Sattler C A, Mason E O, Kaplan S L
Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
Clin Infect Dis. 2000 Dec;31(6):1321-30. doi: 10.1086/317473. Epub 2000 Nov 17.
To describe Stenotrophomonas maltophilia infection in children, we reviewed the medical records of patients with isolates from nonrespiratory sites and identified 85 episodes, 51 (60%) of which represented true infection. Forty-two episodes (82.4%) were hospital acquired. Commonly associated with S. maltophilia infection were underlying illness (in 90.2% of cases), previous hospitalizations (in 78.7%), previous antibiotic exposure (in 78.4%), and the presence of a central venous catheter (in 76.5%). Polymicrobial isolates were obtained in 70.6% of episodes; Pseudomonas aeruginosa and Acinetobacter species were the most common coisolates. Bloodstream infection was the most frequent clinical syndrome (32 [63%] of 51 episodes). Fever or sepsis occurred in 22 (69%) and shock in 10 (31%) of 32 episodes. Infection at other sites was less severe. The most active antibiotics in vitro were trimethoprim-sulfamethoxazole and ticarcillin-clavulanate. The overall and attributable mortality rates were 12.5% and 6.3%, respectively. S. maltophilia appears to be an important cause of nosocomially acquired bacteremia in children. The significance in children of isolation from other sites is less clear.
为描述儿童嗜麦芽窄食单胞菌感染情况，我们回顾了非呼吸道部位分离出该菌的患者病历，共识别出85例感染事件，其中51例（60%）为真正感染。42例（82.4%）为医院获得性感染。嗜麦芽窄食单胞菌感染常与基础疾病（90.2%的病例）、既往住院史（78.7%）、既往抗生素暴露史（78.4%）以及中心静脉导管的存在（76.5%）相关。70.6%的感染事件中分离出多种微生物；铜绿假单胞菌和不动杆菌属是最常见的共分离菌。血流感染是最常见的临床综合征（51例中有32例[63%]）。32例中有22例（69%）出现发热或败血症，10例（31%）出现休克。其他部位的感染症状较轻。体外活性最强的抗生素是复方磺胺甲恶唑和替卡西林-克拉维酸。总体死亡率和归因死亡率分别为12.5%和6.3%。嗜麦芽窄食单胞菌似乎是儿童医院获得性菌血症的重要病因。从其他部位分离出该菌对儿童的意义尚不清楚。
