Gokhan Gozel Mustafa, Celik Cem, Elaldi Nazif
Department of Infectious Diseases and Clinical Microbiology, Cumhuriyet University Education and Research Hospital, Sivas, Turkey.
Department of Medical Microbiology, Cumhuriyet University Education and Research Hospital, Sivas, Turkey.
Jundishapur J Microbiol. 2015 Aug 22;8(8):e23569. doi: 10.5812/jjm.23569. eCollection 2015 Aug.
Stenotrophomonas maltophilia is the third most frequent non-fermentative Gram-negative bacilli in nosocomial infections, and usually causes severe infections such as primary bacteremia and pneumonia.
The current study aimed to compare the demographic and clinical characteristics, microbiological findings and final outcomes of the patients with primary bacteremia and nosocomial pneumonia caused by S. maltophilia.
The current study retrospectively evaluated patients aged 18 years and above with primary bacteremia and nosocomial pneumonia caused by S. maltophilia from January 2006 to December 2013. Medical records of patients, including reports of clinical microbiology and hospital infection control committee, were evaluated.
A total of 71 patients with S. maltophilia nosocomial infections, 35 (49.3%) primary bacteremia and 36 (50.7%) pneumonia, were diagnosed. There were no significant differences in gender, age, and co-morbid diseases, except chronic obstructive pulmonary disease; this infection was significantly higher in patients with pneumonia. A slightly higher 14-day mortality was found in patients with pneumonia, but the difference was not statistically significant. Inappropriate antibiotic use and presence of multiple organ dysfunction syndrome were found as independent risk factors for 14-day mortality in multivariate analysis.
A slightly higher mortality in patients with pneumonia, caused by S. maltophilia, was strived to explain by advanced age, higher acute physiology and chronic health evaluation (APACHE II) and sepsis related organ failure assessment (SOFA) score, and also higher inappropriate antibiotic use.
嗜麦芽窄食单胞菌是医院感染中第三常见的非发酵革兰氏阴性杆菌，通常会引发严重感染，如原发性菌血症和肺炎。
本研究旨在比较由嗜麦芽窄食单胞菌引起的原发性菌血症和医院获得性肺炎患者的人口统计学和临床特征、微生物学检查结果及最终结局。
本研究回顾性评估了2006年1月至2013年12月期间年龄在18岁及以上、由嗜麦芽窄食单胞菌引起原发性菌血症和医院获得性肺炎的患者。对患者的病历进行了评估，包括临床微生物学报告和医院感染控制委员会的报告。
共诊断出71例嗜麦芽窄食单胞菌医院感染患者，其中35例（49.3%）为原发性菌血症，36例（50.7%）为肺炎。除慢性阻塞性肺疾病外，在性别、年龄和合并疾病方面无显著差异；肺炎患者的这种感染明显更高。肺炎患者的14天死亡率略高，但差异无统计学意义。多因素分析发现不适当使用抗生素和存在多器官功能障碍综合征是14天死亡率的独立危险因素。
嗜麦芽窄食单胞菌引起的肺炎患者死亡率略高，这可能是由于高龄、急性生理与慢性健康状况评估（APACHE II）和脓毒症相关器官功能衰竭评估（SOFA）评分较高，以及不适当使用抗生素的情况较多所致。
