Stenotrophomonas maltophilia bloodstream infection in patients with hematologic malignancies: a retrospective study and in vitro activities of antimicrobial combinations

被引:55
|
作者
Cho, Sung-Yeon [1 ,2 ]
Lee, Dong-Gun [1 ,2 ,3 ]
Choi, Su-Mi [1 ,2 ]
Park, Chulmin [2 ]
Chun, Hye-Sun [2 ]
Park, Yeon-Joon [4 ]
Choi, Jae-Ki [1 ,2 ]
Lee, Hyo-Jin [1 ,2 ]
Park, Sun Hee [1 ,2 ]
Choi, Jung-Hyun [1 ,2 ]
Yoo, Jin-Hong [1 ,2 ]
机构
[1] Catholic Univ Korea, Coll Med, Dept Internal Med, Div Infect Dis,St Marys Hosp, Seoul, South Korea
[2] Catholic Univ Korea, Coll Med, Vaccine Bio Res Inst, St Marys Hosp, Seoul, South Korea
[3] Catholic Univ Korea, Coll Med, Catholic Blood & Marrow Transplantat Ctr, St Marys Hosp, Seoul, South Korea
[4] Catholic Univ Korea, Coll Med, Dept Lab Med, St Marys Hosp, Seoul, South Korea
来源
BMC INFECTIOUS DISEASES | 2015年 / 15卷
关键词
Bacteremia; Drug combinations; Hematologic diseases; Mortality; Stenotrophomonas maltophilia; CELL TRANSPLANT RECIPIENTS; TRIMETHOPRIM-SULFAMETHOXAZOLE; CYSTIC-FIBROSIS; BACTEREMIA; SUSCEPTIBILITY; BACTERIAL; PATHOGEN; GUIDELINES; THERAPY; CANCER;
D O I
10.1186/s12879-015-0801-7
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Stenotrophomonas maltophilia causes serious infections in immunocompromised hosts. Here, we analyzed the clinical characteristics of S. maltophilia bloodstream infection (BSI) in patients with hematologic malignancies and evaluated in vitro synergistic effects of antimicrobial combinations. Methods: We retrospectively reviewed all consecutive episodes of S. maltophilia BSIs in adult hematologic patients from June 2009 to May 2014, with in vitro susceptibility and synergy tests using high throughput bioluminescence assay performed for available clinical isolates. Results: Among 11,004 admissions during 5-year period, 31 cases were identified as S. maltophilia BSIs. The incidence rate of S. maltophilia BSI was 0.134 cases/1,000 patient-days. Overall and attributable mortality of S. maltophilia BSI was 64.5% and 38.7%, respectively. Severe neutropenia (adjusted hazard ratio [HR] 5.24, p = 0.013), shock at the onset of BSI (adjusted HR 6.05, p < 0.001), and pneumonia (adjusted HR 3.15, p = 0.017) were independent risk factors for mortality. In vitro susceptibilities to ceftazidime, levofloxacin, ticarcillin-clavulanic acid (TIM) and trimethoprim-sulfamethoxazole (SXT) were 11.1%, 44.0%, 40.7%, and 88.9%, respectively. MIC50/MIC90 for moxifloxacin and tigecycline were 1/4 mg/L and 4/8 mg/L. The 50% and 90% fractional inhibitory concentrations (FIC50/FIC90) of clinical isolates against a combination of SXT and TIM were 0.500/0.750. For SXT plus levofloxacin or moxifloxacin, FIC50/FIC90 were 0.625/1.000 and 0.625/0.625, respectively. Conclusion: S. maltophilia BSIs show high mortality, which is related to severe neutropenia, shock, and S. maltophilia pneumonia. Based upon drug susceptibility testing, the primary treatment of choice for S. maltophilia BSIs should be SXT in hematologic patients, rather than quinolones, with combination therapies including SXT serving as a feasible treatment option.
引用
收藏
页数:8
相关论文
共 50 条
  • [1] Stenotrophomonas maltophilia bloodstream infection in patients with hematologic malignancies: a retrospective study and in vitro activities of antimicrobial combinations
    Sung-Yeon Cho
    Dong-Gun Lee
    Su-Mi Choi
    Chulmin Park
    Hye-Sun Chun
    Yeon-Joon Park
    Jae-Ki Choi
    Hyo-Jin Lee
    Sun Hee Park
    Jung-Hyun Choi
    Jin-Hong Yoo
    BMC Infectious Diseases, 15
  • [2] Fatal hemorrhagic pneumonia in patients with hematologic diseases and Stenotrophomonas maltophilia bacteremia: a retrospective study
    Lixia Zhu
    Lulu Wang
    Yuping Zhang
    Rongrong Chen
    Xueying Li
    Jianai Sun
    De Zhou
    Mingyu Zhu
    Xiaolong Zheng
    Li Li
    Jingjing Zhu
    Mixue Xie
    Xiudi Yang
    Wenjuan Yu
    Hongyan Tong
    Honghu Zhu
    Wanzhuo Xie
    Jie Jin
    Xiujin Ye
    BMC Infectious Diseases, 21
  • [3] Fatal hemorrhagic pneumonia in patients with hematologic diseases and Stenotrophomonas maltophilia bacteremia: a retrospective study
    Zhu, Lixia
    Wang, Lulu
    Zhang, Yuping
    Chen, Rongrong
    Li, Xueying
    Sun, Jianai
    Zhou, De
    Zhu, Mingyu
    Zheng, Xiaolong
    Li, Li
    Zhu, Jingjing
    Xie, Mixue
    Yang, Xiudi
    Yu, Wenjuan
    Tong, Hongyan
    Zhu, Honghu
    Xie, Wanzhuo
    Jin, Jie
    Ye, Xiujin
    BMC INFECTIOUS DISEASES, 2021, 21 (01)
  • [4] In vitro activities of antimicrobial combinations against planktonic and biofilm forms of Stenotrophomonas maltophilia
    Su, Bo-An
    Chen, Chi-Chung
    Chen, Hung-Jui
    Lai, Hsin-Yu
    Tsai, Chia-Hung
    Lai, Chih-Cheng
    Tang, Hung-Jen
    Chao, Chien-Ming
    FRONTIERS IN MICROBIOLOGY, 2023, 14
  • [5] Validation of a Stenotrophomonas maltophilia bloodstream infection prediction score in the hematologic malignancy population
    Gill, Emily L.
    Gill, Christian M.
    McEvoy, Colleen
    ANNALS OF HEMATOLOGY, 2024, 103 (05) : 1745 - 1752
  • [6] In vitro activities of antimicrobial combinations against clinical isolates of Stenotrophomonas maltophilia
    Liaw, SJ
    Teng, LJ
    Hsueh, PR
    Ho, SW
    Luh, KT
    JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION, 2002, 101 (07) : 495 - 501
  • [7] Hemorrhagic Pneumonia Caused by Stenotrophomonas maltophilia in Patients with Hematologic Malignancies-A Systematic Review and Meta-Analysis
    Huang, Chienhsiu
    Kuo, Sufang
    Lin, Lichen
    MEDICINA-LITHUANIA, 2024, 60 (01):
  • [8] Evaluation of clinical outcomes and risk factors associated with mortality in patients with Stenotrophomonas maltophilia bloodstream infection: a multicenter study
    Gezer, Yakup
    Taysi, Muhammet Ridvan
    Tarakci, Arzu
    Gokce, Ozlem
    Danaci, Gamze
    Toplu, Sibel Altunisik
    Karakas, Ezgi Erdal
    Alkan, Sevil
    Gulbudak, Sibel Kuyugoz
    Sahinoglu, Mustafa Serhat
    Gurbuz, Esra
    Ayarci, Ayse Oguz
    Bulut, Rukiyye
    Ural, Onur
    BMC INFECTIOUS DISEASES, 2024, 24 (01)
  • [9] The Burden of Bloodstream Infections due to Stenotrophomonas Maltophilia in the United States: A Large, Retrospective Database Study
    Cai, Bin
    Tillotson, Glenn
    Benjumea, Darrin
    Callahan, Patrick
    Echols, Roger
    OPEN FORUM INFECTIOUS DISEASES, 2020, 7 (05):
  • [10] Clinical Characteristics and Prognosis of Bloodstream Infection with Carbapenem-Resistant Pseudomonas aeruginosa in Patients with Hematologic Malignancies
    Yuan, Fangfang
    Xiao, Weiqiang
    Wang, Xiaokun
    Fu, Yuewen
    Wei, Xudong
    INFECTION AND DRUG RESISTANCE, 2023, 16 : 4943 - 4952