title: Stenotrophomonas maltophilia infection among young children in a cardiac intensive care unit: a single institution experience.
abstract: Stenotrophomonas maltophilia can present as bacteremia, respiratory tract infection, urinary tract infection, soft tissue and wound infections, bone and joint infections, meningitis, and endocarditis especially in immunosuppressed patients and those with underlying medical conditions. The incidence and impact of S. maltophilia in young children with heart disease are poorly defined. A single center retrospective observational study was conducted in infants <180 days of age with positive S. maltophilia cultures over a period of 5 years. The overall incidence for S. maltophilia infection was 0.8 % (n = 32/3656). Among 32 identified infants, there were 47 episodes of S. maltophilia infection 66 % of infants had prior exposure to broad spectrum antibiotics. 97 % of positive isolates were susceptible to trimethoprim/sulfamethoxazole and 91 % to levofloxacin as well as ticarcillin/clavulanate. Ventilator-free days and absolute lymphocyte count prior to acquiring infection were significantly lower in non-survivors than in survivors. 100 % of survivors had clearance of positive cultures compared to 50 % in non-survivors (p < 0.05). The crude all-cause mortality rate was 37.5 %. All non-survivors had increased length of ICU stay and duration of mechanical ventilation and had delayed clearance of infection and required longer duration of treatment.
authors.affiliation: Department of Pediatric Cardiology, Infectious Diseases, Critical Care, Biostatistics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, 72205, USA, carthur@uams.edu.
authors.forename: Ciji
authors.initials: C
authors.lastname: Arthur
authors.forename: Xinyu
authors.initials: X
authors.lastname: Tang
authors.forename: Jose R
authors.initials: JR
authors.lastname: Romero
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Gossett
authors.forename: Nada
authors.initials: N
authors.lastname: Harik
authors.forename: Parthak
authors.initials: P
authors.lastname: Prodhan
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002969:Clavulanic Acids / Q000008:administration & dosage; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D064704:Levofloxacin / Q000008:administration & dosage; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D020615:Stenotrophomonas maltophilia / Q000187:drug effects / Q000302:isolation & purification*; D013982:Ticarcillin / Q000008:administration & dosage; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage
chemical_list: D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D064704:Levofloxacin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; C043215:ticarcillin-clavulanic acid; D013982:Ticarcillin