Agrobacterium radiobacter Bacteremia in a Gastric Cancer Patient: A Case Report and Literature Review

Mengna Liu, Xi Jiang, Yingqi Pi, Xiuqin Ren, Mingming Chen, Shihuan Tang, Xinlu Dai, Yixian Wu, Yanrong Guo, Xinyi Zhang, Zhaofan Luo,* Xiaoying Xie* Department of Clinical Laboratory, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaoying Xie, Department of Clinical Laboratory, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong, People’s Republic of China, Email [email protected]: Agrobacterium radiobacter (A. radiobacter) is a gram-negative environmental bacterium primarily found in soil and plants. While it exhibits low virulence, it can act as an opportunistic pathogen in immunocompromised hosts. Its variable antibiotic resistance patterns pose challenges in clinical management. In this context, we reported a case of catheter-related bloodstream infection (CRBSI) caused by A. radiobacter and reviewed its clinical features, diagnostic challenges, and treatment strategies.Case Presentation: A 70-year-old male with stage IIIA gastric adenocarcinoma and a chemotherapy-associated central venous catheter (CVC) presented with fever and elevated procalcitonin (3.02 ng/mL). Blood cultures from CVC and periphery grew A. radiobacter. Empirical piperacillin/tazobactam transiently improved symptoms, but recurrent fever prompted CVC removal on day 10 of hospitalization, leading to rapid resolution of fever, normalization of procalcitonin, and negative follow-up blood cultures.Conclusion: This case highlights the critical role of catheter removal and susceptibility-guided antibiotic therapy for A. radiobacter infections in immunocompromised patients, addressing biofilm challenges and informing antimicrobial stewardship. Collaborative research integrating microbiology, genomics, and clinical data is essential to refine treatment algorithms and improve outcomes in immunocompromised hosts.Keywords: Agrobacterium radiobacter, catheter-related bloodstream infection, antibiotic therapy, immunocompromised host, case report