Skip to main content
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1986 Jul;24(1):52–55. doi: 10.1128/jcm.24.1.52-55.1986

Associated mortality and clinical characteristics of nosocomial Pseudomonas maltophilia in a university hospital.

A J Morrison Jr, K K Hoffmann, R P Wenzel
PMCID: PMC268830  PMID: 3487553

Abstract

We studied the spectrum of clinical disease in 99 patients with nosocomial Pseudomonas maltophilia isolates at the University of Virginia Hospital from 1981 through 1984. The annual rate of isolation increased from 7.1 to 14.1 per 10,000 patient discharges. A crude mortality rate of 43% was documented in all patients from whom the organism was cultured, and the data include 12 patients with nosocomial bacteremia (four deaths). Risk factors associated with death for patients having a P. maltophilia isolate included the following: requirement for care in any intensive care unit during hospitalization (P = 0.0001), patient age over 40 years (P = 0.002), and a pulmonary source for the P. maltophilia isolate (P = 0.003). All P. maltophilia isolates were susceptible to trimethoprim-sulfamethoxazole, 60% of the isolates were resistant to all aminoglycosides (amikacin, tobramycin, and gentamicin), and more than 75% of the isolates were resistant to all beta-lactam antibiotics. The antibiotic susceptibility pattern allows for a niche exploitable in the hospital microbial environment by an organism with a marked associated mortality.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bauer A. W., Kirby W. M., Sherris J. C., Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966 Apr;45(4):493–496. [PubMed] [Google Scholar]
  2. Ben-Tovim T., Eylan E., Romano A., Stein R. Gram-negative bacteria isolated from external eye infections. Infection. 1974;2(3):162–165. doi: 10.1007/BF01642238. [DOI] [PubMed] [Google Scholar]
  3. Dismukes W. E., Karchmer A. W., Buckley M. J., Austen W. G., Swartz M. N. Prosthetic valve endocarditis. Analysis of 38 cases. Circulation. 1973 Aug;48(2):365–377. doi: 10.1161/01.cir.48.2.365. [DOI] [PubMed] [Google Scholar]
  4. Dyte P. H., Gillians J. A. Pseudomonas maltophilia infection in an abattoir worker. Med J Aust. 1977 Mar 26;1(13):444–445. doi: 10.5694/j.1326-5377.1977.tb130797.x. [DOI] [PubMed] [Google Scholar]
  5. Feeley T. W., Du Moulin G. C., Hedley-Whyte J., Bushnell L. S., Gilbert J. P., Feingold D. S. Aerosol polymyxin and pneumonia in seriously ill patients. N Engl J Med. 1975 Sep 4;293(10):471–475. doi: 10.1056/NEJM197509042931003. [DOI] [PubMed] [Google Scholar]
  6. Felegie T. P., Yu V. L., Rumans L. W., Yee R. B. Susceptibility of Pseudomonas maltophilia to antimicrobial agents, singly and in combination. Antimicrob Agents Chemother. 1979 Dec;16(6):833–837. doi: 10.1128/aac.16.6.833. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fisher M. C., Long S. S., Roberts E. M., Dunn J. M., Balsara R. K. Pseudomonas maltophilia bacteremia in children undergoing open heart surgery. JAMA. 1981 Oct 2;246(14):1571–1574. [PubMed] [Google Scholar]
  8. Fritsche D., Lütticken R., Böhmer H. Pseudomonas maltophilia als Erreger menschlicher Infektionen. Zentralbl Bakteriol Orig A. 1974;229(1):89–97. [PubMed] [Google Scholar]
  9. Gardner P., Griffin W. B., Swartz M. N., Kunz L. J. Nonfermentative gram-negative bacilli of nosocomial interest. Am J Med. 1970 Jun;48(6):735–749. doi: 10.1016/s0002-9343(70)80009-2. [DOI] [PubMed] [Google Scholar]
  10. Gilardi G. L. Infrequently encountered Pseudomonas species causing infection in humans. Ann Intern Med. 1972 Aug;77(2):211–215. doi: 10.7326/0003-4819-77-2-211. [DOI] [PubMed] [Google Scholar]
  11. Gilardi G. L. Pseudomonas maltophilia infections in man. Am J Clin Pathol. 1969 Jan;51(1):58–61. doi: 10.1093/ajcp/51.1.58. [DOI] [PubMed] [Google Scholar]
  12. HUGH R., RYSCHENKOW E. Pseudomonas maltophilia, an alcaligenes-like species. J Gen Microbiol. 1961 Sep;26:123–132. doi: 10.1099/00221287-26-1-123. [DOI] [PubMed] [Google Scholar]
  13. Harlowe H. D. Acute mastoiditis following pseudomonas maltophilia infection: case report. Laryngoscope. 1972 May;82(5):882–883. doi: 10.1288/00005537-197205000-00015. [DOI] [PubMed] [Google Scholar]
