Life-threatening hemorrhagic pneumonia caused by Stenotrophomonas maltophilia in the treatment of hematologic diseases

2014 ◽  
Vol 93 (6) ◽  
pp. 901-911 ◽  
Author(s):  
Minako Mori ◽  
Hiroko Tsunemine ◽  
Kazunori Imada ◽  
Kiminari Ito ◽  
Taiichi Kodaka ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Hematologic Diseases ◽  
Hemorrhagic Pneumonia ◽  
Life Threatening

scholarly journals Fatal hemorrhagic pneumonia in patients with hematologic diseases and Stenotrophomonas maltophilia bacteremia: a retrospective study

2021 ◽  
Author(s):  
Lixia ZHU ◽  
Lulu Wang ◽  
Yuping Zhang ◽  
Rongrong Chen ◽  
Xueying Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Hematologic Diseases ◽  
Hemorrhagic Pneumonia ◽  
Life Threatening ◽  
High Level ◽  
Clinical Records

Abstract Background Fatal hemorrhagic pneumonia is one of the most severe manifestations of Stenotrophomonas maltophilia (SM) infections. Here, we aimed to investigate the clinical characteristics of SM bacteremia and to identify the risk factors of hemorrhagic pneumonia caused by SM in patients with hematologic diseases. Methods The clinical records of 55 patients diagnosed with hematologic diseases and SM bacteremia were retrospectively reviewed. We compared patients’ clinical characteristics and outcomes between the hemorrhagic pneumonia group and non-hemorrhagic pneumonia group. Results Twenty-seven (49.1%) patients developed hemorrhagic pneumonia. The overall mortality rate of SM bacteremia was 67.3%. The 30-day mortality rate was significantly higher in patients with hemorrhagic pneumonia than those without hemorrhagic pneumonia (85.2% and 50.0%, respectively, P = 0.003). Compared with the non-hemorrhagic pneumonia group, patients in the hemorrhagic pneumonia group were older and showed clinical manifestations as higher proportions of isolated SM in sputum culture, neutropenia and elevated procalcitonin. Multivariate analysis showed that neutropenia, high levels of procalcitonin, prior tigecycline therapy within 1 month were independent risk factors associated with hemorrhagic pneumonia. Conclusions Hematologic patients with SM bacteremia who have neutropenia, high level of procalcitonin and prior tigecycline therapy within 1 month should be early treated with combined effective antibiotics and best supportive interventions to avoid life-threatening hemorrhagic pneumonia.

scholarly journals Fatal hemorrhagic pneumonia in patients with hematologic diseases and Stenotrophomonas maltophilia bacteremia: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lixia Zhu ◽  
Lulu Wang ◽  
Yuping Zhang ◽  
Rongrong Chen ◽  
Xueying Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Hematologic Diseases ◽  
Hemorrhagic Pneumonia ◽  
Independent Risk Factors ◽  
High Level ◽  
Clinical Records ◽  
Overall Mortality

Abstract Background Fatal hemorrhagic pneumonia is one of the most severe manifestations of Stenotrophomonas maltophilia (SM) infections. Here, we aimed to investigate the clinical characteristics of SM bacteremia and to identify the risk factors of hemorrhagic pneumonia caused by SM in patients with hematologic diseases. Methods The clinical records of 55 patients diagnosed with hematologic diseases and SM bacteremia were retrospectively reviewed. We compared patients’ clinical characteristics and outcomes between the hemorrhagic pneumonia group and non-hemorrhagic pneumonia group. Results Twenty-seven (49.1%) patients developed hemorrhagic pneumonia. The overall mortality rate of SM bacteremia was 67.3%. Hemorrhagic pneumonia (adjusted HR 2.316, 95% CI 1.140–4.705; P = 0.020) was an independent risk factor of 30-day mortality in hematological patients with SM bacteremia. Compared with the non-hemorrhagic pneumonia group, patients in the hemorrhagic pneumonia group were older and showed clinical manifestations as higher proportions of isolated SM in sputum culture, neutropenia and elevated procalcitonin (PCT). Multivariate analysis showed that neutropenia, high levels of PCT, prior tigecycline therapy within 1 month were independent risk factors associated with hemorrhagic pneumonia. Conclusions Neutropenia, high level of PCT and prior tigecycline therapy within 1 month were significant independent predictors of hemorrhagic pneumonia in hematologic patients with SM bacteremia. Due to no effective antibiotics to prevent hemorrhagic pneumonia, prophylaxis of SM infection and its progression to hemorrhagic pneumonia is particularly important.

