Community-acquired Stenotrophomonas maltophilia infections: a systematic review

Stenotrophomonas maltophilia is a pathogen that causes infections mainly in immunocompromised patients. However, community-acquired S. maltophilia infections have been occasionally reported. The objective of this paper was to collect and evaluate the available published data referring to community-acquired S. maltophilia infections. We searched PubMed, the Cochrane Library, and Scopus for articles providing data for patients with community-acquired S. maltophilia infections. Eight case series and 23 case reports (involving 77 and 26 patients with community-acquired S. maltophilia infections, respectively) were regarded as eligible for inclusion in our review. Regarding the 77 patients with community-acquired S. maltophilia infections included in the identified case series, 45 had bacteremia, six ocular infections, five respiratory tract infections, four wound/soft tissue infections, two urinary tract infections, one conjunctivitis, one otitis, and one cellulitis; data were not reported for the remaining 12 patients. Comorbidity (such as malignancy, HIV infection, prior hospitalization) was common. Data included in the eight case series regarding the outcome of infection were limited. From the 26 patients with community-acquired S. maltophilia infections reported in the case reports, 22 were cured from the infection, whereas 4 of 26 patients died; one death was attributed to septic shock due to S. maltophilia. Several publications report patients with community-acquired S. maltophilia infections; the majority of them refer to patients with some kind of comorbidity. Physicians should be aware that S. maltophilia infections are not restricted to hospitalized patients.