Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study

Johannes B J Scholte, Tan Lai Zhou, Dennis C J J Bergmans, Gernot G U Rohde, Bjorn Winkens, Helke A Van Dessel, Tom P J Dormans, Catharina F M Linssen, Paul M H J Roekaerts, Paul H M Savelkoul, Walther N K A van Mook

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Stenotrophomonas maltophilia is increasingly identified in critically ill patients, but it is considered a pathogen with limited pathogenicity and it is therefore infrequently targeted. This study explores whether S. maltophilia may cause ventilator-associated pneumonia (VAP) and whether it affects intensive care unit (ICU) mortality and 28-day mortality when compared to VAP caused by other Gram-negative bacilli.

METHODS: Retrospective analysis of a 19-year prospectively collected database. Stenotrophomonas maltophilia as a cause was considered in VAP-suspected cases when S. maltophilia growth of ≥10(4) cfu/ml was detected in bronchoalveolar lavage fluid analysis. Cases were matched on hospital, gender, age and acute physiology and chronic health evaluation II score in a 1:3 ratio with controls from the same database suffering from VAP caused by other Gram-negative bacilli.

RESULTS: Eight cases met the inclusion criteria, of which three were labelled as 'probable' SM-VAP and three as 'possible' SM-VAP. These six patients constitute 1.8% of all VAPs in the studied period. No significant differences in baseline characteristics and duration of mechanical ventilation (p = 0.68), length of stay in the ICU (p = 0.55) and hospital (p = 0.84) between cases and controls were identified between cases and controls. Intensive care unit mortality odds ratio was 1.7 (p = 0.55; 95% CI 0.3-10.5) and 28-day mortality odds ratio was 1.4 (p = 0.70; 95% CI 0.2-9.1).

CONCLUSIONS: Stenotrophomonas maltophilia is a possible, yet infrequent cause of VAP. No outcome differences were found when compared to matched VAP caused by other Gram-negative bacilli.

Original languageEnglish
Pages (from-to)738-43
Number of pages6
JournalInfectious diseases (London, England)
Volume48
Issue number10
DOIs
Publication statusPublished - 2016

Cite this

Scholte, J. B. J., Zhou, T. L., Bergmans, D. C. J. J., Rohde, G. G. U., Winkens, B., Van Dessel, H. A., ... van Mook, W. N. K. A. (2016). Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study. Infectious diseases (London, England), 48(10), 738-43. https://doi.org/10.1080/23744235.2016.1185534
Scholte, Johannes B J ; Zhou, Tan Lai ; Bergmans, Dennis C J J ; Rohde, Gernot G U ; Winkens, Bjorn ; Van Dessel, Helke A ; Dormans, Tom P J ; Linssen, Catharina F M ; Roekaerts, Paul M H J ; Savelkoul, Paul H M ; van Mook, Walther N K A. / Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study. In: Infectious diseases (London, England). 2016 ; Vol. 48, No. 10. pp. 738-43.
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title = "Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study",
abstract = "BACKGROUND: Stenotrophomonas maltophilia is increasingly identified in critically ill patients, but it is considered a pathogen with limited pathogenicity and it is therefore infrequently targeted. This study explores whether S. maltophilia may cause ventilator-associated pneumonia (VAP) and whether it affects intensive care unit (ICU) mortality and 28-day mortality when compared to VAP caused by other Gram-negative bacilli.METHODS: Retrospective analysis of a 19-year prospectively collected database. Stenotrophomonas maltophilia as a cause was considered in VAP-suspected cases when S. maltophilia growth of ≥10(4) cfu/ml was detected in bronchoalveolar lavage fluid analysis. Cases were matched on hospital, gender, age and acute physiology and chronic health evaluation II score in a 1:3 ratio with controls from the same database suffering from VAP caused by other Gram-negative bacilli.RESULTS: Eight cases met the inclusion criteria, of which three were labelled as 'probable' SM-VAP and three as 'possible' SM-VAP. These six patients constitute 1.8{\%} of all VAPs in the studied period. No significant differences in baseline characteristics and duration of mechanical ventilation (p = 0.68), length of stay in the ICU (p = 0.55) and hospital (p = 0.84) between cases and controls were identified between cases and controls. Intensive care unit mortality odds ratio was 1.7 (p = 0.55; 95{\%} CI 0.3-10.5) and 28-day mortality odds ratio was 1.4 (p = 0.70; 95{\%} CI 0.2-9.1).CONCLUSIONS: Stenotrophomonas maltophilia is a possible, yet infrequent cause of VAP. No outcome differences were found when compared to matched VAP caused by other Gram-negative bacilli.",
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Scholte, JBJ, Zhou, TL, Bergmans, DCJJ, Rohde, GGU, Winkens, B, Van Dessel, HA, Dormans, TPJ, Linssen, CFM, Roekaerts, PMHJ, Savelkoul, PHM & van Mook, WNKA 2016, 'Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study' Infectious diseases (London, England), vol. 48, no. 10, pp. 738-43. https://doi.org/10.1080/23744235.2016.1185534

Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study. / Scholte, Johannes B J; Zhou, Tan Lai; Bergmans, Dennis C J J; Rohde, Gernot G U; Winkens, Bjorn; Van Dessel, Helke A; Dormans, Tom P J; Linssen, Catharina F M; Roekaerts, Paul M H J; Savelkoul, Paul H M; van Mook, Walther N K A.

