibiotic treatment was 10 days (range 10-14 days). Central venous catheters (CVCs) were removed in 3 patients who developed catheter-related bloodstream infections (CRBSIs). Persistent bacteremia, recurrence and 30-day mortality were not observed in any patient. Conclusion: Sphingomonas paucimobilis remains an important opportunistic pathogen of hospital-acquired bacteremia, especially in children with risk factors. Successful treatment seems possible with systemic antibiotic therapy and removal of CVC in the presence of CRBSI.

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