title: The emergence of Stenotrophomonas maltophilia as a significant nosocomial pathogen at the University Hospital of the West Indies.
abstract: Stenotrophomonas maltophilia is emerging worldwide as a nosocomial pathogen. It is associated with certain risk factors and a wide range of infections. This study was done to document its emergence at the University Hospital of the West Indies and to determine the incidence, distribution and risk factors associated with it. A retrospective study was conducted over the period April 1997 to December 2000. Clinical records were available for 46 of the 66 patients identified over the study period. Fifty-five per cent of the cases came from the Intensive Care Unit (ICU) and the rest from other wards. There was a slight increase in the prevalence of infection with increasing age. The surgical service accounted for the largest number of isolates. Of the cases presented, 95.7% were exposed to a wide range of antibiotics and had some form of instrumentation. Underlying disease was found in 71.7% of the patients. S maltophilia was found most often in the sputum of ICU patients whereas it was most often isolated from wound swabs in the ward patients. The organism was isolated from blood more often in ICU patients (23.3%) than in ward patients (9.5%) and there was a 44% mortality rate among the cases in ICU compared with those on the wards (4.8%). Stenotrophomonas maltophilia is an important nosocomial pathogen and occurs in a wide cross-section of patients. The risk factors must be addressed and infection control measures implemented to restrict the spread of this organism.
authors.affiliation: Departments of Microbiology and Surgery, Radiology Anaesthesia and Intensive Care, Faculty of Medical Sciences, University of the West Indies, Kingston 7, Jamaica West Indies. alison.nicholson@uwimona.edu.jm
authors.forename: A M
authors.initials: AM
authors.lastname: Nicholson
authors.forename: D
authors.initials: D
authors.lastname: Castle
authors.forename: P
authors.initials: P
authors.lastname: Akpaka
authors.forename: I
authors.initials: I
authors.lastname: Tennant
authors.forename: M
authors.initials: M
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008875:Middle Aged; D012189:Retrospective Studies; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*; D014900:West Indies
chemical_list: D000900:Anti-Bacterial Agents