Rapidly progressive fatal hemorrhagic pneumonia caused by <i>Stenotrophomonas maltophilia</i> in hematologic malignancy

Araoka, Hideki; Fujii, Takeshi; Izutsu, Koji; Kimura, Muneyoshi; Nishida, Aya; Ishiwata, Kiichi; Nakano, Nobuaki; Tsuji, Motomu; Yamamoto, Hisashi; Asano‐Mori, Yuki; Uchida, Naoyuki; Wake, Atsushi; Taniguchi, Shuichi; Yoneyama, Akio

doi:10.1111/j.1399-3062.2011.00710.x

Cited by 42 publications

(39 citation statements)

References 27 publications

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“…Prolonged hospitalization, staying in ICU, and mechanical ventilation are reported as precipitating risk factors for S. maltophilia infections (22,26,(29)(30)(31). Time of acquiring infection after hospitalization (median; min-max values were presented in Table 1) was not different in the two groups, and more than half of the patients in the groups were in ICU.…”

Section: Discussionmentioning

confidence: 93%

Stenotrophomonas maltophilia Infections in Adults: Primary Bacteremia and Pneumonia

Gözel

Çelik

Elaldı

2015

Jundishapur J Microbiol

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Background: Stenotrophomonas maltophilia is the third most frequent non-fermentative Gram-negative bacilli in nosocomial infections, and usually causes severe infections such as primary bacteremia and pneumonia. Objectives: The current study aimed to compare the demographic and clinical characteristics, microbiological findings and final outcomes of the patients with primary bacteremia and nosocomial pneumonia caused by S. maltophilia. Patients and Methods: The current study retrospectively evaluated patients aged 18 years and above with primary bacteremia and nosocomial pneumonia caused by S. maltophilia from January 2006 to December 2013. Medical records of patients, including reports of clinical microbiology and hospital infection control committee, were evaluated. Results: A total of 71 patients with S. maltophilia nosocomial infections, 35 (49.3%) primary bacteremia and 36 (50.7%) pneumonia, were diagnosed. There were no significant differences in gender, age, and co-morbid diseases, except chronic obstructive pulmonary disease; this infection was significantly higher in patients with pneumonia. A slightly higher 14-day mortality was found in patients with pneumonia, but the difference was not statistically significant. Inappropriate antibiotic use and presence of multiple organ dysfunction syndrome were found as independent risk factors for 14-day mortality in multivariate analysis. Conclusions: A slightly higher mortality in patients with pneumonia, caused by S. maltophilia, was strived to explain by advanced age, higher acute physiology and chronic health evaluation (APACHE II) and sepsis related organ failure assessment (SOFA) score, and also higher inappropriate antibiotic use.

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Section: Discussionmentioning

confidence: 93%

Stenotrophomonas maltophilia Infections in Adults: Primary Bacteremia and Pneumonia

Gözel

Çelik

Elaldı

2015

Jundishapur J Microbiol

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“…However, it forms biofilm on the surface of medical devices as well as pulmonary epithelial cells, has great influence in respiratory infection, and is becoming multi-drug resistant [20,21,22]. As the study of Araoka et al has reported that pneumonia due to Stenotrophomonas maltophilia in hematologic cancer patients has 100% mortality, it can cause lethal result in immunosuppressed patients though its pathogenicity is low [23,24]. It is worth paying attention to that lately, nosocomial infection of Stenotrophomonas maltophilia is increasing through medical devices inserted after surgery [25], and the detection rate of Stenotrophomonas maltophilia, which is strongly antibiotic-resistant [20], is high in the testing devices in emergency room, which is often an entrance and exist of immunosuppressed patients.…”

Section: Conclusion and Discussionmentioning

confidence: 99%

Analysis of Healthcare Convergence on Bacterial Contamination of Radiological Equipment in Emergency Rooms of General Hospitals

