Related Experiment Video
Updated: Jul 20, 2025
Preparation of a Blood Culture Pellet for Rapid Bacterial Identification and Antibiotic Susceptibility Testing
Published on: October 15, 2014
The Prognosis of Patients Tested Positive for Stenotrophomonas maltophilia from Different Sources
Ru Ma1, Qiang Chen1, Ying Huang2
1Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.
Purpose:
The purpose of this study was to analyze the prognosis of patients tested positive for Stenotrophomonas maltophilia (SMA) from different sources.
Methods:
A retrospective study was conducted among 651 patients tested positive for SMA from January 2020 to October 2022 in the First Affiliated Hospital of Anhui Medical University. The patients were divided into seven groups by the source of SMA. Univariate and multivariate analyses were used to identify risk factors for mortality in patients tested positive for SMA from different sources.
Results:
A total of 651 SMA isolates were collected from various sources, including sputum (348 isolates, 53%), bronchoalveolar lavage fluid (52, 8%), abdominal drainage fluid (76, 12%), wound secretion (66, 10%), blood (62, 10%), urine (41, 6%) and cerebrospinal fluid (6, 1%). Compared with other groups, the mortality of the patients in the bronchoalveolar lavage fluid culture group, blood culture group, and abdominal drainage fluid culture group was higher, at 40.38%, 32.26%, and 26.32%, respectively. Multivariate analysis showed that continuous renal replacement therapy was an independent risk factor for mortality in patients with SMA bloodstream infection (P=0.020, OR=6.86), and effective antimicrobial therapy after being positive for S. maltophilia isolates (P=0.002, OR=0.10) was negatively correlated with the death of patients with SMA bloodstream infection. Age ≥65 years (P= 0.043, OR=4.96), kidney disease (P=0.045, OR=4.62) and antifungal agent exposure (P=0.036, OR=5.13) were independent risk factors for mortality in patients with SMA intra-abdominal infection. Antifungal agent exposure (P=0.024, OR=0.51) and glycopeptide exposure (P=0.045, OR=0.53) were independent risk factors for mortality in patients in the sputum culture group.
Conclusion:
SMA has a high rate of antimicrobial resistance and can cause multisite infection. Pulmonary infections, bloodstream infections and abdominal infections caused by SMA have high mortality, and timely standardized treatment can reduce mortality.
Insights
Stenotrophomonas maltophilia (SMA) infections in the lungs, blood, and abdomen are linked to higher mortality. Early, standardized antimicrobial treatment is crucial for improving patient outcomes and reducing deaths.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Stenotrophomonas maltophilia (SMA) is an opportunistic pathogen known for its high antimicrobial resistance.
- SMA can cause severe infections across multiple body sites, leading to significant patient morbidity and mortality.
- Understanding the specific risk factors and outcomes associated with SMA infections from different sources is critical for effective clinical management.
Purpose of the Study:
- To analyze the prognosis and identify mortality risk factors in patients with Stenotrophomonas maltophilia (SMA) infections originating from various clinical sources.
- To compare mortality rates across different infection sites caused by SMA.
- To determine independent risk factors associated with mortality in patients with SMA bloodstream, intra-abdominal, and pulmonary infections.
Main Methods:
- A retrospective study involving 651 patients with positive SMA cultures from January 2020 to October 2022.
- Patients were categorized into seven groups based on the source of SMA isolation (sputum, bronchoalveolar lavage fluid, abdominal drainage fluid, wound secretion, blood, urine, cerebrospinal fluid).
- Univariate and multivariate logistic regression analyses were employed to identify risk factors for mortality.
Main Results:
- Higher mortality rates were observed in patients with SMA isolated from bronchoalveolar lavage fluid (40.38%), blood (32.26%), and abdominal drainage fluid (26.32%).
- Independent mortality risk factors identified included continuous renal replacement therapy for bloodstream infections and age ≥65 years, kidney disease, and antifungal agent exposure for intra-abdominal infections.
- Antifungal and glycopeptide exposure were associated with mortality in the sputum culture group.
Conclusions:
- Stenotrophomonas maltophilia infections, particularly pulmonary, bloodstream, and abdominal infections, are associated with high mortality rates.
- Effective antimicrobial therapy significantly reduces mortality in patients with SMA bloodstream infections.
- Timely and standardized treatment is essential to improve survival rates in patients with SMA infections.
Related Concept Videos
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:30Pneumonia III: Complications and Assessment