title: Nonrespiratory Stenotrophomonas maltophilia infection at a children's hospital.
abstract: To describe Stenotrophomonas maltophilia infection in children, we reviewed the medical records of patients with isolates from nonrespiratory sites and identified 85 episodes, 51 (60%) of which represented true infection. Forty-two episodes (82.4%) were hospital acquired. Commonly associated with S. maltophilia infection were underlying illness (in 90.2% of cases), previous hospitalizations (in 78.7%), previous antibiotic exposure (in 78.4%), and the presence of a central venous catheter (in 76.5%). Polymicrobial isolates were obtained in 70.6% of episodes; Pseudomonas aeruginosa and Acinetobacter species were the most common coisolates. Bloodstream infection was the most frequent clinical syndrome (32 [63%] of 51 episodes). Fever or sepsis occurred in 22 (69%) and shock in 10 (31%) of 32 episodes. Infection at other sites was less severe. The most active antibiotics in vitro were trimethoprim-sulfamethoxazole and ticarcillin-clavulanate. The overall and attributable mortality rates were 12.5% and 6.3%, respectively. S. maltophilia appears to be an important cause of nosocomially acquired bacteremia in children. The significance in children of isolation from other sites is less clear.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Sattler
authors.forename: E O
authors.initials: EO
authors.lastname: Mason
authors.forename: S L
authors.initials: SL
authors.lastname: Kaplan
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000382:microbiology; D015984:Causality; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D020615:Stenotrophomonas maltophilia / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents