antimicrobial susceptibility testing in the Management of catheter-related bloodstream infection among immunocompromised hosts

Divya Sharma; A. Iyer; K. Iyer

doi:10.5281/zenodo.22812845

Authors

Divya Sharma Department of Clinical Medical Microbiology, Nile Institute of Clinical Bacteriology Author https://orcid.org/3699-4693-9375-4458
A. Iyer Department of Medical Microbiology, Seine Research Center for Medical Microbiology Author https://orcid.org/3676-1180-1905-7506
K. Iyer Department of Clinical Medical Microbiology, Brahmaputra Research Center for Clinical Bacteriology Author https://orcid.org/4347-6115-7745-2174

DOI:

https://doi.org/10.5281/zenodo.22812845

Keywords:

antimicrobial susceptibility testing, catheter-related bloodstream infection, immunocompromised host, multidrug resistance, central venous catheter

Abstract

Graphical abstract

Background/Objective: Catheters are a leading source of bloodstream infection in immunocompromised hosts, and antimicrobial susceptibility testing (AST) is central to translating a microbiological diagnosis into effective therapy; this review synthesizes the diagnostic microbiology and susceptibility profile of catheter-related bloodstream infection (CRBSI) in this population.

Methods: Guideline recommendations, surveillance cohorts, and diagnostic-accuracy studies on CRBSI diagnosis and AST in neutropenic, transplant, and other immunocompromised patients were synthesized against IDSA, European, and CLSI/EUCAST criteria. Results/Conclusions: The organism spectrum is shifted toward Gram-negative Enterobacterales, non-fermenters, and Candida species; carbapenems retain the most reliable Gram-negative activity while piperacillin-tazobactam/ceftazidime activity is eroded, and inappropriate empirical therapy is associated with worse outcomes. Rapid, population-stratified AST, catheter-sparing diagnosis, and decisive catheter removal when biofilm-forming or fungal pathogens are implicated form the core of effective management.

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