Stenotrophomonas maltophilia infection in patients receiving continuous ambulatory peritoneal dialysis.
Stenotrophomonas maltophilia infection in patients receiving continuous ambulatory peritoneal dialysis.
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DOI：
10.3904/kjim.2004.19.2.104
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发表时间：
2004-06
期刊：
影响因子：
--
通讯作者：
Chang SH
中科院分区：
文献类型：
--
作者：
Baek JE;Jung EY;Kim HJ;Lee GW;Hahm JR;Kang KR;Chang SH
嗜麦芽窄食单胞菌是一种革兰氏阴性杆菌，已越来越多地被认为是一种重要的医院病原体，特别是在严重虚弱或免疫抑制的个体中。S.嗜麦芽窄食单胞菌的特征还在于其对多种抗生素的抗性。S. CAPD（持续性非卧床腹膜透析）患者中的嗜麦芽窄食菌性腹膜炎与不良预后和CAPD导管丢失相关。在韩国没有提交有关该实体的报告。因此，我们描述和讨论了S。在3例腹膜炎患者和2例出口部位感染患者中，嗜麦芽窄食单胞菌感染与CAPD相关。我们对S.在我们的肾脏科中与CAPD相关的嗜麦芽窄食单胞菌感染。将血红蛋白、白蛋白、胆固醇、BUN和肌酐的基线水平与年龄、性别以及（如果可能）基础疾病匹配的对照组进行比较。所有S.嗜麦芽窄食单胞菌性腹膜炎的基础疾病为糖尿病。个别患者还具有其他显著的合并症，如全垂体功能减退症、COPD慢性阻塞性肺疾病、脑血管意外和心肌梗死。这些患者的血红蛋白水平显著低于对照组，血清白蛋白、肌酐和BUN的平均值也较低。尿毒症、贫血、营养不良、其他合并症（如糖尿病）引起的免疫功能障碍以及留置腹腔导管可能是S。CAPD患者中的嗜麦芽窄食单胞菌感染。一旦S.如果CAPD患者被诊断为嗜麦芽窄食单胞菌感染，则应根据对该特定微生物的了解对患者进行治疗。
Stenotrophomonas maltophilia is a gram-negative bacillus that has become increasingly recognized as an important nosocomial pathogen, particularly in individuals with severe debilitation or immunosuppression. S. maltophilia is also characterized by its resistance to multiple antibiotics. S. maltophilia peritonitis in CAPD (continuous ambulatory peritoneal dialysis) patients is associated with a poor prognosis and loss of CAPD catheter. No report concerning this entity has been presented in Korea. Therefore, we describe and discuss five cases of the S. maltophilia infection associated with CAPD in three patients with peritonitis and two with exit-site infections. We performed a retrospective search for episodes of S. maltophilia infections related to CAPD in our renal unit. The baseline levels of hemoglobin, albumin, cholesterol, BUN and creatinine were compared with age, sex and, if possible, the underlying disease-matched controls. All the patients with S. maltophilia peritonitis had diabetes mellitus as the underlying disease. The individual patients also had other significant combined morbidities, such as panhypopituitarism, COPD chronic obstructive pulmonary disease, cerebrovascular accident and myocardial infarction. The level of hemoglobin in these patients was significantly lower than in the controls, and the mean values of serum albumin, creatinine and BUN were also low. Immune dysfunction due to uremia, anemia, malnutrition, other comorbidities (e.g. diabetes mellitus), and also, an indwelling peritoneal catheter may be predisposing factors for the S. maltophilia infection in CAPD patients. Once the S. maltophilia infection is diagnosed in CAPD patient, the patient should be treated based on the understanding of this particular organism.