Suitable Empiric Antibiotic Therapy Saves Life in Nosocomial Pneumonia Caused by Stenotrophomonas maltophilia

Authors: GÜRDAL YILMAZ, SAVAŞ ÖZSU, İFTİHAR KÖKSAL, TEVFİK ÖZLÜ

Abstract: Stenotrophomonas maltophilia is a nosocomial pathogen of increasing importance. Empiric antibiotic therapy for S. maltophilia infection is difficult because the microorganism is resistant to a number of agents typically used for health care associated infections, thus potentially increasing mortality. This study investigates 23 nosocomial pneumonia cases caused by S. maltophilia, the antibacterial sensitivity of the bacterium and the effect on mortality of suitable empiric therapy. Materials and methods: Twenty-three patients with nosocomial pneumonia caused by S. maltophilia between January 2000 and December 2006 at the Karadeniz Technical University Hospital were retrospectively investigated. Results: Suitable empiric therapy was used with 12 patients (52.2%), but the therapies administered to the other 11 patients were inappropriate for S. maltophilia infection. Eight (72.7%) of the patients who were not given suitable empiric antibiotherapy died (P = 0.002). Conclusion: The appropriate empiric antibiotic was administered to only 12 of the patients. The mortality rate among those patients to whom appropriate empiric antibiotics were not administered was high, proving that suitable empiric therapy is vitally important. Due to the increase in mortality, it is essential to initiate appropriate empiric therapy by carefully evaluating the risk factors for S. maltophilia in nosocomial pneumonia and taking sputum and bronchoalveolar lavage specimens without delay.

Keywords: Stenotrophomonas maltophilia, nosocomial pneumonia, empiric antibiotic

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