  14. Holmes B., Lapage S. P., Easterling B. G. Distribution in clinical material and identification of Pseudomonas maltophilia. J Clin Pathol. 1979 Jan;32(1):66–72. doi: 10.1136/jcp.32.1.66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Jacobus N. V., Ferreira M. C., Barza M. In vitro activity of azthreonam, a monobactam antibiotic. Antimicrob Agents Chemother. 1982 Nov;22(5):832–838. doi: 10.1128/aac.22.5.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Morris W. T., Say P. J. Piperacillin in surgical infections: a clinical trial. Aust N Z J Surg. 1981 Dec;51(6):614–617. doi: 10.1111/j.1445-2197.1981.tb05264.x. [DOI] [PubMed] [Google Scholar]
  17. Nagai T. Association of Pseudomonas maltophilia with malignant lesions. J Clin Microbiol. 1984 Nov;20(5):1003–1005. doi: 10.1128/jcm.20.5.1003-1005.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Narasimhan S. L., Gopaul D. L., Hatch L. A. Pseudomonas maltophilia bacteremia associated with a prolapsed mitral valve. Am J Clin Pathol. 1977 Aug;68(2):304–306. doi: 10.1093/ajcp/68.2.304. [DOI] [PubMed] [Google Scholar]
  19. Patrick S., Hindmarch J. M., Hague R. V., Harris D. M. Meningitis caused by Pseudomonas maltophilia. J Clin Pathol. 1975 Sep;28(9):741–743. doi: 10.1136/jcp.28.9.741. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Pedersen M. M., Marso E., Pickett M. J. Nonfermentative bacilli associated with man. 3. Pathogenicity and antibiotic susceptibility. Am J Clin Pathol. 1970 Aug;54(2):178–192. doi: 10.1093/ajcp/54.2.178. [DOI] [PubMed] [Google Scholar]
  21. Rosenthal S. L. Sources of pseudomonas and acinetobacter species found in human culture materials. Am J Clin Pathol. 1974 Dec;62(6):807–811. doi: 10.1093/ajcp/62.6.807. [DOI] [PubMed] [Google Scholar]
  22. Saino Y., Kobayashi F., Inoue M., Mitsuhashi S. Purification and properties of inducible penicillin beta-lactamase isolated from Pseudomonas maltophilia. Antimicrob Agents Chemother. 1982 Oct;22(4):564–570. doi: 10.1128/aac.22.4.564. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sarkar T. K., Gilardi G., Aguam A. S., Josephson J., Leventhal G. L. Primary Pseudomonas maltophilia infection of the lung. Postgrad Med. 1979 Feb;65(2):253-6, 260. doi: 10.1080/00325481.1979.11715067. [DOI] [PubMed] [Google Scholar]
  24. Sarvamangala Devi J. N., Venkatesh A., Shivananda P. G. Neonatal infections due to Pseudomonas maltophilia. Indian Pediatr. 1984 Jan;21(1):72–74. [PubMed] [Google Scholar]
  25. Semel J. D., Trenholme G. M., Harris A. A., Jupa J. E., Levin S. Pseudomonas maltophilia pseudosepticemia. Am J Med. 1978 Mar;64(3):403–406. doi: 10.1016/0002-9343(78)90219-x. [DOI] [PubMed] [Google Scholar]
  26. Sonnenwirth A. C. Bacteremia with and without meningitis due to Yersinia enterocolitica, Edwardsiella tarda, Comamonas terrigena, and Pseudomonas maltophilia. Ann N Y Acad Sci. 1970 Oct 30;174(2):488–502. doi: 10.1111/j.1749-6632.1970.tb45575.x. [DOI] [PubMed] [Google Scholar]
  27. Sutter V. L. Identification of Pseudomonas species isolated from hospital environment and human sources. Appl Microbiol. 1968 Oct;16(10):1532–1538. doi: 10.1128/am.16.10.1532-1538.1968. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Von Graevenitz A., Redys J. J. Disc sensitivity as an aid in the identification of some gram-negative non-fermentative rods. Health Lab Sci. 1968 Apr;5(2):107–112. [PubMed] [Google Scholar]
  29. Wishart M. M., Riley T. V. Infection with Pseudomonas maltophilia hospital outbreak due to contaminated disinfectant. Med J Aust. 1976 Nov 6;2(19):710–712. doi: 10.5694/j.1326-5377.1976.tb128238.x. [DOI] [PubMed] [Google Scholar]
  30. Yeh T. J., Anabtawi I. N., Cornett V. E., White A., Stern W. H., Ellison R. G. Bacterial endocarditis following open-heart surgery. Ann Thorac Surg. 1967 Jan;3(1):29–36. doi: 10.1016/s0003-4975(10)66684-2. [DOI] [PubMed] [Google Scholar]
  31. Yu V. L., Felegie T. P., Yee R. B., Pasculle A. W., Taylor F. H. Synergistic interaction in vitro with use of three antibiotics simultaneously against Pseudomonas maltophilia. J Infect Dis. 1980 Oct;142(4):602–607. doi: 10.1093/infdis/142.4.602. [DOI] [PubMed] [Google Scholar]
  32. Yu V. L., Rumans L. W., Wing E. J., McLeod R., Sattler F. N., Harvey R. M., Deresinski S. C. Pseudomonas maltophilia causing heroin-associated infective endocarditis. Arch Intern Med. 1978 Nov;138(11):1667–1671. [PubMed] [Google Scholar]
  33. Zuravleff J. J., Yu V. L. Infections caused by Pseudomonas maltophilia with emphasis on bacteremia: case reports and a review of the literature. Rev Infect Dis. 1982 Nov-Dec;4(6):1236–1246. doi: 10.1093/clinids/4.6.1236. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES