Wu Ping-Sheng, Lu Chun-Yi, Chang Luan-Yin, Hsueh Po-Ren, Lee Ping-Ing, Chen Jong-Min, Lee Chin-Yun, Chan Pei-Chun, Chang Po-Young, Yang Tsao-Ton, Huang Li-Min
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
J Microbiol Immunol Infect. 2006 Apr;39(2):144-9.
Stenotrophomonas maltophilia bacteremia is an important cause of mortality among immunocompromised children. However, there has been little information concerning S. maltophilia bacteremia in the pediatric population.
We reviewed the drug susceptibility of bloodstream isolates of S. maltophilia and medical charts of S. maltophilia bacteremia patients less than 18 years old at the Department of Pediatrics, National Taiwan University Hospital from January 1993 to June 2003. The risk factors associated with mortality of the patients with S. maltophilia bacteremia were analyzed.
In total, 32 episodes (31 patients) of S. maltophilia bacteremia were reviewed. The average rate of nosocomial bloodstream infection was 8.3 episodes per 100,000 patient-days, and an average of 6.4% of them were caused by S. maltophilia. Malignancy was the most common underlying disease (32%). Six episodes of S. maltophilia bacteremia had soft tissue involvement, and only 1 of them underwent surgical intervention and survived. These 32 isolates were most susceptible to trimethoprim-sulfamethoxazole (91%), and no obvious increase in multidrug resistance was noted in the previous 10 years. The crude mortality rate was 40.6%. Malignancy, failure to remove central venous catheter, and ineffective antibiotic treatment were significant risk factors for mortality.
Early and effective antimicrobial therapy and removal of central venous catheter as soon as possible are vital for the successful management of S. maltophilia bacteremia.
嗜麦芽窄食单胞菌血症是免疫功能低下儿童死亡的重要原因。然而，关于儿科人群中嗜麦芽窄食单胞菌血症的信息却很少。
我们回顾了1993年1月至2003年6月台湾大学医院儿科18岁以下嗜麦芽窄食单胞菌血症患者的血流分离株药敏情况及病历。分析了嗜麦芽窄食单胞菌血症患者死亡的相关危险因素。
共回顾了32例（31名患者）嗜麦芽窄食单胞菌血症病例。医院血流感染的平均发生率为每100,000患者日8.3例，其中平均6.4%由嗜麦芽窄食单胞菌引起。恶性肿瘤是最常见的基础疾病（32%）。6例嗜麦芽窄食单胞菌血症有软组织受累，其中仅1例接受了手术干预并存活。这32株分离菌对复方新诺明最敏感（91%），在过去10年中未发现多重耐药性有明显增加。粗死亡率为40.6%。恶性肿瘤、未拔除中心静脉导管和抗生素治疗无效是死亡的重要危险因素。
早期有效的抗菌治疗和尽早拔除中心静脉导管对于成功治疗嗜麦芽窄食单胞菌血症至关重要。
