Treatment Patterns and Clinical Outcomes in Children with Stenotrophomonas maltophilia Infections

Stenotrophomonas maltophilia is an opportunistic, multidrug-resistant pathogen commonly associated with respiratory and bloodstream infections. Owing to extensive intrinsic and acquired antimicrobial resistance and limited pediatric-specific evidence, contemporary management relies heavily on extrapolation from adult data, underscoring the need to better characterize real-world treatment practices and outcomes in children. This was a retrospective, observational cohort that included hospitalized patients < 18 years of age with a positive S. maltophilia culture who received active antimicrobial therapy, excluding cases determined by the treating provider to represent colonization. Outcomes assessed included in-hospital mortality, adverse drug effects, and clinical success rates using descriptive statistics. Forty pediatric patients (median [IQR] age of 2.7 [0.7-7.9] years) were included. Respiratory infections accounted for 77.5% of cases, and sulfamethoxazole-trimethoprim monotherapy was the most common treatment regimen (70.0%). Five patients (12.5%) experienced in-hospital mortality, three patients (7.5%) experienced adverse effects related to treatment, and all patients exhibited clinical success. Larger, multicenter observational and prospective studies are warranted to strengthen evidence-based therapeutic approaches for pediatric patients with S. maltophilia infections.