PMID- 17026755
OWN - NLM
STAT- MEDLINE
DCOM- 20070104
LR  - 20181113
IS  - 1466-609X (Electronic)
IS  - 1364-8535 (Print)
IS  - 1364-8535 (Linking)
VI  - 10
IP  - 5
DP  - 2006
TI  - Intensive care unit-acquired Stenotrophomonas maltophilia: incidence, risk 
      factors, and outcome.
PG  - R143
AB  - INTRODUCTION: The aim of this study was to determine incidence, risk factors, and 
      impact on outcome of intensive care unit (ICU)-acquired Stenotrophomonas 
      maltophilia. METHODS: This prospective observational case-control study, which 
      was a part of a cohort study, was conducted in a 30-bed ICU during a three year 
      period. All immunocompetent patients hospitalised >48 hours were eligible. 
      Patients with non-fermenting Gram-negative bacilli (NF-GNB) at ICU admission were 
      excluded. Patients without ICU-acquired S. maltophilia who developed an 
      ICU-acquired NF-GNB other than S. maltophilia were also excluded. Screening 
      (tracheal aspirate and skin, anal, and nasal swabs) for NF-GNB was performed in 
      all patients at ICU admission and weekly. Univariate and multivariate analyses 
      were performed to determine risk factors for ICU-acquired S. maltophilia and for 
      ICU mortality. RESULTS: Thirty-eight (2%) patients developed an S. maltophilia 
      ICU-acquired colonisation and/or infection and were all successfully matched with 
      76 controls. Chronic obstructive pulmonary disease (COPD) and duration of 
      antibiotic treatment (odds ratio [OR] [95% confidence interval (CI)] = 9.4 [3 to 
      29], p < 0.001, and 1.4 [1 to 2.3], p = 0.001, respectively) were independently 
      associated with ICU-acquired S. maltophilia. Mortality rate (60% versus 40%, OR 
      [95% CI] = 1.3 [1 to 1.7, p = 0.037]), duration of mechanical ventilation (23 +/- 
      16 versus 7 +/- 11 days, p < 0.001), and duration of ICU stay (29 +/- 21 versus 
      15 +/- 17 days, p < 0.001) were significantly higher in cases than in controls. 
      In addition, ICU-acquired infection related to S. maltophilia was independently 
      associated with ICU mortality (OR [95% CI] = 2.8 [1 to 7.7], p = 0.044). 
      CONCLUSION: COPD and duration of antibiotic treatment are independent risk 
      factors for ICU-acquired S. maltophilia. ICU-acquired S. maltophilia is 
      associated with increased morbidity and mortality rates. ICU-acquired infection 
      related to S. maltophilia is an independent risk factor for ICU mortality.
FAU - Nseir, Saad
AU  - Nseir S
AD  - Intensive Care Unit, Calmette Hospital, University Hospital of Lille, boulevard 
      du Pr Leclercq, 59037 Lille cedex, France. s-nseir@chru-lille.fr
FAU - Di Pompeo, Christophe
AU  - Di Pompeo C
FAU - Brisson, Helene
AU  - Brisson H
FAU - Dewavrin, Florent
AU  - Dewavrin F
FAU - Tissier, Stephanie
AU  - Tissier S
FAU - Diarra, Maimouna
AU  - Diarra M
FAU - Boulo, Marie
AU  - Boulo M
FAU - Durocher, Alain
AU  - Durocher A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Crit Care
JT  - Critical care (London, England)
JID - 9801902
SB  - IM
MH  - Case-Control Studies
MH  - Cross Infection/*epidemiology/mortality/therapy
MH  - Gram-Negative Bacterial Infections/*epidemiology/mortality/therapy
MH  - Humans
MH  - Incidence
MH  - *Intensive Care Units
MH  - Prospective Studies
MH  - Risk Factors
MH  - *Stenotrophomonas maltophilia
MH  - Treatment Outcome
PMC - PMC1751051
EDAT- 2006/10/10 09:00
MHDA- 2007/01/05 09:00
PMCR- 2006/10/06
CRDT- 2006/10/10 09:00
PHST- 2006/07/20 00:00 [received]
PHST- 2006/09/05 00:00 [revised]
PHST- 2006/10/06 00:00 [accepted]
PHST- 2006/10/10 09:00 [pubmed]
PHST- 2007/01/05 09:00 [medline]
PHST- 2006/10/10 09:00 [entrez]
PHST- 2006/10/06 00:00 [pmc-release]
AID - cc5063 [pii]
AID - 10.1186/cc5063 [doi]
PST - ppublish
SO  - Crit Care. 2006;10(5):R143. doi: 10.1186/cc5063.