Document Detail


Central venous catheter-related Stenotrophomonas maltophilia bacteraemia and associated relapsing bacteraemia in haematology and oncology patients.
MedLine Citation:
PMID:  16961635     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This retrospective study investigated the clinical significance and impact of Stenotrophomonas maltophilia bacteraemia in 49 haematology and oncology patients at a tertiary referral medical centre in Taipei between July 1999 and December 2003. Sixteen patients had 24 episodes of central venous catheter (CVC)-related bacteraemia, with the main clinical characteristics being a nosocomial bacteraemia (100%), preceding antibiotic therapy (94%), bacteraemia developed in a general ward (87%), immunosuppressive therapy (75%), in-situ CVC-related bacteraemia (75%), and neutropenia (63%). Only four (25%) patients had inflammatory signs at the CVC site following diagnosis of bacteraemia. Five patients had recurrent bacteraemia, with risk-factors being long-lasting (>10 days) neutropenia (p 0.036) and an initial failure to remove the CVC (p 0.001). These cases did not involve re-infection, as the same S. maltophilia strain was identified following random amplified polymorphic DNA (RAPD) analysis of the initial and subsequent isolates. However, relapses could occur after long latency periods (maximum, 200 days). Most patients were cured after removal of the CVC, even without appropriate antibiotic treatment. Physicians should have a high index of suspicion for CVC-related bacteraemia with haematology and oncology patients with CVCs and S. maltophilia bacteraemia. In addition to appropriate antibiotic therapy, removal of the CVC is crucial for successful treatment of CVC-related S. maltophilia bacteraemia and prevention of relapses.
Authors:
C-H Lai; W-W Wong; C Chin; C-K Huang; H-H Lin; W-F Chen; K-W Yu; C-Y Liu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases     Volume:  12     ISSN:  1198-743X     ISO Abbreviation:  Clin. Microbiol. Infect.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-11     Completed Date:  2006-12-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9516420     Medline TA:  Clin Microbiol Infect     Country:  France    
Other Details:
Languages:  eng     Pagination:  986-91     Citation Subset:  IM    
Affiliation:
Department of Infectious Disease, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Bacteremia / etiology*,  microbiology*
Catheterization, Central Venous / adverse effects*
Child
Female
Gram-Negative Bacterial Infections / microbiology*
Hematologic Diseases / complications
Humans
Male
Middle Aged
Neoplasms / complications
Risk Factors
Stenotrophomonas maltophilia / isolation & purification*

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