Risk factors for 30-day mortality among patients with <i>Stenotrophomonas maltophilia</i> bacteraemia

Hashimoto, Takehiro; Komiya, Kosaku; Fujita, Naoko; Usagawa, Yuko; Yamasue, Mari; Umeki, Kenji; Ando, Masayuki; Nureki, Shin-ichi; Hiramatsu, Kazufumi; Kadota, Jun‐ichi

doi:10.1080/23744235.2020.1734653

Cited by 9 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mortality rate was relatively high in the remaining 92 patients diagnosed with clinical infection. The 30-day all-cause mortality was 13% in the 'infection' group, which was lower than mortality rates from other international studies (21 to 69%) [ 19 , 20 ]. We believe that this lower mortality rate is because patients without radiological infiltrate or pneumonia, as per standard definitions [ 15 - 17 ], were also included in the 'infection' as tracheobronchitis.…”

Section: Discussioncontrasting

confidence: 64%

“…International data show that bacteremia and hospital or ventilator-associated pneumonia caused by S. maltophilia results in significant mortality and morbidity, especially in severely immunocompromised and debilitated individuals [ 14 , 18 ]. Overall, mortality estimates range from 21 to 69 percent [ 19 , 20 ]. The actual mortality attributed to these infections when controlling for other variables is unclear.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and Epidemiological Characteristics of Stenotrophomonas maltophilia Associated Lower Respiratory Tract Infections in Qatar: A Retrospective Study

Nair¹,

Sasi²,

Maslamani³

et al. 2022

Cureus

View full text Add to dashboard Cite

Background Stenotrophomonas maltophilia is a rapidly emerging nosocomial pathogen with intrinsic or acquired resistance mechanisms to several antibiotic classes. It can cause life-threatening opportunistic pneumonia, particularly among hospitalized patients. Incidence of infections by S. maltophilia has been reported as 0.07-0.4% of hospital discharges, but its mortality is 20 -60%. This is the first study from Qatar indexing the clinical and epidemiological characteristics and antibiotic susceptibility of S. maltophilia. Materials and methods This retrospective descriptive epidemiological study was conducted in 6 tertiary care hospitals under Hamad Medical Corporation in Doha, Qatar, analyzing inpatient respiratory isolates of S. maltophilia during 2016-17. Out-patients, children below 14 years, and non-respiratory samples except blood cultures in patients with pneumonia were excluded. Clinical records were reviewed to identify possible risk factors. Infection and colonization were identified using the Centers for Disease Control and Prevention (CDC) algorithm for clinically defined pneumonia and statistically analyzed using the chi-square test and Pearson's correlation. Results S. maltophilia was isolated from 2.07% (317/15312) of all respiratory samples received in the microbiology lab during our study period. Three hundred seventeen patients studied had a mean age of 60 ± 20 years, and 68% were men. Most of the isolates were from sputum (179), followed by tracheal aspirate (82) and bronchoscopy (42). Fourteen blood culture samples from patients diagnosed with pneumonia were also included. 67% were hospitalized for more than two weeks, 39.1% were on mechanical ventilators, and 88% had received a broad-spectrum antibiotic before the event. 29.1% were deemed to have an infection and 70.9% colonization. Incidence of infection in those with Charlson’s Co-morbidity Index (CCI) ≥ 3 was 36.5% compared to 24.2% in those with CCI < 3 (Relative Risk (RR)=1.52; 95% CI: 1.04,2.18; p=0.01). Patients with recent chemotherapy, immunosuppressant, or steroid use had a significantly higher infection risk than those without (69.2% v/s 23.3% RR=2.96; 95% CI:2.2,3.9; p<0.005). The most common symptoms in patients with infection were fever (96%) and expectoration (61.9%). The most common radiological finding was lobar consolidation (71.6%). Mean CRP and procalcitonin were 106.5±15.5 mg/l and 12.3 ± 14 ng/ml. Overall mortality was 16.3%. Patients on mechanical ventilator with IBMP-10 score ≥ 2 had 22.8% mortality compared to 5.7% in those with score < 2 (RR=3.9;95%CI:0.9,16.6; p<0.015). As per The US Clinical and Laboratory Standards Institute (CSLI) breakpoint values, Trimethoprim-Sulfamethoxazole (TMP-SMX) showed the highest sensitivity (97.8%), followed by levofloxacin (71.6%). 0.3% of samples were pan-drug resistant. Conclusions S. maltophilia is a f...

