title: Risk factors associated with isolation of Stenotrophomonas (Xanthomonas) maltophilia in clinical specimens.
abstract: OBJECTIVE
  To determine risk factors for patients whose cultures grew Stenotrophomonas maltophilia.
  
  
  METHODS
  Retrospective case-control study of 60 patients with cultures positive for S maltophilia, matched by specimen site to 120 controls whose cultures grew other gram-negative aerobic bacteria.
  
  
  METHODS
  University medical center.
  
  
  RESULTS
  S maltophilia was identified from the following sites: respiratory (36), wound (13), urinary (6), blood (4), and cerebral spinal fluid (1). By univariate analysis, cases had a higher risk of exposure than controls for ampicillin (P < .001), gentamicin (P < .001), vancomycin (P = .001), metronidazole (P = .003), piperacillin (P = .007), cefotaxime (P = .014), ceftazidime (P = .017), ciprofloxacin (P = .030), tobramycin (P = .040), and chronic respiratory disease (P = .024). Length of time foreign objects were in place prior to positive culture differed significantly between cases and controls only for endotracheal tubes in patients with respiratory isolates (median number of days: 12.5 for cases, 5 for controls; P = .007). For patients with urinary tract infections, having a urinary catheter increased the odds of infection 10 times over controls. Exposures found by multivariate analysis to be significantly more prevalent in cases than controls included ampicillin, cefotaxime, erythromycin, gentamicin, metronidazole, piperacillin, tobramycin, chronic respiratory disease, and female gender. Odds ratios were > 1 indicating higher risk for cases, except for erythromycin, which had an odds ratio < 1.
  
  
  CONCLUSIONS
  The primary risk factor associated with isolation of S maltophilia was antibiotic use. For patients with pulmonary infections, chronic respiratory disease and length of time an endotracheal tube was in place also contributed to the risk. This suggests that judicious use of antibiotics may prevent some cases of S maltophilia infection.
authors.affiliation: Division of Nursing, California State University, Sacramento, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: VanCouwenberghe
authors.forename: T B
authors.initials: TB
authors.lastname: Farver
authors.forename: S H
authors.initials: SH
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002908:Chronic Disease; D017714:Community-Acquired Infections / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D016001:Confidence Intervals; D003428:Cross Infection / Q000097:blood / Q000453:epidemiology* / Q000652:urine; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D015999:Multivariate Analysis; D016017:Odds Ratio; D012140:Respiratory Tract Diseases / Q000150:complications; D012307:Risk Factors; D013997:Time Factors; D014974:Xanthomonas / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents