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Published on: October 15, 2014
Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia
Yong Duk Jeon1, Woo Yong Jeong, Moo Hyun Kim
1Department of Internal Medicine AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Abstract:
Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients. In this study, we investigated the risk factors for mortality in patients with S. maltophilia bacteremia.Retrospectively, medical records from all patients with S. maltophilia bacteremia between December 2005 and 2014 at Severance Hospital, a 2000-bed tertiary care hospital in Seoul, Korea, were reviewed. Analysis was performed to identify factors associated with 28-day mortality.In total, 142 bacteremia patients were enrolled in this study. The overall 28-day mortality rate was 36.6%. Based on the univariate analysis, hematologic malignancy (P = 0.015), Sepsis-related Organ Failure Assessment (SOFA) score (P < 0.001) and the removal of a central venous catheter (CVC) (P = 0.040) were significantly related to mortality. In the intensive care unit patients, the Acute Physiology and Chronic Health Evaluation II score (P = 0.001) also had significance. Based on the multivariate analysis, the SOFA score (odds ratio [OR] = 1.323; 95% confidence interval [CI]: 1.159, 1.509; P < 0.001) and removal of the CVC (OR = 0.330; 95% CI: 0.109, 0.996; P = 0.049) were independent factors associated with mortality.Our results suggest that removing a CVC may considerably reduce mortality in patients with S. maltophilia bacteremia.
Insights
Removing central venous catheters (CVCs) may significantly reduce mortality in patients with Stenotrophomonas maltophilia bacteremia. This finding is crucial for improving outcomes in critically ill patients with this nosocomial infection.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Hospital Epidemiology
Background:
- Stenotrophomonas maltophilia is a significant nosocomial pathogen.
- It is associated with high morbidity and mortality, especially in vulnerable patient populations.
- Understanding mortality risk factors is crucial for clinical management.
Purpose of the Study:
- To investigate risk factors for 28-day mortality in patients with S. maltophilia bacteremia.
- To identify independent predictors of mortality in this patient cohort.
- To inform clinical strategies for reducing S. maltophilia bacteremia mortality.
Main Methods:
- Retrospective review of medical records for S. maltophilia bacteremia patients (2005-2014).
- Inclusion of 142 patients from a tertiary care hospital.
- Statistical analysis including univariate and multivariate logistic regression.
Main Results:
- The overall 28-day mortality rate was 36.6%.
- Multivariate analysis identified Sepsis-related Organ Failure Assessment (SOFA) score and central venous catheter (CVC) removal as independent predictors of mortality.
- Removal of CVC was associated with reduced mortality (OR=0.330, P=0.049).
Conclusions:
- Sepsis-related Organ Failure Assessment (SOFA) score is a significant predictor of mortality.
- Removal of central venous catheters (CVCs) is a modifiable factor that can decrease mortality in S. maltophilia bacteremia.
- Early CVC removal should be considered in the management of these patients.
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