Stenotrophomonas maltophilia: An Emerging Pathogen in Paediatric Population
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 1
Abstract
Introduction: Stenotrophomonas maltophilia (formerly Pseudomonas maltophilia/Xanthomonas maltophilia), a Gram- negative, non-fermenting bacillus, is being increasingly recognized as a threatening nosocomial pathogen, associated with significant mortality. Aim: To determine the prevalence of infection, antimicrobial susceptibility pattern and clinical outcome of S. maltophilia in a paediatric population. Materials and Methods: This was a retrospective study conducted over a period of eight months, i.e., October 2015 to May 2016. All clinical samples received in the microbiology laboratory during the study period were processed using standard microbiological procedures. S. maltophilia isolates were selected. Antibiotic susceptibility was performed for levofloxacin and trimethoprim-sulphamethoxazole by Vitek 2C system (Biomerieux, France). Average length of stay and mortality caused by S. maltophilia infection was compared with age and sex matched controls without S. maltophilia infection. Results: A total of 16,234 clinical specimens were received in the microbiology laboratory in the study period, with 2,734 pathogenic bacteria isolated. A total of 1,339 (1.7% of total isolates) Gram-negative bacteria were isolated, out of which 414 were non-fermenters. Among the non-fermenters, 23 (5.5%) were S. maltophilia. Out of the 23 isolates, 15 (65.2%) were isolated from blood, 4 (17.3%) were isolated from urine and tracheal aspirate each. A total of 91.3% of strains were susceptible and 8.6% were resistant to trimethoprimsulphamethoxazole. Total 80% of strains were sensitive and 20% had intermediate susceptibility for levofloxacin. None of the strains were resistant to levofloxacin. Average length of stay of patients with S. maltophilia infection was found out to be 23.3 days as compared to 44.8 days in controls. The average mortality of patients with S. maltophilia infection was found to be same as that of controls (35.2%). Conclusion: S. maltophilia is becoming an important nosocomial pathogen and its isolation rate is reported to be increasing. Trimethoprim-sulphamethoxazole still remains the drug of choice but resistance has been reported for this drug as well. As its isolation is increasing, it is important to study the epidemiology, antimicrobial susceptibility profile and clinical outcomes of these isolates.
Authors and Affiliations
Charu Nayyar, Preeti Thakur, Vibhor Tak, Karnika Saigal
Prevalence and Risk Factor Analysis of Faecal Carriage of Carbapenem Resistant Enterobacteriaceae in a Tertiary Care Hospital
ABSTRACT Introduction: Reduced susceptibility of carbapenems against enterobacterial strains have emerged as an important public health problem worldwide. Infection caused by Carbapenem Resistant Enterobacteriaceae (CRE)...
Autologous Iliac Crest Bone Marrow Mononuclear Cells in Bone Fusion
Introduction: Autologous iliac bone harvesting is associated with significant drawbacks and low fusion rates are noted in conditions such as osteoporosis. Bone Marrow Aspirate (BMA) is relatively inexpensive and contains...
Comparative Study of Etomidate and Midazolam with Fentanyl as Inducing Agents in Patients Undergoing Off-pump Coronary Artery Bypass Graft Surgery
ABSTRACT Introduction: Off-pump Coronary Artery Bypass Graft (CABG) surgery has promising out come with minimal morbidity and mortality. Conduction of anaesthesia is still a challenge in Coronary Artery Disease (CAD) pat...
Cholesterol Management in Indians: Should We Treat the Targets or Treat the Risk?
Abstract Clinical evidence on relationship between cholesterol and Cardiovascular Disease (CVD) has highlighted the importance of all lipid components in the pathogenesis of CVD, thereby generating the concepts of “targe...
Lymph Node Myeloid Sarcoma as a First Presentation of CML Blast Crisis: A Rare Case Report with Review of Literature
ABSTRACT Myeloid Sarcoma (MS) is an extra-medullary accumulation of the immature cells of granulocytic cell lineage. It has been reported commonly in the setting of acute myelogenous leukaemia, however its occurrence in...