Xanthomonas maltophilia: An Emerging Nosocomial Pathogen

Marshall, W F; Keating, Michael R.; Anhalt, John P.; Steckelberg, James M.

doi:10.1016/s0025-6196(12)64979-9

Cited by 124 publications

(75 citation statements)

References 47 publications

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“…3,8,[11][12][13][14][15][16] Recognized risk factors associated with Stenotrophomonas bacteremia include antibiotic pressure, presence of a central venous catheter, prolonged hospital stay, length of intensive care unit stay, mechanical ventilation, and aggressive chemotherapy treatment for malignancies. 2,3,[6][7][8]11,13,[17][18][19][20][21] In addition, severe neutropenia (neutrophil count < 50/mm 3 ) and mucositis were shown to be significant risk factors for S. maltophilia bacteremia in a recent outbreak study of patients receiving allogeneic bone marrow transplants. 8 From June 1999 through April 2001, 13 patients on the transplantation unit acquired S. maltophilia bacteremia compared with 1 patient between July 1997 and May 1999.…”

Section: Stenotrophomonas Maltophilia Formerly Known Asmentioning

confidence: 99%

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: Stenotrophomonas Maltophilia Formerly Known Asmentioning

confidence: 99%

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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“…S. maltophilia is found in a variety of environments and can be isolated from water, soil, sewage, raw milk, frozen fish, and hospital disinfectant solutions (13). Several hospital environment isolates have been recovered from water faucets, respirators, sinks, catheters and the hands of hospital personnel (18).…”

Section: Introductionmentioning

confidence: 99%

“…This microorganism is becoming an important nosocomial pathogen (6,13,22) and has an intrinsic resistance to most of β-lactam antimicrobial agents. When S. maltophilia is isolated from patients with underliyng defficiencies in host defense mechanisms, there is convincing evidence for its potential pathogenicity (21).…”

Section: Introductionmentioning

confidence: 99%

Proteases (caseinase and elastase), hemolysins, adhesion and susceptibility to antimicrobials of Stenotrophomonas maltophilia isolates obtained from clinical specimens

Garcia¹,

Timenetsky²,

Martinez³

et al. 2002

Braz. J. Microbiol.

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Forty-six S. maltophilia isolates obtained from hospital clinical specimens were studied for protease (caseinase and elastase) production, hemolytic activity, adhesion to HEp-2 cells, plastic and glass. Susceptibility to antimicrobial agents was also evaluated. The majority of isolates were obtained from respiratory tract secretions of patients using medical devices. All the isolates grown overnight were able to hydrolyze casein at 30ºC and 37ºC. After 72h, all the isolates hydrolyzed elastase at 30ºC and 40 isolates (87%) at 37ºC. Most of the isolates presented hemolytic activity after 96h of incubation at both temperatures. Rabbit blood showed the hightest hemolytic activity, after 96h 61% and 98% of tested isolates presented β-hemolysis at 30ºC and 37ºC, respectively. All isolates were susceptible to trimethoprim-sulfametoxazole and were resistant to most β-lactams tested. By the dilution method, S. maltophilia showed a high susceptibility to ticarcillin-clavulanate and a lower susceptibility to ciprofloxacin than the agar diffusion. The isolates showed adhesion to HEp-2 cells, plastic and glass. The proteolytic activities and adhesion to inanimate surfaces detected in S. maltophilia can be related to the pathogenesis of this bacterium and/or medical device colonization which favors the development of nosocomial infections.

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“…This organism is an opportunistic pathogen that principally affects patients compromised by debilitating illness, surgical procedures, or indwelling catheters (Elting et ai, 1990). The incidence of clinical isolation of X. maltophilia is increasing, possibly in part because of the selective pressure from some new antimicrobial agents (Marshall et al, 1989). Strains of X. maltophilia are usually resistant to aminoglycosides and most /Mactams, show variable susceptibility to fluoroquinolones and are generally susceptible to trimethoprim/sulphamethoxazole (Neu, Saha & Chin, 1989;Lecso-Bornet et al, 1992).…”

Section: Introductionmentioning

confidence: 99%

Pulsed-field gel electrophoresis of restriction-digested genomic DNA and antimicrobial susceptibility of Xanthomonas maltophilia strains from Brazil, Switzerland and the USA

Sader

Pignatari

Frei³

et al. 1994

J Antimicrob Chemother

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Xanthomonas maltophilia: An Emerging Nosocomial Pathogen

Cited by 124 publications

References 47 publications

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

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

Proteases (caseinase and elastase), hemolysins, adhesion and susceptibility to antimicrobials of Stenotrophomonas maltophilia isolates obtained from clinical specimens

Pulsed-field gel electrophoresis of restriction-digested genomic DNA and antimicrobial susceptibility of Xanthomonas maltophilia strains from Brazil, Switzerland and the USA

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