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Title: Risk factors and outcomes of Stenotrophomonas maltophilia bacteraemia: a comparison with bacteraemia caused by Pseudomonas aeruginosa and Acinetobacter species.
Authors: Hotta, Go
Matsumura, Yasufumi  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0001-8595-8944 (unconfirmed)
Kato, Karin  kyouindb  KAKEN_id
Nakano, Satoshi  kyouindb  KAKEN_id
Yunoki, Tomoyuki
Yamamoto, Masaki
Nagao, Miki  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-8886-6145 (unconfirmed)
Ito, Yutaka
Takakura, Shunji
Ichiyama, Satoshi  kyouindb  KAKEN_id
Author's alias: 松村, 康史
Issue Date: 6-Nov-2014
Publisher: Public Library of Science
Journal title: PloS one
Volume: 9
Issue: 11
Thesis number: e112208
Abstract: Stenotrophomonas maltophilia (SM) is an important nosocomial pathogen that exhibits intrinsic resistance to various antimicrobial agents. However, the risk factors for SM bacteraemia have not been sufficiently evaluated. From January 2005 to September 2012, we retrospectively compared the clinical backgrounds and outcomes of SM bacteraemic patients (SM group) with those of bacteraemic patients due to Pseudomonas aeruginosa (PA group) or Acinetobacter species (AC group). DNA genotyping of the SM isolates using the Diversilab system was performed to investigate the genetic relationships among the isolates. The SM, PA, and AC groups included 54, 167, and 69 patients, respectively. Nine of 17 patients in the SM group receiving trimethoprim-sulfamethoxazole prophylaxis developed SM bacteraemia. Independent risk factors for SM bacteraemia were the use of carbapenems and antipseudomonal cephalosporins and SM isolation within 30 days prior to the onset of bacteraemia. Earlier SM isolation was observed in 32 of 48 patients (66.7%) with SM bacteraemia who underwent clinical microbiological examinations. Of these 32 patients, 15 patients (46.9%) had the same focus of bacteraemia as was found in the previous isolation site. The 30-day all-cause mortality rate among the SM group (33.3%) was higher than that of the PA group (21.5%, p = 0.080) and the AC group (17.3%, p = 0.041). The independent factor that was associated with 30-day mortality was the SOFA score. DNA genotyping of SM isolates and epidemiological data suggested that no outbreak had occurred. SM bacteraemia was associated with high mortality and should be considered in patients with recent use of broad-spectrum antibiotics or in patients with recent isolation of the organism.
Rights: © 2014 Hotta et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
URI: http://hdl.handle.net/2433/192488
DOI(Published Version): 10.1371/journal.pone.0112208
PubMed ID: 25375244
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