Healthcare-Associated Stenotrophomonas maltophilia Bacteraemia: Retrospective Evaluation of Treatment and Outcome

Tuncel, T.; Akalın, Halis; Payaslıoğlu, Ayşe Melda; Yılmaz, Emel; Kazak, Esra; Heper, Yasemin; Özakın, Cüneyt

doi:10.7759/cureus.18916

Cited by 9 publications

(17 citation statements)

References 30 publications

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“…In a retrospective study from China of 51 cases of S. maltophilia bacteremia, mortality rate was 37.3%, while APACHE II was the only independent factor for mortality [ 60 ]. Similarly, data from Turkey showed that the 14th and the 30th-day mortality rates were 32.9% and 45.7%, respectively [ 61 ], while a Danish cohort revealed a 90-day mortality of 18% [ 62 ].…”

Section: Discussionmentioning

confidence: 99%

Upraising Stenotrophomonas maltophilia in Critically Ill Patients: A New Enemy?

et al. 2023

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Stenotrophomonas maltophilia (S. maltophilia), an important pathogen in immuno-compromised patients, has recently gained attention in patients admitted in intensive care units (ICU). We sought to investigate clinical features of infections caused by S. maltophilia in ICU patients and identify risk factors for mortality. We conducted a retrospective study in two multivalent non-COVID-19 ICUs of tertiary-teaching hospitals in Greece and Spain, including patients with isolated S. maltophilia from at least one clinical specimen along with clinical signs of infection. A total of 103 patients (66% male) were analyzed. Median age was 65.5 (54–73.3) years and mean APACHE II and SOFA scores upon ICU admission were 18.36 (±7.22) and 18.17 (±6.95), respectively. Pneumonia was the predominant clinical syndrome (72.8%), while 22% of cases were among hemato/oncology patients. Crude 28-day mortality rate was 54.8%, even though, 14-day clinical and microbiological response was 96%. Age, APACHE II on ICU admission, hemato-oncologic disease, and multi-organ failure were initially identified as potential predictors of mortality. In the multivariable analysis, only increasing age and hemato-oncologic disease were shown to be independent risk factors for 28-day mortality. High all-cause mortality was observed in critically ill patients with predominantly respiratory infections by S. maltophilia, despite initial clinical and laboratory response after targeted treatment. The study elucidates a potentially worrisome emerging pathogen in the ICU.

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Section: Discussionmentioning

confidence: 99%

Upraising Stenotrophomonas maltophilia in Critically Ill Patients: A New Enemy?

et al. 2023

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“…Between 2002 and 2016, 140 patients with nosocomial Stenotrophomonas bacteraemia were examined in a university hospital, and the mortality rate on the 14th day was reported to be 32.9%. It has been shown that starting antibiotics as soon as possible and withdrawing the central venous catheter is essential for patients' survival [10].…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of a Stenotrophomonas maltophilia Outbreak Due to Commercial Arterial Blood Gas Collection Kit

Kazak,

Önal,

Tüzemen

et al. 2023

Preprint

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Background Stenotrophomonas maltophilia is a gram-negative bacterium that can cause hospital infections and outbreaks within hospitals. This study aimed to evaluate an outbreak of Stenotrophomonas maltophilia, caused by ready-to-use commercial syringes containing liquid lithium and heparin for arterial blood gas collection in a university hospital. Methods Upon detecting an increase in Stenotrophomonas maltophilia growth in blood cultures between 15.09.2021 and 19.11.2021, an outbreak analysis and a case-control study (52 patients for the case group, 56 patients for the control group) were performed considering risk factors for bacteraemia. Samples from possible foci for bacteraemia were also cultured. Growing bacteria were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. The genetic linkage and clonal relationship isolates were investigated with pulsed-field gel electrophoresis (PFGE) in the reference laboratory. Results In the case-control study, the odds ratio for the central venous catheter [3.38 (95% confidence interval [CI]: 1.444, 8.705 ; p = 0.006)], for surgery [3.387 (95% confidence interval [CI]: 1.370, 8.373 ; p = 0.008)] and for arterial blood gas collection history [18.584 (95% confidence interval [CI]:4.086, 84.197; p < 0.001)] were identified as significant risk factors. Stenotrophomonas maltophilia growth was found in ready-to-use commercial syringes used for arterial blood gas collection. Molecular analysis showed that the growths in the samples taken from commercial syringes and the growths from blood cultures were the same. After discontinuing the use of the kits with this lot number, the outbreak was brought under control. Conclusions According to our results, disposable or sterile medical equipment should be included as a risk factor in outbreak analyses. The method by which injectors containing liquids, such as heparin, are sterilised should be reviewed. Our study also revealed the importance of the cooperation of the infection control team with the microbiology laboratory.

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“…Although compliance with hand hygiene is the most effective and cheapest method in reducing the rates of NIs, unfortunately, compliance with hand hygiene in healthcare workers has been reported at a very low level in some studies [25]. Length of hospital stay, use of proton-pump inhibitors, steroids, and TPN facilitate the development of NI [26,27]. In the study, there was no difference between the length of hospital stay, protonpump inhibitor use, steroid use, and TPN intake prior to and during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Infections in Non-COVID-19 Pediatric Patients Prior to and During the Pandemic in a Pediatric Intensive Care Unit

İpek¹,

Şahin²,

Güngör³

et al. 2022

Cureus

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Background: Nosocomial infections are a global threat to human health worldwide.Aim: This study aimed to investigate the change of nosocomial infection factors in equivalent historical periods in pediatric patients without COVID-19 before and during the pandemic in the pediatric intensive care unit.Method: The study was planned retrospectively. Data on hospital infection rates, incidence densities, invasive device-associated infections, infectious agents, comorbid diseases, and invasive procedures in non-COVID-19 pediatric patients were obtained from the medical records for the periods of April-September 2019 and April-September 2020 in the pediatric intensive care unit. Hand hygiene compliance rates of healthcare workers were evaluated.Results: Prior to the pandemic, the number of patients was 332, comprising 2,377 patient days with a nosocomial infection rate of 5.12, and an incidence density of 7.15. During the pandemic, the number of patients was 221, comprising 2,260 patient days with a nosocomial infection rate of 4.52, and incidence density of 4.43. Prior to the pandemic, there were 28.80% cases of Klebsiella pneumoniae, 23.81% of Pseudomonas aeruginosa, 9.52% of Enterococcus faecium, and 4.76% of Enterococcus faecalis. During the pandemic, there were decreased 14.29% cases of Klebsiella pneumoniae while Pseudomonas aeruginosa, Enterococcus faecium, and Enterococcus faecalis was not seen. Prior to the pandemic, the hand hygiene compliance rate was 94.83%, and during the pandemic, it was found to be 99.44%. Conclusion:This study showed that the spread of bacteria such as Klebsiella pneumoniae, Pseudomonas aeruginosa, vancomycin-resistant enterococci, and Stenotrophomonas maltophilia, which are a major public health threat, can be decreased by applying simple standard methods.

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Healthcare-Associated Stenotrophomonas maltophilia Bacteraemia: Retrospective Evaluation of Treatment and Outcome

Cited by 9 publications

References 30 publications

Upraising Stenotrophomonas maltophilia in Critically Ill Patients: A New Enemy?

Upraising Stenotrophomonas maltophilia in Critically Ill Patients: A New Enemy?

An Evaluation of a Stenotrophomonas maltophilia Outbreak Due to Commercial Arterial Blood Gas Collection Kit

Nosocomial Infections in Non-COVID-19 Pediatric Patients Prior to and During the Pandemic in a Pediatric Intensive Care Unit

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