Hong¹,

Park²

2017

Journal of the Korea Convergence Society

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It is to establish preliminary data about healthcare convergencr of infection control by performing a bacterial contamination test for CT scanner as well as general radiographic systems in the emergency rooms of general hospitals. The period was December 1 ∼ December 31, 2015. It is detect in the emergency rooms of 7 medical facilities including 2 in Seoul, and 1 in Gyeonggi-do Province, and 2 in Jeonla-do Province, and 2 in Chungcheong-do Province. The surface contamination strains detected from CT scanner in the radiology department emergency rooms were Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enterococcus faecium(4.5%), Providencia stuartii(4.5), and Gram negative bacilli(4.5%). Also, the surface contamination strains detected from general radiographic system in the radiology department emergency rooms were Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), and Gram negative bacilli(11%). Considering that the regions of most detection were all the places closely related to patients, radiologists would have to thoroughly clean with alcohol before and after a test.• Key Words : Computed tomography, Radiology, Bacteria, Infection, Emergency room, Healthcare convergence 요 약 본 연구는 종합병원 내 응급실에 설치된 CT 장비와 일반촬영장비에 대한 세균 오염도 검사를 실시하여 보건학적 융복합 감염관리에 대한 기초자료를 마련하고자 하였다. 연구는 2015년 12월 1일부터 12월 31일까지 수 도권 3곳과 전라도 2곳, 충청도 2곳 등 총 7곳의 의료기관을 대상으로하였다. 영상의학과 응급실 내 CT장비의 검 출된 표면 오염 균주는 Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enteococcus faecium(4.5%), Providencia stuartii(4.5), Gram negative bacilli(4.5%), 일반촬영장비에서 검출된 표면 오염 균 주는 Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), Gram negative bacilli(11%) 로 병원 감염의 원인균으로 알려진 균주는 없었고, 특 이성을 가진 균주 역시 없었지만 가장 많이 검출된 구역이 모두 환자와 밀접한 관련을 갖는 곳이므로 방사선사는 검사 전후 알코올 등으로 깨끗이 닦아내야 할 것이다.

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“…Occasionally, distinguishing between colonization and infection can be problematic (1–3). S. maltophilia infections can be complicated by septic shock, respiratory failure, pulmonary hemorrhage, metastatic cellulitis, tissue necrosis that may be extensive, septic thrombophlebitis, disseminated infection, and death (5–8, 11). …”

Section: Infections Caused By S Maltophiliamentioning

confidence: 99%

“…In patients with HM and in recipients of HSCT having severe lung infection caused by S. maltophilia , life-threatening pulmonary alveolar hemorrhage (PAH) causing acute respiratory failure has been reported (7, 8, 30–32). The risk factors for PAH in these patients include prolonged cytopenias and high C-reactive protein levels at the onset of BSI or pneumonia (7, 8).…”

Section: Pneumonia Caused By S Maltophiliamentioning

confidence: 99%

Infections Caused by Stenotrophomonas maltophilia in Recipients of Hematopoietic Stem Cell Transplantation

Al-Anazi¹,

Al-Jasser²

2014

Front. Oncol.

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Stenotrophomonas maltophilia (S. maltophilia) is a globally emerging Gram-negative bacillus that is widely spread in environment and hospital equipment. Recently, the incidence of infections caused by this organism has increased, particularly in patients with hematological malignancy and in recipients of hematopoietic stem cell transplantation (HSCT) having neutropenia, mucositis, diarrhea, central venous catheters or graft versus host disease and receiving intensive cytotoxic chemotherapy, immunosuppressive therapy, or broad-spectrum antibiotics. The spectrum of infections in HSCT recipients includes pneumonia, urinary tract and surgical site infection, peritonitis, bacteremia, septic shock, and infection of indwelling medical devices. The organism exhibits intrinsic resistance to many classes of antibiotics including carbapenems, aminoglycosides, most of the third-generation cephalosporins, and other β-lactams. Despite the increasingly reported drug resistance, trimethoprim-sulfamethoxazole is still the drug of choice. However, the organism is still susceptible to ticarcillin-clavulanic acid, tigecycline, fluoroquinolones, polymyxin-B, and rifampicin. Genetic factors play a significant role not only in evolution of drug resistance but also in virulence of the organism. The outcome of patients having S. maltophilia infections can be improved by: using various combinations of novel therapeutic agents and aerosolized aminoglycosides or colistin, prompt administration of in vitro active antibiotics, removal of possible sources of infection such as infected indwelling intravascular catheters, and application of strict infection control measures.

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Rapidly progressive fatal hemorrhagic pneumonia caused by Stenotrophomonas maltophilia in hematologic malignancy

Cited by 42 publications

References 27 publications

Stenotrophomonas maltophilia Infections in Adults: Primary Bacteremia and Pneumonia

Stenotrophomonas maltophilia Infections in Adults: Primary Bacteremia and Pneumonia

Analysis of Healthcare Convergence on Bacterial Contamination of Radiological Equipment in Emergency Rooms of General Hospitals

Infections Caused by Stenotrophomonas maltophilia in Recipients of Hematopoietic Stem Cell Transplantation

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