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嗜麦芽窄食单胞菌感染。

Stenotrophomonas maltophilia infections.

作者信息

Dignani M Cecilia, Grazziutti Monica, Anaissie Elias

机构信息

FUNDALEU, Buenos Aires, Argentina.

出版信息

Semin Respir Crit Care Med. 2003 Feb;24(1):89-98. doi: 10.1055/s-2003-37920.

Abstract

Stenotrophomonas maltophilia is a ubiquitous, gram-negative organism that causes hospital-acquired infections. Persons often come in contact with S. maltophilia through environmental water sources, including hospital tap water or faucets, and it has been associated with nosocomial outbreaks of infection. S. maltophilia often infects debilitated persons and those with underlying medical conditions, including immunosuppression. Manifestations of infection include pneumonia, often in mechanically ventilated patients, bacteremia, skin and soft tissue infection, urinary tract infection, and endocarditis. Treatment of S. maltophilia infection is difficult because the organism is resistant to a number of agents typically used for hospital-acquired infections. In vitro and clinical data indicate that trimethoprim-sulfamethoxazole is the agent of choice. Beta-lactamase inhibitors such as clavulanate are also active, and combination therapy may be indicated for certain serious infections due to S. maltophilia.

摘要

嗜麦芽窄食单胞菌是一种普遍存在的革兰氏阴性菌,可引起医院获得性感染。人们常常通过环境水源,包括医院的自来水或水龙头接触嗜麦芽窄食单胞菌,它与医院感染暴发有关。嗜麦芽窄食单胞菌常感染身体虚弱者以及患有基础疾病者,包括免疫抑制患者。感染表现包括肺炎(常在机械通气患者中出现)、菌血症、皮肤和软组织感染、尿路感染以及心内膜炎。嗜麦芽窄食单胞菌感染的治疗很困难,因为该菌对许多常用于医院获得性感染的药物耐药。体外和临床数据表明,复方磺胺甲恶唑是首选药物。β-内酰胺酶抑制剂如克拉维酸也有活性,对于某些由嗜麦芽窄食单胞菌引起的严重感染可能需要联合治疗。

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