Analysis of Epidemic and Endemic Isolates of Xanthomonas maltophilia by Contour-Clamped Homogeneous Electric Field Gel Electrophoresis

VanCouwenberghe, Carolyn; Cohen, Stuart H.

doi:10.1086/646839

Cited by 13 publications

(19 citation statements)

References 28 publications

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“…6,15,21,[25][26][27] In our study, the heterogeneity of the S. maltophilia strain types documented by pulsed-field gel electrophoresis of nine isolates suggested that the organisms came from multiple sources.…”

Section: Discussionmentioning

confidence: 49%

Risk Factors ForStenotrophomonas MaltophiliaBacteremia In Oncology Patients: A Case–Control Study

Apisarnthanarak¹,

Mayfield

Garison

et al. 2003

Infect. Control Hosp. Epidemiol.

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Objective:To characterize risk factors for Stenotrophomonas maltophilia bloodstream infection in oncology patients.Design:A 3:1 case–control study.Setting:Stem Cell Transplant and Leukemic Center at Barnes–Jewish Hospital (St. Louis), a 1,442-bed, tertiary-care teaching hospital with a 26-bed transplantation ward.Method:From June 1999 to April 2001,13 patients with S. maltophilia bacteremia were compared with 39 control-patients who were on the transplantation unit on the same day as the case-patients' positive blood cultures. Information collected included patient demographics, medical history, history of transplantation, transplantation type, graft versus host disease, neutropenia, antibiotic use, chemotherapy, mucositis, diarrhea, the presence of central venous catheter(s), cultures, and concomitant infections.Results:Significant risk factors for S. maltophilia bacteremia included severe mucositis (7 [53.8%] of 13 vs 8 [20.5%] of 39; P = .034), diarrhea (7 [53.8%] of 13 vs 8 [20%] of 39; P = .034), and the use of metronidazole (9 [69.2%] of 13 vs 8 [20.5%] of 39; P = .002). In addition, the number of antibiotics used (median, 9 vs 5; P < .001), duration of mucositis (median, 29 vs 15 days; P = .032), and length of hospital stay (median, 34 vs 22 days; P = .017) were significantly different between case- and control-patients. Nine S. maltophilia isolates tested by pulsed-field gel electrophoresis were found to be distinctly different.Conclusion:Interventions to ameliorate the severity of mucositis, reduce antibiotic pressure, prevent diarrhea, and promote meticulous central venous catheter care may help prevent S. maltophilia bloodstream infection in oncology patients. The role of gastrointestinal tract colonization as a potential source of S. maltophilia bacteremia in oncology patients deserves further investigation.

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Section: Discussionmentioning

confidence: 49%

Risk Factors ForStenotrophomonas MaltophiliaBacteremia In Oncology Patients: A Case–Control Study

Apisarnthanarak¹,

Mayfield

Garison

et al. 2003

Infect. Control Hosp. Epidemiol.

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“…and Citrobacter spp., and 5 to 60 s for 22 h for Serratia spp. (3,8,9,13). The gels were stained with ethidium bromide and photographed under UV light.…”

Section: Methodsmentioning

confidence: 99%

Molecular epidemiology of acquisition of ceftazidime-resistant gram-negative bacilli in a nonoutbreak setting

et al. 1997

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We prospectively studied the acquisition of ceftazidime-resistant gram-negative bacilli (CAZ-RGN) in two surgical intensive care units (SICU) during a nonoutbreak period. Surveillance cultures were obtained from patients at the time of admission and serially thereafter. CAZ-RGN isolates were typed by pulsed-field gel electrophoresis (PFGE). Three hundred and forty-three patients were enrolled from whom 1,621 baseline and follow-up cultures were obtained. The most common species isolated from patients were Pseudomonas aeruginosa (22), Enterobacter cloacae (21), Acinetobacter spp. (13), Enterobacter aerogenes (11), Citrobacter spp. (10), Pseudomonas spp. (non P. aeruginosa) (9), and Stenotrophomonas spp. (7). For each species, PFGE strain types were highly diverse; no single type was recovered from more than four patients. Twenty-eight patients acquired a CAZ-RGN during the SICU stay; in six (21%), emergence of resistance from a previously susceptible strain was documented on the basis of matching serial strain types. Transmission of CAZ-RGN between patients occurred but was infrequent, as judged by analyzing strain types of epidemiologically linked patients. In conclusion, colonization with CAZ-RGN in SICU was associated with diverse species and strains, as determined by molecular typing. Emergence of resistance from previously susceptible strains appeared to be more important than horizontal transmission in acquisition of CAZ-RGN in a nonoutbreak period.

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“…Although not the first evidence of nosocomial cross-transmission of this microorganism, the authors' use of molecular methods was thorough and contributed to what is known about this important organism. We used the molecular techniques contour-clamped homogeneous electric-field gel electrophoresis 2 and arbitrarily primed polymerase chain reaction 3 to compare 64 hospital endemic and neonatal intensive care unit epidemic isolates of S maltophilia. Additionally, we conducted a retrospective chart review to determine risk factors.…”

Section: To the Editormentioning

confidence: 99%

“…We showed antibiograms to have a Simpson's Discriminatory Index of 0.87 when applied to 56 isolates of S maltophilia. 2 Although analyzing variability in antibiograms becomes extremely complicated when multiple strains are involved, a single pair can often be analyzed efficiently and economically. The data may help a bedside clinician motivate others to expend resources constructively to prevent further infections.…”

Section: To the Editormentioning

confidence: 99%

Analysis of Epidemic and Endemic Isolates of Xanthomonas maltophilia by Contour-Clamped Homogeneous Electric Field Gel Electrophoresis

Abstract: Although it is a convenient and economical tool, the antibiogram has limitations. Analysis by CHEF should help to elucidate the epidemiological spread of X maltophilia in the hospital.

Cited by 13 publications

References 28 publications

Risk Factors ForStenotrophomonas MaltophiliaBacteremia In Oncology Patients: A Case–Control Study

Risk Factors ForStenotrophomonas MaltophiliaBacteremia In Oncology Patients: A Case–Control Study

Molecular epidemiology of acquisition of ceftazidime-resistant gram-negative bacilli in a nonoutbreak setting

Evidence of NosocomialStenotrophomonas maltophiliaCross-Infection in a Neonatology Unit Analyzed by Three Molecular Typing Methods

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