title: Stenotrophomonas maltophilia bacteremia in pediatric patients-- a 10-year analysis.
abstract: OBJECTIVE
  Stenotrophomonas maltophilia bacteremia is an important cause of mortality among immunocompromised children. However, there has been little information concerning S. maltophilia bacteremia in the pediatric population.
  
  
  METHODS
  We reviewed the drug susceptibility of bloodstream isolates of S. maltophilia and medical charts of S. maltophilia bacteremia patients less than 18 years old at the Department of Pediatrics, National Taiwan University Hospital from January 1993 to June 2003. The risk factors associated with mortality of the patients with S. maltophilia bacteremia were analyzed.
  
  
  RESULTS
  In total, 32 episodes (31 patients) of S. maltophilia bacteremia were reviewed. The average rate of nosocomial bloodstream infection was 8.3 episodes per 100,000 patient-days, and an average of 6.4% of them were caused by S. maltophilia. Malignancy was the most common underlying disease (32%). Six episodes of S. maltophilia bacteremia had soft tissue involvement, and only 1 of them underwent surgical intervention and survived. These 32 isolates were most susceptible to trimethoprim-sulfamethoxazole (91%), and no obvious increase in multidrug resistance was noted in the previous 10 years. The crude mortality rate was 40.6%. Malignancy, failure to remove central venous catheter, and ineffective antibiotic treatment were significant risk factors for mortality.
  
  
  CONCLUSIONS
  Early and effective antimicrobial therapy and removal of central venous catheter as soon as possible are vital for the successful management of S. maltophilia bacteremia.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ping-Sheng
authors.initials: PS
authors.lastname: Wu
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Lu
authors.forename: Luan-Yin
authors.initials: LY
authors.lastname: Chang
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
authors.forename: Ping-Ing
authors.initials: PI
authors.lastname: Lee
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Chen
authors.forename: Chin-Yun
authors.initials: CY
authors.lastname: Lee
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chan
authors.forename: Po-Young
authors.initials: PY
authors.lastname: Chang
authors.forename: Tsao-Ton
authors.initials: TT
authors.lastname: Yang
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D009369:Neoplasms / Q000150:complications; D012307:Risk Factors; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*; D013624:Taiwan; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination