Stenotrophomonas maltophilia bacteremia in pediatric patients-- a 10-year analysis.
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.
Wu
Ping-Sheng
PS
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Lu
Chun-Yi
CY
Chang
Luan-Yin
LY
Hsueh
Po-Ren
PR
Lee
Ping-Ing
PI
Chen
Jong-Min
JM
Lee
Chin-Yun
CY
Chan
Pei-Chun
PC
Chang
Po-Young
PY
Yang
Tsao-Ton
TT
Huang
Li-Min
LM
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
D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination