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Stenotrophomonas maltophilia in the respiratory tract of medical ICU patients

Introduction

Stenotrophomonas maltophilia can cause pneumonia in critically ill patients. The aim of the study was to investigate characteristics of critically ill patients with S. maltophilia isolated from the respiratory tract and to identify risk factors for S. maltophilia pneumonia and ICU mortality and to analyze antibiotic susceptibility of S. maltophilia.

Methods

A retrospective analysis of medical records (November 2005 to December 2009) for three medical ICUs in a university hospital.

Results

Sixty-four patients with S. maltophilia isolated from the respiratory tract (median age 66.0 years). Thirty-six patients fulfilled the criteria for diagnosis of pneumonia. Mechanical ventilation was needed in 51 patients. A significantly higher lung injury score was observed in patients with pneumonia compared with patients with colonization (P = 0.010). Independent risk factors for S. maltophilia-related pneumonia were higher Sequential Organ Failure Assessment (SOFA) score (P = 0.009) and immunosuppression (P = 0.014). Patients with S. maltophilia pneumonia had higher ICU mortality within a follow-up of 28 days (P = 0.040) and higher hospital mortality (P = 0.018) than patients with colonization. The highest antibiotic susceptibility rates were observed to trimethoprim-sulfamethoxazole, tigecycline, and moxifloxacin. A higher SOFA score when S. maltophilia was isolated (P = 0.001) and development of renal failure (P = 0.021) were independent risk factors for ICU mortality.

Conclusions

Higher SOFA score and immunosuppression are independent risk factors for S. maltophilia pneumonia. Patients with pneumonia caused by S. maltophilia have a significantly higher ICU mortality within a follow-up of 28 days, hospital mortality and lung injury score compared with patients with S. maltophilia colonization.

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Correspondence to B Saugel.

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Saugel, B., Eschermann, K., Schmid, R. et al. Stenotrophomonas maltophilia in the respiratory tract of medical ICU patients. Crit Care 15, P182 (2011). https://doi.org/10.1186/cc9602

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Keywords

  • Pneumonia
  • Respiratory Tract
  • Independent Risk Factor
  • Hospital Mortality
  • Sequential Organ Failure Assessment