Stenotrophomonas maltophilia bacteremia in adults: four years' experience in a medical center in northern Taiwan.

Stenotrophomonas maltophilia has become an important nosocomial pathogen in immunocompromised patients in Taiwan. Patients with underlying diseases such as diabetes, uremia, and solid malignancy are extremely vulnerable to this organism. S. maltophilia bacteremia has a mortality rate of up to 62% if appropriate antibiotics are not instituted early. Knowledge of the risk factors for infection as well as local susceptibility patterns is helpful in determining which patients should receive empirical antibiotics active against S. maltophilia. This study assessed the characteristics of 50 episodes of S. maltophilia bacteremia in 48 patients admitted between March 3, 1999 and May 21, 2003. The new fluoroquinolone levofloxacin showed promising in vitro activity against S. maltophilia in view of the increasing resistance of isolates to trimethoprim-sulfamethoxazole. For patients at risk for S. maltophilia infection, such as those receiving mechanical ventilation in the ICU or those with multiple vascular access devices, the need for antimicrobial agents to which S. maltophilia is normally sensitive should be considered in selecting empiric therapy.