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Volume 39, Number 2, April 2006

Stenotrophomonas maltophilia bacteremia in pediatric patients — a 10-year analysis


Ping-Sheng Wu, Chun-Yi Lu, Luan-Yin Chang, Po-Ren Hsueh, Ping-Ing Lee, Jong-Min Chen, Chin-Yun Lee, Pei-Chun Chan, Po-Young Chang, Tsao-Ton Yang, Li-Min Huang
Departments of Pediatrics and Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan

Received: March 1, 2005    Revised: June 1, 2005    Accepted: June 15, 2005   

 

Corresponding author:

Li-Min Huang, M.D. Ph.D., Department of Pediatrics, National Taiwan University Hospital, Fl. 7, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. E-mail: lmhuang@ha.mc.ntu.edu.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it



 

Background and purpose: 

Stenotrophomonas maltophilia bacteremia is an important cause of mortality among immunocompromised children. However, there has been little information concerning S. maltophilia bacteremia in the pediatric population.
 



 

Methods:

We reviewed the drug susceptibility of bloodstream isolates of S. maltophilia and medical charts of S. maltophilia bacteremia patients less than 18 years old at the Department of Pediatrics, National Taiwan University Hospital from January 1993 to June 2003. The risk factors associated with mortality of the patients with S. maltophilia bacteremia were analyzed.

 



 

Results:

In total, 32 episodes (31 patients) of S. maltophilia bacteremia were reviewed. The average rate of nosocomial bloodstream infection was 8.3 episodes per 100,000 patient-days, and an average of 6.4% of them were caused by S. maltophilia. Malignancy was the most common underlying disease (32%). Six episodes of S. maltophilia bacteremia had soft tissue involvement, and only 1 of them underwent surgical intervention and survived. These 32 isolates were most susceptible to trimethoprim-sulfamethoxazole (91%), and no obvious increase in multidrug resistance was noted in the previous 10 years. The crude mortality rate was 40.6%. Malignancy, failure to remove central venous catheter, and ineffective antibiotic treatment were significant risk factors for mortality.

 



 

Conclusion:

Early and effective antimicrobial therapy and removal of central venous catheter as soon as possible are vital for the successful management of S. maltophilia bacteremia.

 



 

Key words:

Bacteremia, drug resistance, immunocompromised host, soft tissue infections, Stenotrophomonas maltophilia



 



 

J Microbiol Immunol Infect 2006;39:144-149.