In: Infectious diseases (London, England), Vol. 48, No. 10, 2016, p. 738-43.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Stenotrophomonas maltophilia ventilator-associated pneumonia. A retrospective matched case-control study

AU - Scholte, Johannes B J

AU - Zhou, Tan Lai

AU - Bergmans, Dennis C J J

AU - Rohde, Gernot G U

AU - Winkens, Bjorn

AU - Van Dessel, Helke A

AU - Dormans, Tom P J

AU - Linssen, Catharina F M

AU - Roekaerts, Paul M H J

AU - Savelkoul, Paul H M

AU - van Mook, Walther N K A

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Stenotrophomonas maltophilia is increasingly identified in critically ill patients, but it is considered a pathogen with limited pathogenicity and it is therefore infrequently targeted. This study explores whether S. maltophilia may cause ventilator-associated pneumonia (VAP) and whether it affects intensive care unit (ICU) mortality and 28-day mortality when compared to VAP caused by other Gram-negative bacilli.METHODS: Retrospective analysis of a 19-year prospectively collected database. Stenotrophomonas maltophilia as a cause was considered in VAP-suspected cases when S. maltophilia growth of ≥10(4) cfu/ml was detected in bronchoalveolar lavage fluid analysis. Cases were matched on hospital, gender, age and acute physiology and chronic health evaluation II score in a 1:3 ratio with controls from the same database suffering from VAP caused by other Gram-negative bacilli.RESULTS: Eight cases met the inclusion criteria, of which three were labelled as 'probable' SM-VAP and three as 'possible' SM-VAP. These six patients constitute 1.8% of all VAPs in the studied period. No significant differences in baseline characteristics and duration of mechanical ventilation (p = 0.68), length of stay in the ICU (p = 0.55) and hospital (p = 0.84) between cases and controls were identified between cases and controls. Intensive care unit mortality odds ratio was 1.7 (p = 0.55; 95% CI 0.3-10.5) and 28-day mortality odds ratio was 1.4 (p = 0.70; 95% CI 0.2-9.1).CONCLUSIONS: Stenotrophomonas maltophilia is a possible, yet infrequent cause of VAP. No outcome differences were found when compared to matched VAP caused by other Gram-negative bacilli.

AB - BACKGROUND: Stenotrophomonas maltophilia is increasingly identified in critically ill patients, but it is considered a pathogen with limited pathogenicity and it is therefore infrequently targeted. This study explores whether S. maltophilia may cause ventilator-associated pneumonia (VAP) and whether it affects intensive care unit (ICU) mortality and 28-day mortality when compared to VAP caused by other Gram-negative bacilli.METHODS: Retrospective analysis of a 19-year prospectively collected database. Stenotrophomonas maltophilia as a cause was considered in VAP-suspected cases when S. maltophilia growth of ≥10(4) cfu/ml was detected in bronchoalveolar lavage fluid analysis. Cases were matched on hospital, gender, age and acute physiology and chronic health evaluation II score in a 1:3 ratio with controls from the same database suffering from VAP caused by other Gram-negative bacilli.RESULTS: Eight cases met the inclusion criteria, of which three were labelled as 'probable' SM-VAP and three as 'possible' SM-VAP. These six patients constitute 1.8% of all VAPs in the studied period. No significant differences in baseline characteristics and duration of mechanical ventilation (p = 0.68), length of stay in the ICU (p = 0.55) and hospital (p = 0.84) between cases and controls were identified between cases and controls. Intensive care unit mortality odds ratio was 1.7 (p = 0.55; 95% CI 0.3-10.5) and 28-day mortality odds ratio was 1.4 (p = 0.70; 95% CI 0.2-9.1).CONCLUSIONS: Stenotrophomonas maltophilia is a possible, yet infrequent cause of VAP. No outcome differences were found when compared to matched VAP caused by other Gram-negative bacilli.

KW - Journal Article

U2 - 10.1080/23744235.2016.1185534

DO - 10.1080/23744235.2016.1185534

M3 - Article

VL - 48

SP - 738

EP - 743

JO - Infectious diseases (London, England)

JF - Infectious diseases (London, England)

SN - 2374-4243

IS - 10

ER -