Department of Infection Control Science, Osaka City University Graduate School of Medicine, Osaka, Japan; Department of Infectious Disease Medicine, Osaka City University Hospital, Osaka, Japan; Department of Respiratory Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Infection Control Science, Osaka City University Graduate School of Medicine, Osaka, Japan; Department of Infectious Disease Medicine, Osaka City University Hospital, Osaka, Japan.
J Hosp Infect. 2021 May;111:169-175. doi: 10.1016/j.jhin.2021.01.011. Epub 2021 Jan 29.
Stenotrophomonas maltophilia is a pathogen commonly associated with respiratory infection. However, the characteristics of pneumonia caused by S. maltophilia remain unknown.
To evaluate the characteristics of and risk factors for S. maltophilia pneumonia.
A retrospective evaluation was undertaken of 2002 patients with sputum cultures positive for S. maltophilia between January 2010 and December 2019. Cases were excluded based on clinical information and laboratory results. Included cases were divided into two groups: the S. maltophilia pneumonia group (patients with pneumonia caused by S. maltophilia) and the non-S. maltophilia pneumonia group (patients with pneumonia caused by pathogens other than S. maltophilia). Patient characteristics, clinical data and Sequential Organ Failure Assessment (SOFA) scores were compared between the groups.
Eight and 91 patients were assigned to the S. maltophilia pneumonia and non-S. maltophilia pneumonia groups, respectively. The median age was significantly lower in the S. maltophilia pneumonia group than in the non-S. maltophilia pneumonia group (63.4 vs 73.1 years; P<0.01), and the SOFA score was significantly higher in the S. maltophilia pneumonia group (7.5 vs 3.0; P<0.01). Underlying malignancy and pre-administration of antipseudomonal β-lactams and steroids were confirmed in seven of the eight cases in the S. maltophilia pneumonia group, suggesting an association with immunosuppression.
Pneumonia due to S. maltophilia is a rare occurrence. Treatment for this pathogen should be considered in cases of pneumonia with: (1) predominance of S. maltophilia in sputum cultures; (2) pre-administration of broad-spectrum antibiotics; (3) immunodeficiency; and (4) a high SOFA score.
嗜麦芽窄食单胞菌是一种常见的呼吸道感染病原体。然而，嗜麦芽窄食单胞菌肺炎的特征尚不清楚。
评估嗜麦芽窄食单胞菌肺炎的特征和危险因素。
回顾性分析 2010 年 1 月至 2019 年 12 月期间痰培养阳性的 2002 例嗜麦芽窄食单胞菌患者。根据临床信息和实验室结果排除病例。纳入的病例分为两组：嗜麦芽窄食单胞菌肺炎组（由嗜麦芽窄食单胞菌引起的肺炎患者）和非嗜麦芽窄食单胞菌肺炎组（由嗜麦芽窄食单胞菌以外的病原体引起的肺炎患者）。比较两组患者的特征、临床资料和序贯器官衰竭评估（SOFA）评分。
8 例和 91 例患者分别被分配到嗜麦芽窄食单胞菌肺炎组和非嗜麦芽窄食单胞菌肺炎组。嗜麦芽窄食单胞菌肺炎组的中位年龄明显低于非嗜麦芽窄食单胞菌肺炎组（63.4 岁 vs 73.1 岁；P<0.01），嗜麦芽窄食单胞菌肺炎组的 SOFA 评分明显更高（7.5 分 vs 3.0 分；P<0.01）。在嗜麦芽窄食单胞菌肺炎组的 8 例中，有 7 例存在潜在恶性肿瘤和使用抗假单胞菌β-内酰胺类药物和皮质类固醇，这表明与免疫抑制有关。
嗜麦芽窄食单胞菌肺炎较为罕见。对于以下患者，应考虑治疗该病原体引起的肺炎：（1）痰培养中嗜麦芽窄食单胞菌占优势；（2）使用广谱抗生素治疗前；（3）存在免疫缺陷；（4）SOFA 评分较高。
