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Updated: Oct 12, 2025
Identification of Rare Bacterial Pathogens by 16S rRNA Gene Sequencing and MALDI-TOF MS
Published on: July 11, 2016
Stenotrophomonas isolates in a tertiary care centre in South India
Amita Jacob1, Ramya Iyadurai1, J V Punitha1
1Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Purpose:
Stenotrophomonas maltophilia is an emerging multi-drug resistant pathogen increasingly isolated in India. This study aimed to identify patients from whom Stenotrophomonas maltophilia had been isolated and assess predictors of mortality in this population.
Methods:
This was a retrospective cohort study of hospitalized patients with a positive culture for S. maltophilia over a 3-year period. Clinical details and laboratory results were assessed from hospital records. Bivariate and multivariate analysis was used to identify risk factors for mortality.
Results:
One hundred and nineteen patients (mean age 48.6 years) were included in the study. Of these, 111 patients were hospitalized for at least 48 hours prior to culture and 98 were admitted in the intensive care unit. Bivariate analysis revealed multiple associations with mortality, including a background of renal, cardiac, autoimmune disease, recent carbapenam use and COVID-19 infection and increasing ventilatory requirement, lower PaO2/FiO2 (P/F) ratio, vasopressor use, thrombocytopenia, and hypoalbuminemia at the time of positive isolate. Multivariate analysis showed that autoimmune disease [OR 27.38; 95% CI (1.39-540)], a P/F ratio of less than 300 [OR 7.58; 95% CI (1.52-37.9)], vasopressor requirement [OR 39.50; 95% CI (5.49-284)] and thrombocytopenia [OR 11.5; 95% CI (2.04-65.0)] were statistically significantly associated with increased mortality, while recent surgery and receipt of antibiotics [OR 0.16; 95% CI (0.03-0.8)] targeted against S. maltophilia were associated with decreased mortality.
Conclusion:
Stenotrophomonas maltophilia is primarily isolated in patients in the intensive care unit. In our study the need for vasopressors, autoimmune disease, lower P/F ratios and thrombocytopenia were associated with higher mortality. The association of targeted antibiotics with reduced mortality suggests that the pathogenic role of S. maltophilia should not be underestimated. This finding needs to be confirmed with larger, prospective studies.
Insights
Stenotrophomonas maltophilia infections are rising in India, particularly in intensive care units. Autoimmune disease, low oxygen levels, vasopressor use, and thrombocytopenia predict higher mortality, while targeted antibiotics may reduce it.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Antimicrobial Resistance
Background:
- Stenotrophomonas maltophilia is an emerging multi-drug resistant pathogen.
- Increasing isolation rates of S. maltophilia are noted in India.
- Understanding mortality predictors is crucial for patient management.
Purpose of the Study:
- Identify patients with S. maltophilia isolates.
- Assess predictors of mortality in this patient population.
- Evaluate factors associated with increased or decreased mortality.
Main Methods:
- Retrospective cohort study over a 3-year period.
- Inclusion of hospitalized patients with positive S. maltophilia cultures.
- Bivariate and multivariate analyses to identify risk factors for mortality.
Main Results:
- 119 patients included; most were in intensive care.
- Mortality associated with autoimmune disease, low PaO2/FiO2 ratio, vasopressor use, and thrombocytopenia.
- Receipt of targeted antibiotics was associated with decreased mortality.
Conclusions:
- S. maltophilia is frequently isolated in ICU patients.
- Vasopressor need, autoimmune disease, low P/F ratio, and thrombocytopenia are key mortality predictors.
- Targeted antibiotic use suggests a significant pathogenic role for S. maltophilia.
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