Risk factors and outcomes of Stenotrophomonas maltophilia bacteraemia: a comparison with bacteraemia caused by Pseudomonas aeruginosa and Acinetobacter species

Autor: Shunji Takakura, Yasufumi Matsumura, Karin Kato, Satoshi Nakano, Miki Nagao, Masaki Yamamoto, Go Hotta, Tomoyuki Yunoki, Yutaka Ito, Satoshi Ichiyama
Rok vydání: 2014
Předmět:
Male
Bacterial Diseases
Epidemiology
Stenotrophomonas maltophilia
Cephalosporin
Antibiotics
Bacteremia
Plant Science
medicine.disease_cause
Risk Factors
Medicine and Health Sciences
Multidisciplinary
biology
Acinetobacter
Hematology
Middle Aged
Infectious Diseases
Pseudomonas aeruginosa
Medicine
SOFA score
Female
medicine.drug
Acinetobacter Infections
Research Article
Adult
medicine.medical_specialty
medicine.drug_class
Science
Microbial Sensitivity Tests
Infectious Disease Epidemiology
Microbiology
Internal medicine
Trimethoprim
Sulfamethoxazole Drug Combination
medicine
Humans
Pseudomonas Infections
Mortality
Genotyping
Aged
Retrospective Studies
business.industry
Biology and Life Sciences
Bloodstream Infections
Plant Pathology
biology.organism_classification
bacterial infections and mycoses
Trimethoprim
business
Gram-Negative Bacterial Infections
Zdroj: PLoS ONE
PLoS ONE, Vol 9, Iss 11, p e112208 (2014)
ISSN: 1932-6203
Popis: Stenotrophomonas maltophilia (SM) is an important nosocomial pathogen that exhibits intrinsic resistance to various antimicrobial agents. However, the risk factors for SM bacteraemia have not been sufficiently evaluated. From January 2005 to September 2012, we retrospectively compared the clinical backgrounds and outcomes of SM bacteraemic patients (SM group) with those of bacteraemic patients due to Pseudomonas aeruginosa (PA group) or Acinetobacter species (AC group). DNA genotyping of the SM isolates using the Diversilab system was performed to investigate the genetic relationships among the isolates. The SM, PA, and AC groups included 54, 167, and 69 patients, respectively. Nine of 17 patients in the SM group receiving trimethoprim-sulfamethoxazole prophylaxis developed SM bacteraemia. Independent risk factors for SM bacteraemia were the use of carbapenems and antipseudomonal cephalosporins and SM isolation within 30 days prior to the onset of bacteraemia. Earlier SM isolation was observed in 32 of 48 patients (66.7%) with SM bacteraemia who underwent clinical microbiological examinations. Of these 32 patients, 15 patients (46.9%) had the same focus of bacteraemia as was found in the previous isolation site. The 30-day all-cause mortality rate among the SM group (33.3%) was higher than that of the PA group (21.5%, p = 0.080) and the AC group (17.3%, p = 0.041). The independent factor that was associated with 30-day mortality was the SOFA score. DNA genotyping of SM isolates and epidemiological data suggested that no outbreak had occurred. SM bacteraemia was associated with high mortality and should be considered in patients with recent use of broad-spectrum antibiotics or in patients with recent isolation of the organism.
Databáze: OpenAIRE
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