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STENOTROPHOMONAS
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AMBULATORY MORBIDITY AND HOSPITAL ACQUIRED PREVENTION

BACTERIA SOURCES PATHOPHYSIOLOGY TREATMENT
SETTING MORTALITY INFECTIONS

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• Non fermentative, • Personnel • Few pathogenic • Frequent • Related to the inoculum Infection Predisposing • Unnecessary If • Because S.
aerobic, gm (-) o Hands, mechanisms colonizer in that is able to bypass Factors colonization only maltophilia is a
bacillus antiseptic • Predominantly the normal host defense Catheter- In-dwelling • Resistant to common nosocomial
• Infrequent soaps, results in respiratory mechanism associated catheters many antibiotics colonizer of patients
pathogen in hand colonization tract in Px • If an IV infusion contains bacteruria considered with medical fluids,
humans lotions rather than with cystic large numbers, direct IV line Central IV effective for recovery should be
• Found in aquatic • Respiratory infection fibrosis injection into the blood infections catheters pseudomonas considered
environments equipments • Invasive medical stream may result in the Urosepsis UT • Resistant to nonpathogenic
• Low virulence and/or fluids devices – vehicles signs and symptoms instrumentati aminoglycosides, unless proven
• Frequent • Ultrasonic by which the associated with gm (-) on antipseudomonal otherwise
decolorizer of fluids nebulizers, organism bacteremia Primary Arterial penicillins, • Effective infection
used in hospital inhalation bypasses normal • Recovery from respiratory bacteremia monitoring antipseudomonal control
setting – IV fluids medications host defense secretions or from the devices 3rd gen. • Appropriate isolation
(irrigant solutions), • Respiratory urine of catheterized Px Pseudobactere Contaminatio cephalosporins procedures
patients secretions tubings, should be regarded as mia n of blood • Sensitive to TMP-
must bypass condensate colonization unitl proven SMX or cefepime
normal host • IV lines otherwise
defenses and/or fluids o Common cause of
• Distinguished from o IV catheter – associated
pseudomonas: solutions becteruria in
o Lysine (+) o Central hospitalized patients
o DNAse test (+) venous • Commonly colonizes the
cathethers urine and potentially
• Pressure pathogenic only in those
monitoring with impaired host
devices defenses
• Pressure o DM, SLE, cirrhosis,
transducer multiple myeloma, on
fluids steroids
• Urine and/or • If recovered from blood
fluids cultures may come from
contaminated IV fluids or
• Indwelling
from a distant infected
foley
source
cathethers
• If recovered from a wound
o Urometers
with a clear or a
o Irrigation
serosanguinous discharge
solutions
– NO clinical significance
o If recovered from a
purulent wound: S.
maltophilia maybe the
cause
• Virtually never causes
nosocomial pneumonia in
Px who are ventilated and
presumed to have
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STENOTROPHOMONAS
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...One last time...I want to put my dreams in you.... ^_^ shar ^_^
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