Meropenem-Resistant Achromobacter xylosoxidans, Subspecies Denitrificans Bacteremia in a Patient With Stage IV Adenocarcinoma of the Lung

Achromobacter xylosoxidans,subspecies denitrificans is a rare Gram-negative bacillus that causes health care associated infections in immunocompromised hosts. Carbapenems and anti-pseudomonal penicillins are listed as suitable empiric therapy in the literature. Herein, we report a case of a 77-year-old male with stage IV adenocarcinoma of the lung who presented with and was improving from Salmonella javiana enterocolitis, only to subsequently develop A. xylosoxidans,subspecies denitrificans bacteremia that was resistant to both meropenem and piperacillin-tazobactam. With empiric antibiotic coverage falling short of microbial clearance, timelyin vitrosusceptibility testing and prompt infectious disease consultation are of the utmost importance for treatment.