TY - JOUR
T1 - Clinical importance of Stenotrophomonas maltophilia nosocomial pneumonia due to its high mortality in hemodialysis patients
AU - Wakino, Shu
AU - Imai, Eiko
AU - Yoshioka, Kyoko
AU - Kamayachi, Tadashi
AU - Minakuchi, Hitoshi
AU - Hayashi, Koichi
AU - Inamoto, Hajime
AU - Itoh, Hiroshi
PY - 2009/6/1
Y1 - 2009/6/1
N2 - Patients undergoing hemodialysis are immunocompromized and can suffer from pneumonia with various pathogens in nosocomial conditions. We investigated the fundamental information on the characteristics of hemodialysis inpatients and nosocomial pneumonia. We surveyed 1803 hemodialysis patients admitted to our university hospital between 2001 and 2007. The mean patient age was 64.8 years and the average period of hospitalization was 28.1 days, which was considerably longer than the average stay in our hospital (14.2 days). Patients were admitted to many different departments and for various reasons. We isolated 391 microorganisms from the sputum of 120 pneumonia patients undergoing hemodialysis, including Candida albicans, methicillin-resistant Staphylococcus aureus, and Staphylococcus epidermidis, which were the leading three isolates. From these 120 patients, a total of 199 pathogens were identified as being responsible for the pneumonia. Multi-drug resistant Stenotrophomonas maltophilia was found to be susceptible to a new fluoroquinolone, but is resistant to older generation quinolones. Out of the 120 patients with pneumonia, 12 out of 18 patients infected with S. maltophilia died, indicating the highest fatality rate for this pathogen. In this survey, we found that hemodialysis patients were hospitalized for long periods, and for various reasons in many departments. They suffered from nosocomial pneumonia caused by multi-drug resistant pathogens, including S. maltophilia. For pneumonia due to S. maltophilia, new generation fluoroquinolones can be the treatment of choice, although S. maltophilia-related pneumonia should be treated very carefully because of its high fatality rate.
AB - Patients undergoing hemodialysis are immunocompromized and can suffer from pneumonia with various pathogens in nosocomial conditions. We investigated the fundamental information on the characteristics of hemodialysis inpatients and nosocomial pneumonia. We surveyed 1803 hemodialysis patients admitted to our university hospital between 2001 and 2007. The mean patient age was 64.8 years and the average period of hospitalization was 28.1 days, which was considerably longer than the average stay in our hospital (14.2 days). Patients were admitted to many different departments and for various reasons. We isolated 391 microorganisms from the sputum of 120 pneumonia patients undergoing hemodialysis, including Candida albicans, methicillin-resistant Staphylococcus aureus, and Staphylococcus epidermidis, which were the leading three isolates. From these 120 patients, a total of 199 pathogens were identified as being responsible for the pneumonia. Multi-drug resistant Stenotrophomonas maltophilia was found to be susceptible to a new fluoroquinolone, but is resistant to older generation quinolones. Out of the 120 patients with pneumonia, 12 out of 18 patients infected with S. maltophilia died, indicating the highest fatality rate for this pathogen. In this survey, we found that hemodialysis patients were hospitalized for long periods, and for various reasons in many departments. They suffered from nosocomial pneumonia caused by multi-drug resistant pathogens, including S. maltophilia. For pneumonia due to S. maltophilia, new generation fluoroquinolones can be the treatment of choice, although S. maltophilia-related pneumonia should be treated very carefully because of its high fatality rate.
KW - Fatality
KW - Hemodialysis
KW - Multi-drug esistance
KW - Nosocomial pneumonia
KW - Quinolone
KW - Stenotrophomonas maltophilia
UR - http://www.scopus.com/inward/record.url?scp=66549100677&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=66549100677&partnerID=8YFLogxK
U2 - 10.1111/j.1744-9987.2009.00693.x
DO - 10.1111/j.1744-9987.2009.00693.x
M3 - Article
C2 - 19527465
AN - SCOPUS:66549100677
VL - 13
SP - 193
EP - 198
JO - Therapeutic Apheresis and Dialysis
JF - Therapeutic Apheresis and Dialysis
SN - 1744-9979
IS - 3
ER -