- 期刊
Stenotrophomonas Maltophilia在醫療照護相關感染及社區感染的重要性
The Role of Stenotrophomonas Maltophilia in Healthcare-associated and Community-acquired Infections
摘要
Stenotrophornonas maltophilia（S. maltophilia）是非發酵性革蘭氏陰性桿菌，儘管它以往被視為低致病性的細菌，但已經有報導顯示在免疫不全的病人中可導致顯著的致病率及死亡率。因天生就對許多廣效的抗生素具抗藥性，包括對Carbapenems類，使得它的治療變得復雜。近年來，許多文獻已經闡明S. maltophilia感染的危險因子，包括：白血球低下、中央靜脈導管留置、延長住院、先前使用過廣效抗生素等。然而感染S. maltophilia後的臨床預後，以及最適當的治療共識都尚未被釐清及建立。此外，除了醫療照護相關感染外，也逐漸有社區型感染的文獻報告，這群病患大部分都具潛在性疾病或接受過特殊臨床處置，如：手術、創傷、惡性腫瘤、免疫缺失、醫療裝置的留置、曾使用過抗生素或住院的病史。因此，除了醫療照護相關感染外，S. maltophilia在社區感染的角色亦值得受到注意。
並列摘要
Stenotrophomonas maltophilia, a non-fermentative and gram-negative bacillus, plays an increasingly important role as a nosocomial pathogen in compromised patients, although it was previously considered to have limited pathogenicity. The treatment of S. maltophilia infections is complicated by its intrinsic resistance to many broad-spectrum antibiotics, including carbapenems. Recent studies have elucidated the risk factors for S. maltophilia infection, such as neutropenia, indwelling central venous catheters, prolonged hospitalization, and prior exposure to broad-spectrum antibiotics. However, the outcomes and optimal treatment for S. maltophilia infection are not clearly established. Studies have been conducted to evaluate community-acquired infection. Most patients have underlying comorbidities, such as surgery, trauma, malignancy, an immunocompromised status, an indwelling device, prior antibiotic use, or a history of hospitalization.