TY - JOUR
T1 - Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study
AU - Scholte, Johannes B. J.
AU - Zhou, Tan Lai
AU - Bergmans, Dennis C. J. J.
AU - Rohde, Gernot G. U.
AU - Winkens, Bjorn
AU - Van Dessel, Helke A.
AU - Dormans, Tom P. J.
AU - Linssen, Catharina F. M.
AU - Roekaerts, Paul M. H. J.
AU - Savelkoul, Paul H. M.
AU - van Mook, Walther N. K. A.
PY - 2016
Y1 - 2016
N2 - Background: Stenotrophomonas maltophilia is increasingly identified in critically ill patients, but it is considered a pathogen with limited pathogenicity and it is therefore infrequently targeted. This study explores whether S. maltophilia may cause ventilator-associated pneumonia (VAP) and whether it affects intensive care unit (ICU) mortality and 28-day mortality when compared to VAP caused by other Gram-negative bacilli.Methods: Retrospective analysis of a 19-year prospectively collected database. Stenotrophomonas maltophilia as a cause was considered in VAP-suspected cases when S. maltophilia growth of 10(4) cfu/ml was detected in bronchoalveolar lavage fluid analysis. Cases were matched on hospital, gender, age and acute physiology and chronic health evaluation II score in a 1:3 ratio with controls from the same database suffering from VAP caused by other Gram-negative bacilli.Results: Eight cases met the inclusion criteria, of which three were labelled as probable' SM-VAP and three as possible' SM-VAP. These six patients constitute 1.8% of all VAPs in the studied period. No significant differences in baseline characteristics and duration of mechanical ventilation (p=0.68), length of stay in the ICU (p=0.55) and hospital (p=0.84) between cases and controls were identified between cases and controls. Intensive care unit mortality odds ratio was 1.7 (p=0.55; 95% CI 0.3-10.5) and 28-day mortality odds ratio was 1.4 (p=0.70; 95% CI 0.2-9.1).Conclusions:Stenotrophomonas maltophilia is a possible, yet infrequent cause of VAP. No outcome differences were found when compared to matched VAP caused by other Gram-negative bacilli.
AB - Background: Stenotrophomonas maltophilia is increasingly identified in critically ill patients, but it is considered a pathogen with limited pathogenicity and it is therefore infrequently targeted. This study explores whether S. maltophilia may cause ventilator-associated pneumonia (VAP) and whether it affects intensive care unit (ICU) mortality and 28-day mortality when compared to VAP caused by other Gram-negative bacilli.Methods: Retrospective analysis of a 19-year prospectively collected database. Stenotrophomonas maltophilia as a cause was considered in VAP-suspected cases when S. maltophilia growth of 10(4) cfu/ml was detected in bronchoalveolar lavage fluid analysis. Cases were matched on hospital, gender, age and acute physiology and chronic health evaluation II score in a 1:3 ratio with controls from the same database suffering from VAP caused by other Gram-negative bacilli.Results: Eight cases met the inclusion criteria, of which three were labelled as probable' SM-VAP and three as possible' SM-VAP. These six patients constitute 1.8% of all VAPs in the studied period. No significant differences in baseline characteristics and duration of mechanical ventilation (p=0.68), length of stay in the ICU (p=0.55) and hospital (p=0.84) between cases and controls were identified between cases and controls. Intensive care unit mortality odds ratio was 1.7 (p=0.55; 95% CI 0.3-10.5) and 28-day mortality odds ratio was 1.4 (p=0.70; 95% CI 0.2-9.1).Conclusions:Stenotrophomonas maltophilia is a possible, yet infrequent cause of VAP. No outcome differences were found when compared to matched VAP caused by other Gram-negative bacilli.
KW - Intensive care unit
KW - mechanical ventilation
KW - mortality
KW - multidrug-resistant
KW - Stenotrophomonas maltophilia
KW - ventilator-associated pneumonia
U2 - 10.1080/23744235.2016.1185534
DO - 10.1080/23744235.2016.1185534
M3 - Article
C2 - 27207483
SN - 2374-4235
VL - 48
SP - 738
EP - 743
JO - Infectious Diseases
JF - Infectious Diseases
IS - 10
ER -