Iowa City VA Health Care System, 601 Highway 6 W, Iowa City, IA 52246, USA.
Merck Research Labs, Merck & Co., Inc., 2000 Galloping Hill Road, Kenilworth, NJ 07033, USA.
J Glob Antimicrob Resist. 2018 Mar;12:104-106. doi: 10.1016/j.jgar.2017.09.015. Epub 2017 Sep 28.
Stenotrophomonas maltophilia causes high mortality rates, especially in bloodstream infections (BSIs) where there is a lack of comparative data with fluoroquinolones (FQs) and sulfamethoxazole/trimethoprim (SXT). The objective of this study was to evaluate outcomes in patients with S. maltophilia BSI who were treated with FQs versus SXT.
A retrospective study was conducted to compare FQs (levofloxacin, ciprofloxacin and moxifloxacin) versus SXT for the treatment of S. maltophilia BSI.
A total of 54 patients were included in this retrospective study, including 32 treated with SXT and 22 treated with FQs (11 ciprofloxacin, 5 levofloxacin and 6 moxifloxacin). There were 3 deaths (13.6%) in the FQ group versus 10 (31.3%) in the SXT group (P=0.20). Modified Acute Physiology and Chronic Health Evaluation (APACHE) II score [odds ratio (OR)=1.4, 95% confidence interval (CI) 1.1-1.8] and broad-spectrum antibiotics prior to culture (OR=8, 95% CI 1.3-49.8) were significant predictors of mortality.
Ciprofloxacin, moxifloxacin and levofloxacin are possible alternatives to SXT for S. maltophilia BSI; however, further investigation is needed to confirm these findings.
嗜麦芽窄食单胞菌引起的死亡率很高，特别是在血流感染（BSI）中，与氟喹诺酮类药物（FQs）和磺胺甲噁唑/甲氧苄啶（SXT）相比，缺乏对照数据。本研究的目的是评估 FQs 与 SXT 治疗嗜麦芽窄食单胞菌 BSI 患者的结局。
进行了一项回顾性研究，比较了 FQs（左氧氟沙星、环丙沙星和莫西沙星）与 SXT 治疗嗜麦芽窄食单胞菌 BSI。
共有 54 例患者纳入本回顾性研究，其中 32 例接受 SXT 治疗，22 例接受 FQs（11 例环丙沙星、5 例左氧氟沙星和 6 例莫西沙星）治疗。FQs 组有 3 例死亡（13.6%），SXT 组有 10 例死亡（31.3%）（P=0.20）。改良急性生理学和慢性健康评估（APACHE）Ⅱ评分[比值比（OR）=1.4，95%置信区间（CI）1.1-1.8]和培养前使用广谱抗生素（OR=8，95%CI 1.3-49.8）是死亡的显著预测因素。
环丙沙星、莫西沙星和左氧氟沙星可能是 SXT 治疗嗜麦芽窄食单胞菌 BSI 的替代药物；然而，需要进一步的研究来证实这些发现。
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