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Stenotrophomonas maltophilia pneumonia in critical COVID-19 patients

Marc Raad1, Marc Abou Haidar2, Racha Ibrahim3

  • 1Pulmonary and Critical Care Department, University Medical Center Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.

Scientific Reports
|February 28, 2023
PubMed

Insights

Stenotrophomonas maltophilia pneumonia occurred in 16.3% of critical COVID-19 patients, increasing hospital stay. Key risk factors included prior meropenem use, thrombocytopenia, and invasive devices like endotracheal tubes and catheters.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Microbiology

Background:

  • Stenotrophomonas maltophilia (S. maltophilia) is an opportunistic pathogen frequently implicated in nosocomial infections.
  • Critical COVID-19 patients in intensive care units (ICUs) are particularly vulnerable due to prolonged hospital stays and severe immunosuppression.
  • Understanding the prevalence and risk factors of S. maltophilia pneumonia in this population is crucial for effective management.

Purpose of the Study:

  • To determine the prevalence of S. maltophilia pneumonia among critically ill COVID-19 patients.
  • To identify significant risk factors associated with the development of S. maltophilia pneumonia in this patient cohort.
  • To inform strategies for reducing the incidence and impact of S. maltophilia pneumonia in ICUs.

Main Methods:

  • A retrospective analysis of 123 critical COVID-19 patients admitted to the ICU between March 2020 and March 2021.
  • Data collection included demographic information, clinical parameters (APACHE, SOFA, NEWS2 scores), ICU length of stay, and pneumonia diagnosis.
  • Statistical analysis was performed to identify risk factors associated with S. maltophilia pneumonia.

Main Results:

  • S. maltophilia was identified in 16.3% of patients with nosocomial pneumonia.
  • Patients with S. maltophilia pneumonia experienced a significantly longer hospital stay (34 days vs. 20 days; p < 0.001).
  • Significant risk factors included prior meropenem treatment (p < 0.01), thrombocytopenia (p = 0.034), endotracheal intubation (p < 0.001), Foley catheter use (p = 0.009), and central venous catheter insertion (p = 0.016).

Conclusions:

  • Nosocomial S. maltophilia pneumonia is a frequent complication in critically ill COVID-19 patients.
  • Several modifiable risk factors, including antibiotic exposure and the use of invasive devices, are associated with its development.
  • Targeted interventions addressing these risk factors are necessary to mitigate the prevalence and adverse outcomes of S. maltophilia pneumonia.

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