Evaluation of children with stenotrophomonas maltophilia bacteremia

Abstract

Introduction: Stenotrophomonas maltophilia (S. maltophilia) is a resistant gramnegative rod that can often cause serious infections, especially in patients with long hospital stays and using broad-spectrum antibiotics. In this study, clinical data, and mortality-related risk factors of patients with S. maltophilia bacteremia were evaluated.Materials and Methods: Patients with S. maltophilia bacteremia included in this study and evaluated retrospectively, when hospitalized between 2013 and 2018 in our pediatric wards and intensive care units.Results: A total of 67 patients had 100 S. maltophilia bacteremia in 70 different episodes. Sixty percent (n=40) of the cases were male and their median age were 9 months. Sixty-nine percent (n=46) of the cases were admitted in intensive care units. The most common comorbidity was malignancy. All bacteremias were healthcare associated, and 55% (n=55) were catheter-related. In the total of 70 episodes; 57% (n=37) of the patients had central venous catheters, 47% (n=33) were entubated. Fourty-seven percent (n=33) of the patients had broad spectrum antibiotic use over 14 days. In the blood cultures, 98% of S. maltophilia-producing strains were sensitive to trimethoprim-sulfamethoxazole. Ciprofloxacin and trimethoprim-sulfamethoxazole combination therapy had used for treatment. The mortality rate in the first 30 days was 16% (n=11). Mechanical ventilation was found to be significant (p<0.05) as a predisposing factor related to mortality.Conclusion: Stenotrophomonas maltophilia is the causative pathogen in healthcare associated bloodstream infections especially in intensive care unit. In our study, 69% of the cases were admitted in the intensive care unit and mechanical ventilation status increased mortality.