Clinical characteristics of Stenotrophomonas maltophilia meningitis in adults: A high incidence in patients with a postneurosurgical state, long hospital staying and antibiotic use

Huang, Chi-Ren; Chen, Shufeng; Tsai, Nai‐Wen; Chang, Chiung‐Chih; Lu, Chen-Hsien; Chuang, Yao-Chung; Chien, Chun-Chih; Chang, Wen-Neng

doi:10.1016/j.clineuro.2013.03.006

Cited by 11 publications

(24 citation statements)

References 35 publications

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“…This bacterium is increasingly recognized as an emerging global opportunistic pathogen of infections, causing severe infections in hospitalized patients, including bacteremia [2], biliary [3] and urinary tract infections [4], respiratory tract infections [5], skin and soft tissue infections [6], bone and joint infections [7], endocarditis [8], meningitis [9], and ocular infections [10].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and risk factors of infections caused by Stenotrophomonas maltophilia in a hospital in northwest China

Meng

Zhang

et al. 2014

J Infect Dev Ctries

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Introduction: Stenotrophomonas maltophilia infections have recently increased in importance in China, particularly in intensive care units (ICUs). The aim of this study was to investigate the clinical characteristics and risk factors of S. maltophilia infection in ICU of a hospital in northwest China. Methodology: The characteristics and outcomes of patients with any type of S. maltophilia infection at Shaanxi Provincial People's Hospital, Shaanxi, China, over a two-year period (from July 2011 to June 2013) were studied. S. maltophilia antimicrobial susceptibility was tested with the agar dilution method. The risk factors for all-cause in-hospital mortality were assessed with multivariate logistic regression. Results: Forty patients (median age, 72 years; 77.5% males) with S. maltophilia infection were identified. The main type of infection was lower respiratory tract infection (97.5%); one patient had a bloodstream infection. A total of 97.5% patients were infected with two or more organisms at the same time. The main characteristics of the patients were prolonged use of mechanical ventilation, urethral catheter, and central venous catheter before the infections occurred. The case number of infection was not different in the four seasons. High in vitro sensitivity was observed to minocycline (91.2%), levofloxacin (85.3%), and trimethoprim-sulfamethoxazole (79.4%). Most patients received therapy with a combination of agents. The crude mortality was 50%. By multivariate analysis, low albumin content and hypotension were the independent prognostic factors for mortality. Conclusions: Appropriate antimicrobial treatment had no positive impact on mortality. The impacts of albumin supplements and increasing blood pressure on mortality require further clinical studies.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics and risk factors of infections caused by Stenotrophomonas maltophilia in a hospital in northwest China

Meng

Zhang

et al. 2014

J Infect Dev Ctries

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“…Although S. maltophilia is a rare cause of community‐acquired infections, it is increasingly recognized as an emerging cause of nosocomial infections, particularly among severely debilitated or immunosuppressed patients …”

Section: Discussionmentioning

confidence: 99%

“…Based on susceptibility studies, however, TMP‐SMX is the drug of choice for the treatment of this infection . Nevertheless, recent data indicate that the percentage of strains resistant to TMP‐SMX may be increasing . Also, the role of combined therapy in the treatment of serious S. maltophilia infections remains controversial .…”

Section: Discussionmentioning

confidence: 99%

“…6 Although S. maltophilia is a rare cause of communityacquired infections, it is increasingly recognized as an emerging cause of nosocomial infections, particularly among severely debilitated or immunosuppressed patients. 7 The reported risk factors associated with S. maltophilia infection are prematurity, neurosurgical procedures (especially shunts and drainages), intracranial hemorrhage and malignancy. 2,3,8 The present patient had undergone several neurosurgical procedures and he had also been previously treated with broad-spectrum antibiotics such as vancomycin, which constitutes a risk factor for infection with S. maltophilia.…”

Section: Discussionmentioning

confidence: 99%

“…The risk factors for colonization and infection due to S. maltophilia include prolonged hospitalization requiring invasive procedures, previous exposure to broad‐spectrum antibiotics, mechanical ventilation, and severe mucositis . Although this microorganism is considered an infrequent cause of meningitis, it has become a focus of interest not only due to increasing recognition of its pathogenic potential but also because of its marked antibiotic resistance …”

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confidence: 99%

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Stenotrophomonas maltophilia: Rare cause of meningitis

Correia

Ferreira

Nunes

2014

Pediatrics International

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Stenotrophomonas maltophilia is a Gram-negative bacillus, which is an extremely rare cause of meningitis. To our knowledge, there are only five previous pediatrics cases. Here, we describe the case of a 4-year-old boy who developed meningitis associated with this organism, after several neurosurgical procedures and previous treatment with a broad-spectrum antibiotic. He was treated successfully with a combination of trimethoprim-sulfamethoxazole, ceftazidime and levofloxacin. Stenotrophomonas maltophilia should be considered as a potential cause of meningitis, especially among severely debilitated or immunosuppressed patients. Antimicrobial therapy is complicated by the high resistance of the organism to multiple antibiotics.

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Non-cephalosporin-susceptible, glucose non-fermentative Gram-negative bacilli meningitis in post-neurosurgical adults: Clinical characteristics and therapeutic outcome

Lai

Chen

Tsai

et al. 2014

Clinical Neurology and Neurosurgery

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Clinical characteristics of Stenotrophomonas maltophilia meningitis in adults: A high incidence in patients with a postneurosurgical state, long hospital staying and antibiotic use

Cited by 11 publications

References 35 publications

Clinical characteristics and risk factors of infections caused by Stenotrophomonas maltophilia in a hospital in northwest China

Clinical characteristics and risk factors of infections caused by Stenotrophomonas maltophilia in a hospital in northwest China

Stenotrophomonas maltophilia: Rare cause of meningitis

Non-cephalosporin-susceptible, glucose non-fermentative Gram-negative bacilli meningitis in post-neurosurgical adults: Clinical characteristics and therapeutic outcome

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