FIG 1.

Synopsis of the treatment of bacteremia due to MDR S. maltophilia. (A) PFGE of S. maltophilia clinical isolates using Xba1. CTRL 1 and 2, contemporaneous control isolates of S. maltophilia from different patients. Isolates obtained on day (D1), day 45, and day 50 (primary cluster) are indistinguishable on PFGE. The PI is different by one band, suggesting that it is probably the same strain as the primary cluster. The isolate obtained on day 43 has up to four bands different from the primary cluster, suggesting that it may be related to the primary cluster. The two control clusters are significantly different from the strains isolated from the patient. (B) Noncontrast chest CT scan demonstrating an intravascular calcific lesion. Line arrow, area of calcification in the right pulmonary artery, the suspected site of an endovascular focus. Block arrow, calcification at a prior surgical site of a lung biopsy. (C) Disk diffusion susceptibility testing of the MDR S. maltophilia isolate in Mueller-Hinton agar. Note the synergy between CZA and ATM. IMI, imipenem. (D) Time line of bacteremia, antimicrobial therapy, and indwelling vascular devices. FEP, cefepime; AG, aminoglycoside; mino, minocycline. Downward triangles represent positive blood cultures for S. maltophilia. Upright triangles represent blood cultures without growth. Gray boxes indicate times when indwelling vascular devices were present.