Bacteraemia due to Stenotrophomonas maltophilia: An Analysis of 45 Episodes

Friedman, N Deborah; Korman, Tony M.; Fairley, CK; Franklin, Judith; Spelman, Dennis

doi:10.1053/jinf.2002.0978

Cited by 132 publications

(108 citation statements)

References 18 publications

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“…Our results highlight the fact that Central-venous lines are the most common source of SMB (SMB was attributed to a CVC infection in almost 55.6% of our patients). This finding is consistent with those of other reports [5] In cases where there is no obvious source of infection it has been suggested that these devices may be the primary source [16]. Muder et al [11] reported that in their series 56% of cases with SMB did not have a clinically apparent portal of entry but 84% of these individuals had a CVC in place.…”

Section: Discussionsupporting

confidence: 89%

“…First, the absence of a control group is a limitation recognised by the authors, and has previously been a valuable inclusion in studies of this kind [22] [23]. Second, we've included only 31 cases, indeed most previous studies had analysed a small population and have been mostly retrospective and only few of these included more than 35 patients [5] [11] [22] [24]. Finally, the heterogeneity of patients, lack of appropriate statistical analysis and lack of definition of nosocomial episodes of bacteraemia, lack of the criteria for attributing death to the bacteraemic episode were not specified, thus we had difficulties of determining a precise cause of death for our population who had multiple active co-morbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Although not highly virulent, reports indicate that infection with this organism is associated with significant morbidity and mortality particularly in severely compromised patients [3] [4]. Infection with this pathogen commonly manifests as bacteraemia [5] [6], but it also may cause a wide range of other infections [7]- [9]. Progress has been made in identifying risk factors for the acquisition of severe S. maltophilia infections [10].…”

Section: Introductionmentioning

confidence: 99%

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Stenotrophomonas maltophilia Bacteraemia: Analysis of 33 Episodes Occurred in the ICU at the University Hospital in Sousse, Tunisia

Jaidane¹,

Chaouech²,

Naija³

et al. 2014

OALib

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Background: Stenotrophomonas maltophilia is a multidrug-resistant, Gram negative bacillus that has emerged as an opportunistic pathogen associated with high morbidity and mortality rates. Aim: The aim of this study is to describe the characteristics of patients with bloodstream infections due to S. maltophilia. Methods: A descriptive retrospective study was performed at the ICUs over seven-year period in a teaching hospital. Cases of SMB were identified through a review of clinical microbiology laboratory and patient's records were retrieved for analysis. Findings: There were 22 deaths (71%) 15 ± 12 days after the bactaeremia. In our study, more than half of patients (17/31) was exposed to broad-spectrum antibiotic specifically imipinem (IMP) before their positive culture. Antibiotic susceptibility testing revealed that isolates were most sensitive to ciprofloxacin (84%) and to trimethoprim-sulfamethoxazole (71%). A probable portal of entry was identified in 27.3% of cases and 57% were catheter-related. Conclusion: Our results were similar to those described by other authors reported in the literature in the last 20 years. Prevention of S. maltophilia acquisition and infection depends on higher emphasis on control of antimicrobial consumption and consideration of environmental reservoirs.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stenotrophomonas maltophilia Bacteraemia: Analysis of 33 Episodes Occurred in the ICU at the University Hospital in Sousse, Tunisia

Jaidane¹,

Chaouech²,

Naija³

et al. 2014

OALib

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“…When S. maltophilia was again detected in the same patient at an interval of 8 or more days after the first BSI episode had improved, the detection of the isolate was regarded as a different episode of BSI, as previously reported. 13,20 The severity of illness was assessed by the bacteremia score according to the University of Pittsburgh (PITT score). 21,22 The D-index and cumulative D-index, which were calculated as the area over the neutrophil curve that is based on a graph plotting the absolute neutrophil counts during neutropenia, 23 were also investigated to evaluate the impact of both duration and severity of neutropenia on S. maltophilia infection.…”

Section: Definitionsmentioning

confidence: 99%

Stenotrophomonas maltophilia infection in hematopoietic SCT recipients: high mortality due to pulmonary hemorrhage

Tada¹,

Kurosawa²,

Hiramoto³

et al. 2012

Bone Marrow Transplant

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To clarify the clinical features and outcome of Stenotrophomonas maltophilia infection among hematopoietic SCT (HCT) recipients, we retrospectively reviewed the records of 1085 consecutive HCT recipients and identified 42 episodes in 31 HCT recipients with S. maltophilia infection. We compared these recipients with 30 non-HCT patients with S. maltophilia infection. The mortality rate in HCT recipients was significantly higher than that in non-HCT patients (relative risk 5.7, P ¼ 0.04), and we identified seven patients with pulmonary hemorrhage due to S. maltophilia, exclusively in the HCT cohort. Six of these latter seven patients died within 1 day from the onset of hemorrhage and the isolate was identified after death in most cases; one patient, who received empiric therapy for S. maltophilia and granulocyte transfusion, survived for more than 2 weeks. The patients with pulmonary hemorrhage had a more severe and longer duration of neutropenia, persistent fever despite of the use of broad-spectrum antibiotics, complication by pneumonia and higher C-reactive protein levels than those without pulmonary hemorrhage. In conclusion, S. maltophilia was associated with fulminant and fatal pulmonary hemorrhage in HCT recipients. Empiric therapy with antibiotics before the onset of pulmonary hemorrhage may be effective in HCT recipients who carry the conditions identified.

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“…Catheter removal seems to be crucial, since 92% of patients with catheter removal survived, compared with only 54% without catheter removal [69].…”

Section: Of 42mentioning

confidence: 99%

Catheter-related bloodstream infections: catheter management according to pathogen

Leonidou

Gogos

2010

International Journal of Antimicrobial Agents

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Bacteraemia due to Stenotrophomonas maltophilia: An Analysis of 45 Episodes

Cited by 132 publications

References 18 publications

Stenotrophomonas maltophilia Bacteraemia: Analysis of 33 Episodes Occurred in the ICU at the University Hospital in Sousse, Tunisia

Stenotrophomonas maltophilia Bacteraemia: Analysis of 33 Episodes Occurred in the ICU at the University Hospital in Sousse, Tunisia

Stenotrophomonas maltophilia infection in hematopoietic SCT recipients: high mortality due to pulmonary hemorrhage

Catheter-related bloodstream infections: catheter management according to pathogen

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