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Stenotrophomonas maltophilia bacteraemia in 40 haematology patients: risk factors, therapy and outcome

Bone Marrow Transplantation volume 45, pages 1109–1110 (2010)Cite this article

Stenotrophomonas maltophilia is a Gram-negative bacillus that is ubiquitous in the environment. It possesses limited virulence factors but is a significant pathogen in immunocompromised patients with indwelling central venous catheters (CVC) and may colonize the respiratory tract.1 Management is difficult because of inherent resistance to multiple antibiotics and technical problems in performing and interpreting sensitivity tests. We reviewed our patients with S. maltophilia bacteraemia in a Blood and Marrow Transplant (BMT) and non-BMT haematology setting. Previously we showed a high mortality rate of Gram-negative sepsis in BMT patients.2 We aimed to define the presenting clinical features and the demographics of patients with S. maltophilia bacteraemia and also the time course for diagnosis and the outcome with different therapeutic manoeuvres.

We conducted a search of our microbiology laboratory database to identify episodes of S. maltophilia bacteraemia from January 1994 to December 2004. Forty-two episodes were identified and the case notes reviewed for 16 BMT and 24 non-BMT haematology patients. Median age was 16 years (range 3 months to 52 years) in BMT and 52 years (22–66 years) in non-BMT patients. The most common underlying diagnosis was leukaemia. Median time from haematological diagnosis to the S. maltophilia bacteraemia was 5 months in the BMT and 4 months in the non-BMT patients. Fifty-five percent of the BMT patients underwent a sibling allograft and the remainder had unrelated allografts. Blood cultures were taken through a central venous (CV) line in 84% but concurrently taken negative sets were not documented.

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References

  1. Micozzi A, Venditti M, Monaco M, Friedrich A, Taglietti F, Santilli S et al. Bacteraemia due to Stenotrophomonas maltophilia in patients with haematological malignancies. Clin Infect Dis 2000; 31: 705–711.

    Article  CAS  PubMed  Google Scholar 

  2. Mitchell A, Derrington P, Turner P, Oakhill A, Marks DI . Gram negative bacteraemia occurring after unrelated donor stem cell transplantation: risk factors, prophylaxis, therapy and outcome. Bone Marrow Transplant 2004; 33: 303–310.

    Article  CAS  PubMed  Google Scholar 

  3. Identification of Stenotrophomonas maltophilia www.hpa-standardmethods.org.uk/documents/bsopid/pdf/bsopid17.pdf.

  4. Susceptibility testing for Stenotrophomonas maltophilia. www.hpa-standardmethods.org.uk/documents/bsop/pdf/bsop45.pdf.

  5. Howe R . Stenotrophomonas maltophilia. www.bsac.org.uk/_db/_documents/steno.pdf.

  6. Falagas ME, Valkimadi P, Huang YT, Matthaiou DK, Hseuh PR . Therapeutic options for Stenotrophomonas maltophilia infections beyond co-trimoxazole: a systematic review. J Antimicrob Chemother 2008; 62: 889–894.

    Article  CAS  PubMed  Google Scholar 

  7. Chee L, Brown M, Sasadeusz J, MacGregor L, Grigg AP . Gram-negative organisms predominate in Hickman line-related infections in non-neutropenic patients with haematological malignancies. J Infect 2008; 56: 227–233.

    Article  CAS  PubMed  Google Scholar 

  8. Garcia Paez JI, Costa SF . Risk factors associated with mortality of infections caused by Stenotrophomonas maltophilia: a systematic review. J Hosp Infect 2008; 70: 101–108.

    Article  Google Scholar 

  9. Lai CH, Wong WW, Chin C, Huang CK, Lin HH, Chen WF et al. Central venous catheter-related Stenotrophomonas maltophilia bacteraemia as associated relapsing bacteraemia in haematology and oncology patients. Clin Microbiol Infect 2006; 12: 986–991.

    Article  CAS  PubMed  Google Scholar 

  10. Garcia Paez JI, Tengan FM, Barone AA, Levin AS, Costa SF . Factors associated with mortality in patients with bloodstream infections and pneumonia due to Stenotrophomonas maltophilia. Eur J Clin Microbiol Infect Dis 2008; 27: 901–906.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. HPA Southwest Regional Laboratory, Bristol Royal Infirmary, Bristol, UK

    R Chaplow

  2. Department of Microbiology, Royal United Hospital, Bath, UK

    B Palmer

  3. Department of Molecular and Cellular Medicine, University Hospitals Bristol Foundation Trust, Bristol, UK

    D I Marks

  4. Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chichiri, Blantyre, Malawi

    R Heyderman

  5. Department of Paediatric Haematology and Oncology, Bristol Royal Hospital for Children, Bristol, UK

    J Moppett

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  1. R Chaplow
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  2. B Palmer
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  5. D I Marks
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Correspondence to D I Marks.

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Chaplow, R., Palmer, B., Heyderman, R. et al. Stenotrophomonas maltophilia bacteraemia in 40 haematology patients: risk factors, therapy and outcome. Bone Marrow Transplant 45, 1109–1110 (2010). https://doi.org/10.1038/bmt.2009.274

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