Attributable Mortality of
            <i>Stenotrophomonas Maltophilia</i>
            Infections: A Systematic Review of the Literature

The purpose of this study was to investigate characteristics of critically ill patients with Stenotrophomonas maltophilia (S. maltophilia) isolated from the respiratory tract, to identify risk factors for S. maltophilia-pneumonia and intensive care unit (ICU) mortality and to analyze antibiotic susceptibility of S. maltophilia. This was a retrospective analysis of 64 medical ICU patients with S. maltophilia in the respiratory tract. Thirty-six patients fulfilled the criteria for diagnosis of pneumonia. A significantly higher lung injury score (LIS) was observed in patients with pneumonia compared to patients with colonization (p=0.010). Independent risk factors for S. maltophilia-pneumonia were higher Sequential Organ Failure Assessment (SOFA) score (p=0.009) and immunosuppression (p=0.014). Patients with S. maltophilia-pneumonia had higher ICU mortality within a 28-day follow-up (p=0.040) and higher hospital mortality (p=0.018) than patients with colonization. The highest antibiotic susceptibility rates were observed to trimethoprim-sulfamethoxazole, tigecycline, and moxifloxacin. Higher SOFA score when S. maltophilia was isolated (p=0.001) and development of renal failure (p=0.021) were independent risk factors for ICU mortality. Higher SOFA score and immunosuppression are independent risk factors for S. maltophilia-pneumonia. Patients with S. maltophilia-pneumonia have a significantly higher ICU mortality within a 28-day follow-up, hospital mortality and LIS compared to patients with S. maltophilia-colonization.

show abstract

“…In accordance, in previous studies S. maltophilia infection has been shown to be associated with bad outcomes and high mortality rates [27,30].…”

Section: Discussionsupporting

confidence: 90%

Stenotrophomonas maltophilia in the respiratory tract of medical intensive care unit patients

Saugel

Eschermann

Hoffmann

et al. 2011

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

show abstract

“…3C). Similar to P. aeruginosa, S. maltophilia is highly resistant to antibiotics due to the presence of various intrinsic and acquired resistance mechanisms that include ␤-lactamases, penicillinase, cephalosporinase, aminoglycoside acetyl-transferase (aac), efflux pumps, and biofilm formation (35)(36)(37). An up-to-date database containing comprehensive annotations for aminoglycoside and macrolide resistance mechanisms facilitated the detection of resistance genes present in the metagenomic data, especially across the S. maltophilia-rich microbiomes in patient CF7.…”

Section: Discussionmentioning

confidence: 99%

Clinical Insights from Metagenomic Analysis of Sputum Samples from Patients with Cystic Fibrosis

et al. 2014

View full text Add to dashboard Cite

f As DNA sequencing becomes faster and cheaper, genomics-based approaches are being explored for their use in personalized diagnoses and treatments. Here, we provide a proof of principle for disease monitoring using personal metagenomic sequencing and traditional clinical microbiology by focusing on three adults with cystic fibrosis (CF). The CF lung is a dynamic environment that hosts a complex ecosystem composed of bacteria, viruses, and fungi that can vary in space and time. Not surprisingly, the microbiome data from the induced sputum samples we collected revealed a significant amount of species diversity not seen in routine clinical laboratory cultures. The relative abundances of several species changed as clinical treatment was altered, enabling the identification of the climax and attack communities that were proposed in an earlier work. All patient microbiomes encoded a diversity of mechanisms to resist antibiotics, consistent with the characteristics of multidrug-resistant microbial communities that are commonly observed in CF patients. The metabolic potentials of these communities differed by the health status and recovery route of each patient. Thus, this pilot study provides an example of how metagenomic data might be used with clinical assessments for the development of treatments tailored to individual patients.

show abstract

“…S. maltophilia is not a highly virulent pathogen, but it has emerged as an important nosocomial pathogen associated with crude mortality rates in patients with bacteremia. S. maltophilia was associated with pneumonia, bloodstream infections, urinary tract infections, intra-abdominal infections, meningitis and ocular infections (Brooke, 2012;Falagas et al, 2009). S. maltophilia is an emerging global opportunistic pathogen and has been recovered from soils and plant roots, animals, invertebrates, water treatment and distribution systems, wastewater plants, sinkholes, lakes, rivers, biofilms on fracture surfaces in aquifers, washed salads, hemodialysis water and dialysate samples, faucets, tap water, bottled water, contaminated chlorhexidine-cetrimide topical antiseptic, hand-washing soap, contact lens solutions, ice machines, and sink drains (Brooke, 2012).…”

Section: Introductionmentioning

confidence: 99%

Stenotrophomonas maltophilia as an opportunistic pathogen in cultured African catfish Clarias gariepinus (Burchell, 1822)

et al. 2016

View full text Add to dashboard Cite

Attributable Mortality of Stenotrophomonas Maltophilia Infections: A Systematic Review of the Literature

Abstract: A considerable mortality rate (up to 37.5%) can be attributed to S. maltophilia infection. Thus, clinicians should not underestimate the clinical significance of S. maltophilia infections.

Cited by 150 publications

References 53 publications

Stenotrophomonas maltophilia in the respiratory tract of medical intensive care unit patients

Stenotrophomonas maltophilia in the respiratory tract of medical intensive care unit patients

Clinical Insights from Metagenomic Analysis of Sputum Samples from Patients with Cystic Fibrosis

Stenotrophomonas maltophilia as an opportunistic pathogen in cultured African catfish Clarias gariepinus (Burchell, 1822)

Contact Info

Product

Resources

About