TY - JOUR
T1 - Stenotrophomonas maltophilia infections
T2 - Clinical characteristics in a military trauma population
AU - the IDCRP TIDOS Group
AU - Patterson, Shane B.
AU - Mende, Katrin
AU - Li, Ping
AU - Lu, Dan
AU - Carson, M. Leigh
AU - Murray, Clinton K.
AU - Tribble, David R.
AU - Blyth, Dana M.
N1 - Publisher Copyright:
© 2019
PY - 2020/2
Y1 - 2020/2
N2 - Stenotrophomonas maltophilia is a pathogen with unique resistance patterns. We assessed 70 combat casualties with S. maltophilia clinical isolates to examine its role as a nosocomial pathogen in critically-ill trauma patients. Incidence density was 0.36 S. maltophilia infections per 100 patient-days (95% CI: 0.29–0.44). Patients predominantly had blast trauma (97%) and were critically injured (injury severity score [ISS] >25; 80%). Restricting to patients with ISS >15, 50 patients with S. maltophilia infections were compared to 441 patients with infections attributed to other gram-negative bacilli. Patients with S. maltophilia infections had significantly more operating room visits prior to isolation, traumatic or early surgical amputations, longer hospitalization (median 71 vs 47 days), and higher overall mortality (10% vs 2%; P = 0.01). Initial and serial (≥7 days between initial and subsequent isolation) S. maltophilia isolates had high susceptibility to trimethoprim-sulfamethoxazole and minocycline. Evaluation of newer agents awaiting CLSI breakpoints, including moxifloxacin, showed promising results.
AB - Stenotrophomonas maltophilia is a pathogen with unique resistance patterns. We assessed 70 combat casualties with S. maltophilia clinical isolates to examine its role as a nosocomial pathogen in critically-ill trauma patients. Incidence density was 0.36 S. maltophilia infections per 100 patient-days (95% CI: 0.29–0.44). Patients predominantly had blast trauma (97%) and were critically injured (injury severity score [ISS] >25; 80%). Restricting to patients with ISS >15, 50 patients with S. maltophilia infections were compared to 441 patients with infections attributed to other gram-negative bacilli. Patients with S. maltophilia infections had significantly more operating room visits prior to isolation, traumatic or early surgical amputations, longer hospitalization (median 71 vs 47 days), and higher overall mortality (10% vs 2%; P = 0.01). Initial and serial (≥7 days between initial and subsequent isolation) S. maltophilia isolates had high susceptibility to trimethoprim-sulfamethoxazole and minocycline. Evaluation of newer agents awaiting CLSI breakpoints, including moxifloxacin, showed promising results.
KW - Combat-related infections
KW - Stenotrophomonas maltophilia
KW - Trauma-related infections
KW - Wound infections
UR - http://www.scopus.com/inward/record.url?scp=85075878987&partnerID=8YFLogxK
U2 - 10.1016/j.diagmicrobio.2019.114953
DO - 10.1016/j.diagmicrobio.2019.114953
M3 - Article
C2 - 31791809
AN - SCOPUS:85075878987
SN - 0732-8893
VL - 96
JO - Diagnostic Microbiology and Infectious Disease
JF - Diagnostic Microbiology and Infectious Disease
IS - 2
M1 - 114953
ER -