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Isolation of Stenotrophomonas maltophilia in asymptomatic Lung Transplant Recipients: Effects of Treatment on Eradication and Outcome


Hofmann, Patrick; Hombach, Michael; Seifert, Burkhardt; Schuurmans, Macé M; Bürgi, Urs; Isenring, Bruno; Mueller, Nicolas J; Kohler, Malcolm; Benden, Christian; Huber, Lars C (2016). Isolation of Stenotrophomonas maltophilia in asymptomatic Lung Transplant Recipients: Effects of Treatment on Eradication and Outcome. Clinical Transplantation, 30(8):857-863.

Abstract

In this retrospective, single-center data analysis, we audit our clinical practice to treat S. maltophilia in asymptomatic Lung Transplant Recipients (LTRs). 18 LTRs with confirmed isolation of S. maltophilia were identified. 12 of these LTRs have been treated with antibiotics, while 6 were managed without treatment. Treatment was based on antibiograms (trimethoprim-sulfamethoxazole [TMP/SMX] (8/12), levofloxacin (1/12) or both (3/12). Clearance (12/12 vs. 6/6), eradication (10/12 vs. 3/6, p=0.27), and freedom from S. maltophilia recurrence (83±11% vs. 40±22% after one year, log-rank p=0.09) were not found to differ significantly between treated and untreated patients. None of the patient groups showed significant changes in lung function or biochemical variables. Creatinine levels at the end of the study period were found to be higher in treated patients compared to the untreated group (p=0.049). De novo acquired TMP/SMX resistance in S. maltophilia strains was not observed. These results indicate no evidence that antibiotic treatment for S. maltophilia in asymptomatic LTRs alters lung function or the clinical outcome. This article is protected by copyright. All rights reserved.

Abstract

In this retrospective, single-center data analysis, we audit our clinical practice to treat S. maltophilia in asymptomatic Lung Transplant Recipients (LTRs). 18 LTRs with confirmed isolation of S. maltophilia were identified. 12 of these LTRs have been treated with antibiotics, while 6 were managed without treatment. Treatment was based on antibiograms (trimethoprim-sulfamethoxazole [TMP/SMX] (8/12), levofloxacin (1/12) or both (3/12). Clearance (12/12 vs. 6/6), eradication (10/12 vs. 3/6, p=0.27), and freedom from S. maltophilia recurrence (83±11% vs. 40±22% after one year, log-rank p=0.09) were not found to differ significantly between treated and untreated patients. None of the patient groups showed significant changes in lung function or biochemical variables. Creatinine levels at the end of the study period were found to be higher in treated patients compared to the untreated group (p=0.049). De novo acquired TMP/SMX resistance in S. maltophilia strains was not observed. These results indicate no evidence that antibiotic treatment for S. maltophilia in asymptomatic LTRs alters lung function or the clinical outcome. This article is protected by copyright. All rights reserved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > University Hospital Zurich > Clinic for Pneumology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:24 May 2016
Deposited On:02 Jun 2016 14:49
Last Modified:08 Dec 2017 19:36
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0902-0063
Publisher DOI:https://doi.org/10.1111/ctr.12770
PubMed ID:27219076

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