Infection Trends, Susceptibility Pattern, and Treatment Options for Stenotrophomonas maltophilia Infections in Trauma Patients: A Retrospective Study.

IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Journal of Laboratory Physicians Pub Date : 2023-03-01 DOI:10.1055/s-0042-1757413
Smriti Srivastava, Parul Singh, Neha Sharad, Vandana Vijayeta Kiro, Rajesh Malhotra, Purva Mathur
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引用次数: 3

Abstract

IntroductionStenotrophomonas maltophilia is an emerging environmental, gram-negative, multidrug-resistant organism, associated with risk factors such as prolonged hospitalization, invasive procedures, admission to the intensive care unit, mechanical ventilation, use of indwelling catheters, administration of immunosuppressants or corticosteroids, human immunodeficiency virus infection, underlying malignancy, and organ transplantation. The organism, despite being of low invasiveness in immune-competent individuals, is difficult to treat because of intrinsic resistance to several antimicrobial agents. Materials and Methods  This study focuses on commonly encountered resistance from among the isolates over a duration of 7 years from 2012 to 2018, analyzed retrospectively. Identification and susceptibility testing were performed using Vitek 2 (BioMérieux, Marcy-l'Etoile, France). Results  Bloodstream infections were found to be most common (52.02%), followed by respiratory infections (35.83%). The median age of the patients was 36 years, and male to female ratio was 143:27. The median duration of hospital stay was 18 days, and mortality was seen in 18.82% of patients. Susceptibility to cotrimoxazole and levofloxacin was seen in 97.1% of isolates (168 out of 173) and 90.1% of isolates (156 out of 173), respectively. Conclusion  Despite being effective in a majority of S . maltophilia isolates, both cotrimoxazole and levofloxacin have their shortcomings. Cotrimoxazole is bacteriostatic and can cause bone marrow suppression and resistance to levofloxacin sometimes develops during therapy. Thus, the therapy should be decided considering the characteristics of both of these drugs.

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创伤患者嗜麦芽窄养单胞菌感染的感染趋势、易感性模式和治疗选择:一项回顾性研究。
嗜麦芽窄养单胞菌是一种新兴的环境、革兰氏阴性、多重耐药生物,与长期住院、侵入性手术、入住重症监护病房、机械通气、留置导尿管的使用、免疫抑制剂或皮质类固醇的使用、人类免疫缺陷病毒感染、潜在恶性肿瘤和器官移植等危险因素相关。尽管在免疫能力强的个体中侵袭性低,但由于对几种抗菌素具有内在耐药性,因此很难治疗。材料与方法本研究对2012 - 2018年7年间分离株中常见的耐药情况进行回顾性分析。使用Vitek 2 (biomrieux, Marcy-l'Etoile,法国)进行鉴定和药敏试验。结果以血流感染最多(52.02%),其次为呼吸道感染(35.83%);患者中位年龄36岁,男女比例为143:27。中位住院时间为18天,死亡率为18.82%。对复方新诺明和左氧氟沙星的敏感性分别为97.1%(173株中168株)和90.1%(173株中156株)。结论:尽管对大多数S。嗜麦芽菌分离株,复方新诺明和左氧氟沙星都有各自的缺点。复方新诺明具有抑菌作用,可引起骨髓抑制,在治疗过程中有时会产生对左氧氟沙星的耐药性。因此,治疗应考虑到这两种药物的特点来决定。
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来源期刊
Journal of Laboratory Physicians
Journal of Laboratory Physicians MEDICINE, GENERAL & INTERNAL-
自引率
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发文量
99
审稿时长
31 weeks
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