Long Island Jewish Medical Center, Division of Infectious Diseases, New Hyde Park, New York, NY, USA.
J Hosp Infect. 2012 Jun;81(2):114-8. doi: 10.1016/j.jhin.2012.02.008. Epub 2012 Apr 10.
Stenotrophomonas maltophilia is a significant nosocomial pathogen, responsible for an increasing number of infections, particularly in immunocompromised patients.
This study describes the clinical and microbiological characteristics of patients with Stenotrophomonas maltophilia bacteraemia.
We reviewed the charts of 102 patients with Stenotrophomonas maltophilia bacteraemia over a seven-year period from 2001 to 2007 in two tertiary care centres in New York, USA.
There were 79 episodes (77.5%) related to nosocomial acquisition, 21 (20.6%) were healthcare-associated and two episodes (2%) were community-acquired. The most common source of bacteraemia was an infected central catheter in 44 patients (43.1%); 17 (16.6%) were related to neutropenic sepsis; nine (8.8%) were from an abdominal source; six (5.9%) were from a respiratory source, and the source of the bacteraemia was unclear in 26 cases (25.5%). The majority (94.1%) of the patients had central venous access devices. Intensive care unit stay, intubation, septic shock, neutropenia at the time of bacteraemia or carbapenem antibiotic use within 30 days of the episode were associated with mortality according to univariate analysis. By multivariate analysis, hypotensive shock and carbapenem use within 30 days of the episode were factors significantly correlated with mortality. The 102 isolates were mostly susceptible in vitro to trimethoprim-sulfamethoxazole (97.1%), levofloxacin (92.9%), ceftazidime (53.0%) and ticarcillin-clavulanic acid (49.2%).
Our data describe the characteristics of patients with Stenotrophomonas maltophilia bacteraemia and emphasize the importance of careful evaluation of vascular access devices in those patients.
嗜麦芽窄食单胞菌是一种重要的医院获得性病原体，导致越来越多的感染，特别是在免疫功能低下的患者中。
本研究描述了嗜麦芽窄食单胞菌菌血症患者的临床和微生物学特征。
我们回顾了 2001 年至 2007 年期间美国纽约两家三级保健中心的 102 例嗜麦芽窄食单胞菌菌血症患者的病历。
79 例（77.5%）与医院获得性感染有关，21 例（20.6%）与医疗保健相关，2 例（2%）为社区获得性感染。菌血症最常见的来源是 44 例患者（43.1%）的感染中心导管；17 例（16.6%）与中性粒细胞减少性败血症有关；9 例（8.8%）来自腹部来源；6 例（5.9%）来自呼吸道来源，26 例（25.5%）菌血症的来源不明。大多数（94.1%）患者有中心静脉置管。根据单变量分析，入住重症监护病房、插管、感染性休克、菌血症时中性粒细胞减少或在发病后 30 天内使用碳青霉烯类抗生素与死亡率相关。多变量分析显示，低血压休克和发病后 30 天内使用碳青霉烯类抗生素是与死亡率显著相关的因素。102 株分离株体外对甲氧苄啶-磺胺甲恶唑（97.1%）、左氧氟沙星（92.9%）、头孢他啶（53.0%）和替卡西林-克拉维酸（49.2%）的敏感性较高。
我们的数据描述了嗜麦芽窄食单胞菌菌血症患者的特征，并强调了仔细评估血管内装置在这些患者中的重要性。
