The Clinical Spectrum of Stenotrophomonas (Xanthomonas) Maltophilia Respiratory Infection

Shahe E. Vartivarian; Elias J. Anaissie; Elias N. Kiwan; Konstantinos A. Papadakis

doi:10.1055/s-2000-9859

Seminars in Respiratory and Critical Care Medicine, Table of Contents

Semin Respir Crit Care Med 2000; 21(4): 349-356
DOI: 10.1055/s-2000-9859

The Clinical Spectrum of Stenotrophomonas (Xanthomonas) Maltophilia Respiratory Infection

Shahe E. Vartivarian, Elias J. Anaissie, Elias N. Kiwan, Konstantinos A. Papadakis

Presented in part at the 34th Annual Meeting of the Infectious Disease Society of America (IDSA), September 1996, New Orleans, LA. Supported in part by a grant from Merck, Sharp, & Dohme. Myeloma and Transplantation Research Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas (E.J.A, and E.N.K.); Metropolitan Infectious Disease Associates, Houston, Texas (S.E.V); and The University of Texas Medical School, Houston, Texas (K.A.P)

Abstract

ABSTRACT

During a 15-month retrospective clinical study in an academic referral-based cancer center, 26 patients with S. maltophilia respiratory tract infections were identified (which were associated with bacteremia in 13 patients). Five of these 26 patients had previously undescribed sinopulmonary involvement. The infections were typically nosocomial. Nine patients with solid tumors had malignant involvement of the respiratory tract (five with obstruction). In two patients, the infection co-existed with pulmonary aspergillosis. Fifteen patients (58%) died of the infection. The factors that correlated with a poor outcome included bacteremic pneumonia, persistent neutropenia, presence of obstruction, development of septic shock or multiple organ dysfunction, and delay in institution of appropriate antibiotic therapy. In multivariate analysis, only septic shock and delayed therapy remained significant. Trimethoprim-sulfamethoxazole and/or ticarcillin-clavulanate were most commonly associated with a favorable outcome.

KEYWORD

Stenotrophomonas maltophilia, Multidrug-resistance - trimethoprim-sulfamethoxazole

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References

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