Bacteremia due to Stenotrophomonas (Xanthomonas) maltophilia: a prospective, multicenter study of 91 episodes.
We identified 91 cases of bacteremia due to Stenotrophomonas (Xanthomonas) maltophilia in a prospective, multicenter observational study. The patients were highly compromised; the majority had an underlying malignancy, had received immunosuppressive therapy, and had indwelling venous catheters. Although 94% of patients received an antimicrobial agent to which the blood isolate was susceptible, the mortality among these patients 14 days after the onset of bacteremia was 21%. Mortality was significantly correlated with the presence of a hematologic malignancy or neutropenia or transplantation, immunosuppressive therapy, and a severity-of-illness score of > 4. S. maltophilia infection is associated with substantial morbidity and mortality among highly compromised patients. The organism is typically resistant to expanded spectrum beta-lactam agents and aminoglycoside antibiotics. Trimethoprim-sulfamethoxazole should be administered if the isolate is susceptible to this combination; addition of another agent to which the isolate is susceptible should be considered in treating patients who are neutropenic, immunocompromised, or critically ill.
Muder
R R
RR
Veterans Affairs Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Harris
A P
AP
Muller
S
S
Edmond
M
M
Chow
J W
JW
Papadakis
K
K
Wagener
M W
MW
Bodey
G P
GP
Steckelberg
J M
JM
D016470:Bacteremia / Q000150:complications / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D015984:Causality; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D014974:Xanthomonas / Q000187:drug effects / Q000302:isolation & purification*