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Case series: Stenotrophomonas maltophilia in pediatric oncology patients
Sanila Sarkar1, Lea M Stitzlein1, Emily Rav1
1Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Background:
Stenotrophomonas maltophilia is a bacterial pathogen that can be fatal in hospitalized and immunocompromised patients with mortality as high as 69%. Pediatric cancer patients often have risk factors that are common for this infection, making them particularly susceptible. Managing S. maltophilia is especially challenging as it has inherent resistance to several antibiotics. Furthermore, soft tissue infections in neutropenic patients may deviate from the typical clinical presentation of S. maltophilia.
Case Details:
This case series describes an in-depth examination of three cases involving immunocompromised pediatric patients with S. maltophilia infections. Each case exhibited a distinct clinical presentation, encompassing infection of the blood, lung, and skin, which highlights the variability in which S. maltophilia manifests in immunocompromised pediatric patients. These patients were treated at MD Anderson Cancer Center (MDACC) from 2020 to 2023, unfortunately resulting in fatality.
Conclusions:
The study aims to provide valuable insights and guidance for the management of patients with S. maltophilia infections. Emphasizing a heightened clinical suspicion will potentially lead to early initiation of directed therapy against S. maltophilia. Timely intervention may play a pivotal role in improving patient outcomes and reduce further burden to the healthcare system.
Insights
Stenotrophomonas maltophilia infections are dangerous in immunocompromised children, especially cancer patients. Early suspicion and treatment are vital for managing this antibiotic-resistant bacterium.
Area of Science:
- Infectious Diseases
- Pediatric Oncology
- Bacteriology
Background:
- Stenotrophomonas maltophilia is a significant bacterial pathogen with high mortality rates (up to 69%) in vulnerable populations.
- Immunocompromised pediatric cancer patients face heightened susceptibility due to common risk factors.
- Antibiotic resistance and atypical presentations complicate S. maltophilia infection management.
Observation:
- A case series examined three immunocompromised pediatric patients with S. maltophilia infections.
- Infections involved the blood, lung, and skin, demonstrating varied clinical manifestations.
- All three cases, treated at MD Anderson Cancer Center from 2020-2023, were fatal.
Findings:
- S. maltophilia presents diverse clinical pictures in immunocompromised pediatric patients.
- The study underscores the challenges in diagnosing and treating these infections.
- Fatal outcomes highlight the severity and difficulty in managing S. maltophilia.
Implications:
- Heightened clinical suspicion for S. maltophilia is crucial for early diagnosis.
- Prompt, directed therapy can potentially improve patient outcomes.
- Effective management strategies are needed to reduce healthcare burdens and improve survival rates.
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