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Nosocomial Infection Caused by Xanthomonas maltophilia A Case-Control Study of Predisposing Factors

Published online by Cambridge University Press:  05 January 2022

Linda S. Elting ,
Nancy Khardori ,
Gerald P. Bodey  and
Victor Fainstein
Linda S. Elting*
Affiliation:
Department of Medical Specialties, Section of Infectious Diseases, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Nancy Khardori
Affiliation:
Department of Medical Specialties, Section of Infectious Diseases, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Gerald P. Bodey
Affiliation:
Department of Medical Specialties, Section of Infectious Diseases, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Victor Fainstein
Affiliation:
Department of Medical Specialties, Section of Infectious Diseases, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
*
Infectious Diseases (Box 471, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030
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Abstract

Factors predisposing to clinically significant nosocomial infection with Xanthomonas maltophilia were examined in a matched case-control study using multivariate techniques. Sixteen cases occurred among cancer patients in a six-month period, including an apparent cluster of three cases in an intensive care unit. These infections were unusually serious; eight patients had disseminated infection caused by X maltophilia and six died as a result of their infections.

Among the 64 factors that were examined, therapy with broad-spectrum antibiotics and central venous catheterization were found to significantly increase susceptibility to infection. Therapy with imipenem was more than ten times more frequent among cases than among controls (p < .001). All fatal infections occurred in patients who had received imipenem, including two patients who died before the organism could be identified and appropriate therapy instituted.

Infection with X maltophilia should be suspected in patients who develop superinfection while receiving imipenem, and prompt therapy should be instituted to improve chances of survival. Because a common environmental source of X maltophilia was not identified, further study is necessary to determine specific preventive measures.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 3 , March 1990 , pp. 134 - 138
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

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