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Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
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Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study

Johannes B J Scholte1,2, Tan Lai Zhou2, Dennis C J J Bergmans2

  • 1a Department of Intensive Care Medicine , Luzerner Kantonspital , Luzern , Switzerland ;

Infectious Diseases (London, England)
|May 22, 2016
PubMed
Abstract

Insights

Stenotrophomonas maltophilia is an infrequent cause of ventilator-associated pneumonia (VAP) in critically ill patients. This study found no significant differences in outcomes, including mortality, when comparing S. maltophilia VAP to VAP from other Gram-negative bacteria.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Microbiology

Background:

  • Stenotrophomonas maltophilia is increasingly identified in critically ill patients but often considered a low-pathogenicity organism.
  • Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in intensive care units (ICUs).

Purpose of the Study:

  • To investigate whether Stenotrophomonas maltophilia can cause VAP.
  • To compare the impact of S. maltophilia- VAP on ICU and 28-day mortality versus VAP caused by other Gram-negative bacilli.

Main Methods:

  • Retrospective analysis of a 19-year prospectively collected database.
  • Cases of VAP with S. maltophilia growth (≥10^4 cfu/ml in bronchoalveolar lavage) were identified.
  • Matched analysis (1:3 ratio) comparing S. maltophilia VAP cases with VAP caused by other Gram-negative bacilli based on hospital, gender, age, and APACHE II score.

Main Results:

  • Six cases met inclusion criteria for S. maltophilia VAP (probable or possible), representing 1.8% of all VAPs.
  • No significant differences were observed in baseline characteristics, mechanical ventilation duration, or ICU/hospital length of stay.
  • Odds ratios for ICU mortality (1.7) and 28-day mortality (1.4) were not statistically significant when comparing S. maltophilia VAP to other Gram-negative bacilli VAP.

Conclusions:

  • Stenotrophomonas maltophilia is an infrequent but possible cause of VAP in critically ill patients.
  • No significant differences in patient outcomes, including mortality, were found between S. maltophilia VAP and VAP caused by other Gram-negative bacilli.
Keywords:
Intensive care unitStenotrophomonas maltophiliamechanical ventilationmortalitymultidrug-resistantventilator-associated pneumonia

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