Stenotrophomonas maltophilia bacteremia in children: risk factors and mortality rate

Abstract

Purpose Stenotrophomonas maltophilia (S. maltophilia) is an opportunistic and nosocomial pathogen that can cause an invasive and fatal infection, particularly in hospitalized and immunocompromised patients. However, little is known about the impact of S. maltophilia bacteremia in pediatric patients. Therefore, we aimed to identify risk factors for mortality, antibiotics susceptibility to S. maltophilia, and mortality rates in pediatric patients with S. maltophilia bacteremia. Methods We conducted a retrospective cohort study by identifying all S. maltophilia positive blood cultures in the microbiology laboratory database between January 2007 and December 2018 from hospitalized pediatric patients (age 1–14 years). After identifying patients with S. maltophilia bacteremia, medical charts were reviewed for demographics, clinical data, and outcomes within seven days of bacteremia diagnosis. Risk factors associated with mortality in S. maltophilia bacteremia patients were determined using univariate and multivariate analyses. Findings Sixty-eight pediatric patients with S. maltophilia bacteremia were identified. All infections were nosocomial infections, and (88.2%) bacteremia cases were catheter-related bloodstream infections. On multivariate analysis, ICU admission prior to bacteremia episode and neutropenia were the major risk factors associated with mortality. S. maltophilia was the most susceptible to trimethoprim and sulfamethoxazole (TMP/SMX, 94.1%), followed by levofloxacin (85.7%). The overall mortality rate within seven days of S. maltophilia bacteremia diagnosis was 33.8%. Conclusion S. maltophilia bacteremia is a devastating emerging infection associated with high mortality among hospitalized children. Therefore, early diagnosis and prompt management based on local susceptibility data are crucial. Various risk factors, especially ICU admission prior to bacteremia episode and neutropenia, are associated with S. maltophilia bacteremia mortality.

Three-year evaluation of the nosocomial infections in pediatrics: bacterial and fungal profile and antimicrobial resistance pattern

“…However, treatment of S. maltophilia infection is difficult due to antimicrobial resistance to a variety of agents; trimethoprim-sulfamethoxazol can continue to be the first choice for the treatment of S. maltophilia. In the study performed by Alsuhaibani et al, [ 33 ] the most effective antibiotic against S. maltophilia isolates was Trimethoprim−sulfamethoxazole (94.1%), which is consistent with our data (100%). Also in the study by Sun et al [ 32 ], the resistance rate of S. maltophilia strains to cefpime, cefotaxime, ceftazidime and gentamicin was 45.1%, 94.1%, 60.8% and 82.4%, respectively.…”

Risk Factors for Mortality in Hospitalized Patients with Stenotrophomonas maltophilia Bacteremia

“…The susceptibility to TMP/SMX was 92.2%, consistent with the reported studies. 20,21 Although increasing resistance of S. maltophilia to TMP-SMX had been reported, 2 the present study suggested that TMP-SMX might still be suitable as first-line drug for S. maltophilia infection. The susceptibility to minocycline was 94.7%, consistent with the previous studies.…”

Pathogenic potential of bacteria isolated from commercial biostimulants

“…strain I6 showed high similarity (identity ≥ 99.88%) with Stenotrophomonas maltophilia. This species is increasingly reported as an opportunistic and nosocomial pathogens (Alsuhaibani et al 2021 ) and it shows resistance to different antibiotics such as carbapenems and fluoroquinolone (Harmon et al 2019 ; Azimi et al 2021 ; Bostanghadiri et al 2021 ). Results of BLAST and RDP analyses were confirmed by the Bayesian and ML phylogenetic analyses inferred on the basis of the obtained 16S rRNA gene sequences (Fig.…”