Risk Factors for a First Episode of Ventilator-Associated Pneumonia Caused by Stenotrophomonas Maltophilia

Canivet, Clémence M.; Teysseyre, Laura; Aujoulat, Thomas; Caron, Margot; Nativel, Mathilde; Miltgen, Guillaume; Vidal, Charles; Allou, Nicolas; Puech, Bérénice

doi:10.21203/rs.3.rs-1280164/v1

Cited by 3 publications

(2 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It causes HAP in critically ill patients in the ICU due to its ability of biofilm formation and site adhesion in respiratory instruments and its intrinsic and acquired resistance to various antibiotics makes treatment difficult [ 130 , 131 ]. In recent studies, the incidence of VAP due to S. maltophilia was 0.27 to 0.93% [ 131 – 133 ]. It causes severe hemorrhagic pneumonia with a reported mortality rate of 100% [ 134 ].…”

Section: Introductionmentioning

confidence: 99%

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Assefa

2022

Pneumonia

View full text Add to dashboard Cite

Bacterial pneumonia is one of the most serious public health issues owing to its medical and economic costs, which result in increased morbidity and mortality in people of all ages around the world. Furthermore, antimicrobial resistance has risen over time, and the advent of multi-drug resistance in GNB complicates therapy and has a detrimental impact on patient outcomes. The current review aimed to summarize bacterial pneumonia with an emphasis on gram-negative etiology, pathogenesis, risk factors, resistance mechanisms, treatment updates, and vaccine concerns to tackle the problem before it causes a serious consequence. In conclusion, the global prevalence of GNB in CAP was reported 49.7% to 83.1%, whereas in VAP patients ranged between 76.13% to 95.3%. The most commonly reported MDR-GNB causes of pneumonia were A. baumannii, K. pneumoniae, and P. aeruginosa, with A. baumannii isolated particularly in VAP patients and the elderly. In most studies, ampicillin, tetracyclines, amoxicillin-clavulanic acid, cephalosporins, and carbapenems were shown to be highly resistant. Prior MDR-GNB infection, older age, previous use of broad-spectrum antibiotics, high frequency of local antibiotic resistance, prolonged hospital stays, ICU admission, mechanical ventilation, and immunosuppression are associated with the MDR-GNB colonization. S. maltophilia was reported as a severe cause of HAP/VAP in patients with mechanically ventilated and having hematologic malignancy due to its ability of biofilm formation, site adhesion in respiratory devices, and its intrinsic and acquired drug resistance mechanisms. Effective combination therapies targeting PDR strains and drug-resistant genes, antibiofilm agents, gene-based vaccinations, and pathogen-specific lymphocytes should be developed in the future.

show abstract

Section: Introductionmentioning

confidence: 99%

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Assefa

2022

Pneumonia

View full text Add to dashboard Cite

show abstract

“…On the other hand, our cohort stands apart from other outbreak scenarios due to several factors: (1) All patients with S. maltophilia infection developed respiratory colonization with or without nosocomial pneumonia, with no cases of bacteremia; (2) no diagnostic or therapeutic material was found to be contaminated [35,36]; (3) a single principal ST was found to be the culprit of the outbreak [37]; and (4) our investigation did not find evidence of polymicrobial colonization or infection from bronchoaspiration samples [38].…”

Section: Discussionmentioning

confidence: 52%

Stenotrophomonas maltophilia Outbreak in an ICU: Investigation of Possible Routes of Transmission and Implementation of Infection Control Measures

Cristina,

Sartini,

Ottria

et al. 2024

Pathogens

View full text Add to dashboard Cite

Stenotrophomonas maltophilia, a non-fermentative, ubiquitous, gram-negative aerobic bacterium, is associated with high mortality rates, particularly in immunocompromised or debilitated patients. The prevalence rate of ICU-acquired pneumonia episodes caused by this microorganism has been found to be 2%. S. maltophilia has been identified as one of the top 10 microorganisms responsible for such infections in EU/EEA countries. This study describes an outbreak of S. maltophilia in an intensive care unit of a hospital in northern Italy. This includes an epidemiological investigation of the cases, the environmental microbiological controls carried out, a comparison of the strains by multilocus sequence typing (MLST), and the measures taken to prevent and control the outbreak. Among the seven clinical isolates of S. maltophilia analyzed herein, six demonstrated susceptibilities to trimethoprim–sulfamethoxazole. Conversely, one isolate of S. maltophilia exhibited resistance to first-line antibiotics. ST was found to be identical for six patients (ST 4), as well as in the environmental feedback on the trolley of Box 2. The analysis of the temporal and spatial progression of the outbreak has suggested that the transmission of S. maltophilia may have occurred through cross-transmission during care practices.

show abstract

Clinical profile and outcomes of Stenotrophomonas maltophilia pneumonia in Philippine General Hospital

Reña,

Manzano,

Salamat

2024

Preprint

View full text Add to dashboard Cite

Objectives. To determine the clinical profile and treatment outcomes of patients with Stenotrophomonas maltophilia pneumonia admitted to the University of the Philippines – Philippine General Hospital (UP-PGH) Methodology. We reviewed the medical and laboratory records of patients with Stenotrophomonas maltophiliapneumonia who were admitted to the UP-PGH from January 2019 to December 2022. Results. A total of 265 patients (50.6% males, median age of 59 years) with S. maltophilia pneumonia were included. Forty-five percent were admitted to the service ward, and 43% were admitted to the ICU. Most patients were ventilator-associated (67.2%). Only three cases were community-acquired. Sixty-four percent of S. maltophilia pneumonia cases were monomicrobial. K. pneumoniae and A. baumannii were the most common isolates in patients with polymicrobial pneumonia. Septic shock was present in 41.5% of the patients. In vitro susceptibility to levofloxacin (90.6%) and minocycline (85.7%) was greater than that to TMP-SMX (75.8%). Most patients received targeted therapy consisting of TMP-SMX monotherapy. In two-thirds of the patients, the duration of antibiotic therapy ranged from 7 to 14 days. The overall mortality rate was 45.3%, with 60.8% attributed to S. maltophilia infection. Conclusion. S. maltophilia pneumonia was common among patients with comorbidities who were on prolonged hospitalization and on mechanical ventilation. It was associated with a high mortality rate.

show abstract

Risk Factors for a First Episode of Ventilator-Associated Pneumonia Caused by Stenotrophomonas Maltophilia

Cited by 3 publications

References 42 publications

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns

Stenotrophomonas maltophilia Outbreak in an ICU: Investigation of Possible Routes of Transmission and Implementation of Infection Control Measures

Clinical profile and outcomes of Stenotrophomonas maltophilia pneumonia in Philippine General Hospital

Contact Info

Product

Resources

About