Nosocomial infection caused by Xanthomonas maltophilia: a case-control study of predisposing factors.
Factors predisposing to clinically significant nosocomial infection with Xanthomonas maltophilia were examined in a matched case-control study using multivariate techniques. Sixteen cases occurred among cancer patients in a six-month period, including an apparent cluster of three cases in an intensive care unit. These infections were unusually serious; eight patients had disseminated infection caused by X maltophilia and six died as a result of their infections. Among the 64 factors that were examined, therapy with broad-spectrum antibiotics and central venous catheterization were found to significantly increase susceptibility to infection. Therapy with imipenem was more than ten times more frequent among cases than among controls (p less than .001). All fatal infections occurred in patients who had received imipenem, including two patients who died before the organism could be identified and appropriate therapy instituted. Infection with X maltophilia should be suspected in patients who develop superinfection while receiving imipenem, and prompt therapy should be instituted to improve chances of survival. Because a common environmental source of X maltophilia was not identified, further study is necessary to determine specific preventive measures.
Elting
L S
LS
Department of Medical Specialties, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Khardori
N
N
Bodey
G P
GP
Fainstein
V
V
D001424:Bacterial Infections / Q000382:microbiology* / Q000517:prevention & control; D016022:Case-Control Studies; D003428:Cross Infection / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006760:Hospitalization; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014974:Xanthomonas / Q000302:isolation & purification
D015378:Imipenem; D015662:Trimethoprim, Sulfamethoxazole Drug Combination