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Risk Factors for Infection and Mortality Associated With Stenotrophomonas maltophilia Bloodstream Infections in

Nimet Melis Bilen1, Zumrut Sahbudak Bal1, Gizem Güner Özenen1

  • 1From the Department of Pediatrics, Division of Infectious Disease, Medical School of Ege University, Izmir, Turkey.

The Pediatric Infectious Disease Journal
|February 16, 2023
PubMed
Abstract

Insights

Prior carbapenem use increases the risk of Stenotrophomonas maltophilia bloodstream infections (BSIs) in children. Previous Pediatric Intensive Care Unit admission and glycopeptide use are risk factors for S. maltophilia BSI mortality.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Microbiology
  • Critical Care Medicine

Background:

  • Stenotrophomonas maltophilia (S. maltophilia) infections are increasingly concerning due to high fatality rates.
  • Understanding risk factors for S. maltophilia bloodstream infections (BSIs) in children is crucial for effective management.

Purpose of the Study:

  • To evaluate risk factors for S. maltophilia BSIs in children.
  • To identify risk factors associated with mortality in pediatric S. maltophilia BSIs.
  • To compare S. maltophilia BSIs with Pseudomonas aeruginosa BSIs.

Main Methods:

  • Retrospective analysis of 73 S. maltophilia and 80 Pseudomonas aeruginosa BSIs from January 2014 to December 2021.
  • Comparison of patient demographics, clinical characteristics, and treatment outcomes.
  • Multivariate analysis to identify independent risk factors for infection and mortality.

Main Results:

  • Prior Pediatric Intensive Care Unit (PICU) admission, glycopeptide, and carbapenem use were more frequent in S. maltophilia BSIs.
  • Higher C-reactive protein (CRP) levels were observed in S. maltophilia BSIs.
  • Prior carbapenem use (AOR: 2.710) and PICU admission (AOR: 19.155) with prior glycopeptide use (AOR: 9.629) were significant risk factors for S. maltophilia BSI and mortality, respectively.

Conclusions:

  • Prior carbapenem use is a significant risk factor for S. maltophilia BSIs in children.
  • PICU admission and prior glycopeptide use are associated with increased mortality in pediatric S. maltophilia BSIs.
  • Empirical antibiotic treatment should consider S. maltophilia in high-risk patients.

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