PDF(Pubmed)
Abstract：
Background and Objectives: Stenotrophomonas maltophilia is a ubiquitous, aerobic, Gram-negative bacillus causing increasing concern in patients affected by haematological malignancies. Materials and Methods: We report a case series from two centres in Northern Italy to describe the characteristics, outcome and microbiological response of S. maltophilia infections in patients with haematological malignancies and/or allogenic hematopoietic stem cell transplantation (aHSCT). Results: Ten patients were included. The median age was 67 years, and seven patients (70%) were males. The median Charlson Comorbidity Index was 6 (IQR: 4-8). The most frequent haematological comorbidities were acute myeloid leukaemia (AML; n = 3; 30%) and non-Hodgkin\'s lymphoma (n = 3; 30%). Three (30%) patients underwent aHSCT before infection, all for AML. All the patients had undergone a recent antibiotics course and had an indwelling central venous catheter before infection. The main clinical presentations were nosocomial pneumonia, with (2; 20%) or without (4; 40%) secondary bloodstream infection and CRBSI (3; 30%). Four patients were treated with cefiderocol in monotherapy or combinations therapy with cotrimoxazole. The rest of the patients were treated with cotrimoxazole or levofloxacin in monotherapy. Conclusions: Despite a high rate of clinical improvement (90%) after starting antimicrobial therapy, we faced high 30-day mortality (30%) and in-hospital mortality (50%) rates in a highly comorbid population.
摘要：
背景和目的:嗜麦芽窄食单胞菌是一种普遍存在的,有氧,革兰氏阴性杆菌在受血液恶性肿瘤影响的患者中引起越来越多的关注。材料和方法：我们报告了来自意大利北部两个中心的病例系列，以描述其特征，血液系统恶性肿瘤和/或异基因造血干细胞移植(aHSCT)患者嗜麦芽嗜血杆菌感染的结局和微生物学反应.结果：纳入10例患者。中位年龄为67岁,7名患者(70%)为男性。Charlson合并症指数中位数为6(IQR:4-8)。最常见的血液合并症是急性髓性白血病（AML；n=3；30％）和非霍奇金淋巴瘤（n=3；30％）。3例（30%）患者在感染前接受了aHSCT，都是AML。所有患者最近都接受了抗生素疗程，并在感染前留置了中心静脉导管。主要临床表现为医院获得性肺炎,有（2;20％）或没有（4;40％）继发性血流感染和CRBSI（3;30％）。四名患者接受头孢地洛单药或复方新诺明联合治疗。其余患者接受复方新诺明或左氧氟沙星单药治疗。结论：尽管开始抗菌治疗后临床改善率很高（90％），在高共患人群中,我们面临高30日死亡率(30%)和院内死亡率(50%).
