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Stenotrophomonas Bacteremia Antibiotic Susceptibility and Prognostic Determinants: Mayo Clinic 10-Year Experience

Ahmed M Hamdi1, Madiha Fida1, Omar M Abu Saleh1

  • 1Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.

Open Forum Infectious Diseases
|February 5, 2020
PubMed
Abstract

Insights

Trimethoprim-sulfamethoxazole (TMP-SMX) remains effective against Stenotrophomonas maltophilia bacteremia, though resistance emerged in patients with prior TMP-SMX exposure. Catheter-related infections were most common, with high mortality observed in pulmonary cases.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Stenotrophomonas maltophilia is an opportunistic gram-negative bacterium causing severe hospital-acquired infections.
  • Increasing incidence of S. maltophilia infections is linked to a growing at-risk patient population.

Purpose of the Study:

  • To analyze a decade of S. maltophilia bacteremia data in hospitalized adults.
  • To identify at-risk populations, infection sources, complications, and antimicrobial resistance trends.

Main Methods:

  • Retrospective review of 10-year patient data.
  • Analysis of S. maltophilia bacteremia cases in hospitalized adults.
  • Assessment of antimicrobial susceptibility profiles and clinical outcomes.

Main Results:

  • Catheter-related infections were the most frequent source (63.3%).
  • High resistance rates were observed for ceftazidime (65%), with lower rates for trimethoprim-sulfamethoxazole (TMP-SMX; 2.1%) and levofloxacin (23.4%).
  • Overall in-hospital mortality was 29.6%, with pulmonary sources showing the highest mortality (53.8%).

Conclusions:

  • TMP-SMX demonstrated reliable activity in the studied cohort.
  • Emergence of TMP-SMX resistance was noted in patients with recent exposure, including during therapy.
  • Catheter-related bacteremia and pulmonary infections represent significant challenges in managing S. maltophilia.
Keywords:
Stenotrophomonasbacteremiamultidrug resistance

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