Neonatal infection with Stenotrophomonas maltophilia (2 case studies)

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie 2012-04, Vol.19 (4), p.404-407
• Main Authors: Issaoui, S, Maoulainine, F M R, Elidrissi, N S, Sorra, N, Chabaa, L, Aboussad, A
• Format: Article
• Language: fre
• Subjects: Amikacin - therapeutic use; Anti-Bacterial Agents - therapeutic use; Brain Abscess - diagnosis; Brain Abscess - drug therapy; Chloramphenicol - therapeutic use; Ciprofloxacin - therapeutic use; Cross Infection - diagnosis; Cross Infection - drug therapy; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Echoencephalography; Empyema, Subdural - diagnosis; Empyema, Subdural - drug therapy; Fatal Outcome; Female; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - drug therapy; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Male; Meningitis, Bacterial - diagnosis; Meningitis, Bacterial - drug therapy; Microbial Sensitivity Tests; Pneumonia, Bacterial - diagnosis; Pneumonia, Bacterial - drug therapy; Sepsis - diagnosis; Sepsis - drug therapy; Stenotrophomonas maltophilia; Thiamphenicol - therapeutic use; Tomography, X-Ray Computed
• ISSN: 1769-664X
• DOI: 10.1016/j.arcped.2012.01.011

Stenotrophomonas maltophilia (S.M.) is a Gram-negative bacillus, naturally resistant to cephalosporins and carbapenems, which can colonize different sites and may be responsible for serious infections for which treatment is a real challenge. We report 2 cases of nosocomial S.M. infection in 2 hospitalized newborns in the neonatal intensive care unit. CASE 1: A 3-day-old newborn presented with infection beginning in the respiratory system, treated with ciprofloxacin, and complicated by septicemia, resulting in death. CASE 2: An 11-day-old newborn presented with brain S.M. suppuration: empyema and multiple abscesses were treated successfully with the combination of amikacin and chloramphenicol with good progression in the short and medium terms. Some epidemiological studies report that S.M. is the second Gram-negative bacillus responsible for nosocomial infection after Klebsiella pneumoniae. While the respiratory location of the bacterium is typical, cerebral parenchyma damage is rare in the newborn. The treatment remains very delicate and difficult because of this bacterium's drug multiresistance. These 2 cases of infection caused by S.M. including respiratory tract infection with bacteremia and cerebral suppuration in newborns have broadened the spectrum of diseases caused by this organism and are a reminder of the emergence of this organism and its natural resistance to several antibiotics.