Stenotrophomonas (Xianthomonas) maltophilia as an emerging opportunistic pathogen in association with HIV infection:: A 10-year surveillance study

被引:46
作者
Calza, L [1 ]
Manfredi, R [1 ]
Chiodo, F [1 ]
机构
[1] Univ Bologna, S Orsola M Malpighi Hosp, Infect Dis Sect, Dept Clin & Expt Med, I-40138 Bologna, Italy
关键词
D O I
10.1007/s15010-003-3113-6
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Stenotrophomonas (Xanthomonas) maltophilia has been increasingly reported as a nosocomial opportunistic pathogen, responsible for serious infectious complications in immunocompromised patients. At present very Limited information is available concerning its clinical significance in the setting of HIV infection. Patients and Methods: A retrospective survey of clinical and microbiological records of 1,374 HIV-infected patients referring to our tertiary care center during a 10-year period (1991-2000) was performed to identify all episodes of S. maltophilia infection and analyze epidemiological, clinical and Laboratory variables. The episodes of S. maltophilia bacteremia were compared with those caused by non-typhoid Salmonella spp. occurring in HIV-infected patients referring to our center during the same period, in order to evaluate eventual predisposing risk factors. Results: 61 episodes of S. maltophilia infection were observed in 59 HIV-infected patients: sepsis/bacteremia in 48 cases (78.7%), Lower airways infection in five, urinary tract infection in four, pharyngitis in two, Lymphadenitis and Liver abscess in one case each. 47 of 61 episodes (77%) of S. maltophilia infection occurred as nosocomial disease (i.e. were diagnosed after the 3rd day of hospitalization) and bacterial isolates showed an elevated resistance profile against many beta-lactam compounds, aztreonam, imipenem and aminoglycosides. At the same time, 38 episodes of bacteremia due to non-typhoid Salmonella spp. were diagnosed in our patients, 13 of which were nosocomial infections. Conclusion: When compared with non-typhoid Salmonella spp. bacteremia, a significantly higher risk of developing S. maltophilia disseminated infection was seen in association with advanced immunodeficiency, Leukopenia-neutropenia, central venous catheterization, prior broad-spectrum antimicrobial therapy and/or corticosteroid treatment.
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页码:155 / 161
页数:7
相关论文
共 47 条
[1]   INVASIVE BACTERIAL-INFECTIONS IN CHILDREN BORN TO WOMEN INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 [J].
ANDIMAN, WA ;
MEZGER, J ;
SHAPIRO, E .
JOURNAL OF PEDIATRICS, 1994, 124 (06) :846-852
[2]  
Aydin K, 2000, SCAND J INFECT DIS, V32, P427, DOI 10.1080/003655400750045060
[3]   PSEUDOMONAS-AERUGINOSA BRONCHOPULMONARY INFECTION IN LATE HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE [J].
BARON, AD ;
HOLLANDER, H .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1993, 148 (04) :992-996
[4]  
BERGER BJ, 1994, INFECT DIS CLIN N AM, V8, P449
[5]  
Bernard E, 1996, PRESSE MED, V25, P746
[6]   Liver abscess caused by Stenotrophomonas (Xanthomonas) maltophilia in a patient with AIDS [J].
Calza, L ;
Manfredi, R ;
Marinacci, G ;
Fortunato, L ;
Chiodo, F .
AIDS, 2001, 15 (18) :2465-2467
[7]   SYNERGISTIC INTERACTIONS OF CIPROFLOXACIN AND EXTENDED-SPECTRUM BETA-LACTAMS OR AMINOGLYCOSIDES AGAINST MULTIPLY DRUG-RESISTANT PSEUDOMONAS-MALTOPHILIA [J].
CHOW, AW ;
WONG, J ;
BARTLETT, KH .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1988, 32 (05) :782-784
[8]  
Del Toro MD, 2002, MEDICINE, V81, P228
[9]   Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia [J].
Denton, M ;
Kerr, KG .
CLINICAL MICROBIOLOGY REVIEWS, 1998, 11 (01) :57-+
[10]  
ELTING LS, 1990, INFECT CONT HOSP EP, V11, P134