show abstract

Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Clinical and Epidemiological Characteristics of Stenotrophomonas maltophilia Associated Lower Respiratory Tract Infections in Qatar: A Retrospective Study

Nair¹,

Sasi²,

Maslamani³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…About 16–38% of cases of S. maltophilia bacteremia have been reported to be polymicrobial and it is associated with a worse prognosis compared to mono bacterial infection. 8 In our study, out of 3 patients who died, 2 had polymicrobial infection with K. pneumoniae .…”

Section: Discussionmentioning

confidence: 60%

Risk Factors and Clinical Outcomes of Stenotrophomonas maltophilia Infections: Scenario in a Tertiary Care Center from South India

Ganesan¹,

Rajendran²,

Sundaramurthy³

et al. 2022

Indian Journal of Critical Care Medicine

View full text Add to dashboard Cite

A bstract Stenotrophomonas maltophilia , a gram-negative non-fermenter has evolved from a colonizer to a significant pathogen over the last decade. It resides in various ecological niches both inside and outside the hospital settings. Infections due to S. maltophilia can be life-threatening, especially in immunocompromised patients. S. maltophilia is intrinsically resistant to most of the antibiotics, which limits treatment options. There are several risk factors involved. The present study was done to assess the risk factors and clinical outcomes associated with S. maltophilia blood stream infections and non-blood stream infections. How to cite this article Varshini MK, Ganesan V, Sundaramurthy R, Rajendran T. Risk Factors and Clinical Outcomes of Stenotrophomonas maltophilia Infections: Scenario in a Tertiary Care Center from South India. Indian J Crit Care Med 2022;26(8):935–937.

show abstract

“…maltophilia and E. anophelis are not typical microbial populations found in the human body, but they have been detected in hospital settings, where they pose a risk as opportunistic pathogens for individuals with weakened immune systems. Host factors that increase the risk of S. maltophilia and E. anophelis infections include advanced age, neonate status, the presence of central venous catheters or indwelling devices, underlying malignancy, chronic respiratory disease, prior use of broad-spectrum antibiotics, long-term hospitalization or intensive care unit (ICU) stay, severe immunocompromise, particularly among recipients of haematopoietic stem cell transplantation, cytotoxic chemotherapy, radiotherapy, neutropenia therapy, immunosuppressive therapies, monoclonal antibodies, critical care in the ICU, and mechanical ventilation [28][29][30][31][32][33][34][35][36][37][38][39]. The presentation of S. maltophilia and E. anophelis infections depends on the infected site.…”

Section: Risk Factors and Clinical Presentations Of Stenotrophomonas ...mentioning

confidence: 99%

Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis

Lee,

Hsueh

2023

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Purpose of review This systematic review aimed to explore the recent trends in the epidemiology, risk factors, and antimicrobial susceptibility of two emerging opportunistic pathogens, Stenotrophomonas maltophilia and Elizabethkingia anophelis. Recent findings Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia. Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis, there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis. The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported. Summary Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis, but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens.

show abstract

Risk factors for 30-day mortality among patients with Stenotrophomonas maltophilia bacteraemia

Cited by 9 publications

References 9 publications

Clinical and Epidemiological Characteristics of Stenotrophomonas maltophilia Associated Lower Respiratory Tract Infections in Qatar: A Retrospective Study

Clinical and Epidemiological Characteristics of Stenotrophomonas maltophilia Associated Lower Respiratory Tract Infections in Qatar: A Retrospective Study

Risk Factors and Clinical Outcomes of Stenotrophomonas maltophilia Infections: Scenario in a Tertiary Care Center from South India

Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis

Contact Info

Product

Resources

About