Abstract
Background. Stenotrophomonas maltophilia bacteremia (SMB) is the most perilous situation as compared to other types of S. maltophilia infection. The present study aimed to investigate the clinical features, distribution, drug resistance, and predictors of survival of SMB in a tertiary-care hospital of China. Methods. SMB that occurred in a tertiary-care hospital in Beijing, China, within 9 years (2010–2018) was investigated in a retrospective study. Demographics, incidence, commodities, drug resistance, mortality, as well as antibiotics administration were summarized according to the electronic medical records. The risk factors for survival were analyzed by Chi-square test, Kaplan–Meier curve and Cox regression. Results. A total of 76 episodes of SMB were analyzed. The overall incidence of SMB fluctuated from 3.4 to 15.4 episodes per 1000 admissions over 9 years. Malignancy was the most common comorbidity. High in vitro sensitivity was observed to minocycline (96.1%), levofloxacin (81.6%), and trimethoprim-sulfamethoxazole (89.5%). Central venous catheter (CVC) (p = 0.004), mechanical ventilation (MV) (p = 0.006), hemodialysis (p = 0.024), and septic shock (p = 0.016) were significantly different between survival and death group. The 30-day mortality was 34.2% within 30 days after confirmation of blood culture. Factors such as hemodialysis (OR 0.287, 95% CI: 0.084–0.977, p = 0.046), T-tube (OR 0.160, 95% CI: 0.029–0.881, p = 0.035), and septic shock (OR 0.234, 95% CI: 0.076–0.719, p = 0.011) were associated with survival. Conclusions. S. maltophilia is the major nosocomial blood stream infectious pathogenic bacteria. Trimethoprim-sulfamethoxazole and minocycline are optimal antibiotics for the treatment of SMB. T-tube, hemodialysis, and septic shock were the risk factors associated with survival of SMB patients.
Highlights
Stenotrophomonas maltophilia (S. maltophilia) is a Gramnegative, glucose non fermentative bacterium, widely existing in nature and hospital environment
Due to its weak invasiveness, S. maltophilia commonly causes infections related to immunological deficiency in critically ill patients, especially lower respiratory tract infection, and for urinary system, blood stream, abdominal, and skin and so tissue infections, resulting in up to 37.5% mortality [2]. e intrinsic resistance of the bacteremia to specific antibiotics renders the clinical treatment difficult. erefore, in the cases of S. maltophilia bacteremia (SMB), the 30-day mortality was 53.3% [3, 4]. e literature reported certain risk factors for S. maltophilia infection in Korea and Canada [4]
SMB in China manifests a different spectrum antibiotic susceptibility in vulnerable population [2, 10]. us, it is imperative to have a detailed insight into the characteristics, risk factors as well as drug resistance of SMB in China. erefore, we analyzed the clinical data of patients with SMB within 9 years (2010–2018) in a tertiary care, teaching hospital, focused on risk factors associated with the survival rate and drug resistance, thereby providing evidence on the predictors of mortality and appropriate treatment of SMB patients in China
Summary
Stenotrophomonas maltophilia (S. maltophilia) is a Gramnegative, glucose non fermentative bacterium, widely existing in nature and hospital environment. Erefore, we analyzed the clinical data of patients with SMB within 9 years (2010–2018) in a tertiary care, teaching hospital, focused on risk factors associated with the survival rate and drug resistance, thereby providing evidence on the predictors of mortality and appropriate treatment of SMB patients in China. E present study aimed to investigate the clinical features, distribution, drug resistance, and predictors of survival of SMB in a tertiary-care hospital of China. E 30-day mortality was 34.2% within 30 days a er confirmation of blood culture Factors such as hemodialysis (OR 0.287, 95% CI: 0.084–0.977, 푝 = 0.046), T-tube (OR 0.160, 95% CI: 0.029–0.881, 푝 = 0.035), and septic shock (OR 0.234, 95% CI: 0.076–0.719, 푝 = 0.011) were associated with survival
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