Trimethoprim–sulfamethoxazole-induced refractory hypoglycaemia successfully treated with octreotide

2021 ◽  
Vol 14 (5) ◽  
pp. e240232
Author(s):  
Jordan Kit Mah ◽  
Daniel Negreanu ◽  
Suhaib Radi ◽  
Stavroula Christopoulos
Keyword(s):  
Risk Factor ◽  
Adverse Effects ◽  
Renal Insufficiency ◽  
Antimicrobial Agent ◽  
Side Effect ◽  
Stenotrophomonas Maltophilia ◽  
Case Reports ◽  
Overwhelming Majority ◽  
Life Threatening ◽  
Intravenous Dextrose

Trimethoprim–sulfamethoxazole (TMP–SMX) is a commonly prescribed antimicrobial agent for a wide variety of infections. It is generally well tolerated in a majority of patients; however, serious adverse effects have been described with its usage. Hypoglycaemia is an exceedingly rare but potentially life-threatening side effect of this antimicrobial agent due to its sulfonylurea-like effect. We describe a case of symptomatic, refractory hypoglycaemia secondary to TMP–SMX in a patient being treated for Stenotrophomonas maltophilia bacteraemia, which required treatment with 10 hours of intravenous dextrose (including several 50% dextrose boluses), as well as intramuscular glucagon and octreotide. We reviewed previous case reports described in the literature of TMP–SMX-induced hypoglycaemia, in which renal insufficiency was noted to be a common predisposing risk factor in an overwhelming majority of cases. In refractory cases of TMP–SMX-induced hypoglycaemia, intravenous octeotride may be considered for treatment.

Life-Threatening Chronic Enteritis Due to Colonization of the Small Bowel With Stenotrophomonas maltophilia

2005 ◽  
Vol 129 (2) ◽  
pp. 706-712 ◽  
Author(s):  
Stephan Hellmig ◽  
Stephan Ott ◽  
Meike Musfeldt ◽  
Markus Kosmahl ◽  
Phillip Rosenstiel ◽  
...  
Keyword(s):  
Small Bowel ◽  
Stenotrophomonas Maltophilia ◽  
Life Threatening

scholarly journals Fatal hemorrhagic pneumonia: Don’t forget Stenotrophomonas maltophilia

2016 ◽  
Vol 19 ◽  
pp. 12-14
Author(s):  
Cristina Gutierrez ◽  
Egbert Pravinkumar ◽  
Dave Balachandran ◽  
Virginia Schneider
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Hemorrhagic Pneumonia

scholarly journals Clinical Characteristics of Rapidly Progressive Fatal Hemorrhagic Pneumonia Caused by Stenotrophomonas maltophilia

2020 ◽  
Vol 59 (2) ◽  
pp. 193-198 ◽  
Author(s):  
Waki Imoto ◽  
Koichi Yamada ◽  
Kazushi Yamairi ◽  
Wataru Shibata ◽  
Hiroki Namikawa ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Clinical Characteristics ◽  
Hemorrhagic Pneumonia

scholarly journals Antibacterial and Antivirulence Activity of Glucocorticoid PYED-1 against Stenotrophomonas maltophilia

Antibiotics ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 105 ◽  
Author(s):  
Anna Esposito ◽  
Adriana Vollaro ◽  
Eliana Pia Esposito ◽  
Daniele D’Alonzo ◽  
Annalisa Guaragna ◽  
...  
Keyword(s):  
Biofilm Formation ◽  
Stenotrophomonas Maltophilia ◽  
Opportunistic Pathogen ◽  
Pulmonary Infections ◽  
Negative Bacterium ◽  
Standard Strain ◽  
Chain Reaction ◽  
Qpcr Analysis ◽  
Life Threatening ◽  
Polymerase Chain

Stenotrophomonas maltophilia, an environmental Gram-negative bacterium, is an emerging nosocomial opportunistic pathogen that causes life-threatening infections in immunocompromised patients and chronic pulmonary infections in cystic fibrosis patients. Due to increasing resistance to multiple classes of antibiotics, S. maltophilia infections are difficult to treat successfully. This makes the search for new antimicrobial strategies mandatory. In this study, the antibacterial activity of the heterocyclic corticosteroid deflazacort and several of its synthetic precursors was tested against S. maltophilia. All compounds were not active against standard strain S. maltophilia K279a. The compound PYED-1 (pregnadiene-11-hydroxy-16α,17α-epoxy-3,20-dione-1) showed a weak effect against some S. maltophilia clinical isolates, but exhibited a synergistic effect with aminoglycosides. PYED-1 at sub-inhibitory concentrations decreased S. maltophilia biofilm formation. Quantitative real-time polymerase chain reaction (RT-qPCR) analysis demonstrated that the expression of biofilm- and virulence- associated genes (StmPr1, StmPr3, sphB, smeZ, bfmA, fsnR) was significantly suppressed after PYED-1 treatment. Interestingly, PYED-1 also repressed the expression of the genes aph (3′)-IIc, aac (6′)-Iz, and smeZ, involved in the resistance to aminoglycosides.

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