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Infections caused by Stenotrophomonas maltophilia--a prospective study
R Schaumann1, K Stein, C Eckhardt
1Institute for Medical Microbiology and Epidemiology of Infectious Diseases, University of Leipzig, Germany. schaur@medizin.uni-leipzig.de.
Background:
Stenotrophomonas maltophilia is an opportunistic microorganism, often highly resistant to routinely tested antibiotics. This microorganism is isolated in specimens from patients with nosocomial infections with increasing frequency.
Patients And Methods:
During a 1-year period (1998/1999) S. maltophilia was isolated from 137 specimens (0.26% of all investigated specimens) from 80 patients who were treated in a 1,500 bed major tertiary care teaching hospital in Leipzig. The data of 76 patients (133 specimens) could be collected and analyzed completely.
Results:
The pathogen was most frequently detected in specimens from the respiratory tract (54%). In five patients (six cases) S. maltophilia was isolated from blood cultures (0.3% of all positive blood cultures; 1.4% of all gram-negative isolates from blood cultures). 70 of the infected patients were inpatients and 32 (42%) of them were treated on the internal medicine wards. Of these 32 patients only six (19%) were pretreated with imipenem. The Length of stay at the hospital resulted in an independent increased risk of infection with S. maltophilia. In addition, this organism was detected in six infected outpatients.
Conclusion:
S. maltophilia is not only a nosocomial pathogen. Pretreatment with a carbapenem is no longer an unequivocal risk factor for an infection with S. maltophilia.
Insights
Stenotrophomonas maltophilia is increasingly found in hospitals, not just from hospital-acquired infections. Prior carbapenem antibiotic use is not a definitive risk factor for this resistant bacterium.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Stenotrophomonas maltophilia is an opportunistic pathogen known for antibiotic resistance.
- Its isolation from nosocomial infections is increasing.
- Understanding its epidemiology is crucial for infection control.
Purpose of the Study:
- To investigate the incidence and characteristics of Stenotrophomonas maltophilia infections in a tertiary care hospital.
- To identify risk factors associated with S. maltophilia infections.
- To evaluate the role of prior carbapenem use.
Main Methods:
- Retrospective analysis of S. maltophilia isolates from 1998-1999.
- Data collected from 76 patients and 133 specimens.
- Analysis of patient demographics, specimen sources, and treatment history.
Main Results:
- S. maltophilia was isolated from 137 specimens (0.26% of all specimens) in 80 patients.
- Most frequent isolation site was the respiratory tract (54%).
- Hospital length of stay was an independent risk factor; prior imipenem use was not consistently observed in infected inpatients.
Conclusions:
- S. maltophilia is not exclusively a nosocomial pathogen.
- Carbapenem pretreatment is not a reliable indicator for S. maltophilia infection risk.
- Further research into S. maltophilia epidemiology and resistance mechanisms is warranted.
