Xanthomonas maltophilia bacteremia: An analysis of factors influencing outcome

Xanthomonas maltophilia has emerged as an important nosocomial pathogen, particularly in immunocompromised patients. In this retrospective analysis, the clinical and epidemiologic factors as well as the response to therapy in patients with xanthomonas bacteremia are examined. During a 6-year period, 24 patients had bacteremia with this organism. The crude mortality rate was 42%. There was no difference in outcome on the basis of sex, age, underlying disease, polymicrobial bacteremia, total leukocyte count, or absolute neutrophil count. Statistically significant differences in mortality were observed in patients with a pulmonary source of infection, septic shock, or inappropriate antimicrobial therapy. The isolates were uniformly resistant to the extended-spectrum penicillins and cephalosporins, except cefoperazone and ceftazidime. Three quarters of the isolates were resistant to all aminoglycosides tested. X. maltophilia bacteremia is an important cause of morbidity and mortality, and antibiotic therapy should be based on in vitro susceptibility.