Stenotrophomonas maltophilia Bacteraemia: Analysis of 33 Episodes Occurred in the ICU at the University Hospital in Sousse, Tunisia

Abstract

Introduction: Stenotrophomonas maltophilia is a gram negative bacillus that has emerged as an opportunistic pathogen associated with high morbidity and mortality rates. Objectives: The aim of this study is to describe the characteristics of bactaeremia due to this strain, their outcome, the antibiotic sensitivity patterns of isolates. Results: In our study, 93% of 33 episodes were nosocomial. There were 22 deaths (71%) 15±12 days after the bactaeremia. 17/31 of patients were exposed to broad-spectrum antibiotic specifically imipinem (IMP) before their positive culture. Among cases, 23 (74%) patient had mechanical ventilation and 29 (93.5%) had central venous catheterization. Antibiotic susceptibility testing revealed that isolates were most sensitive to Ciprofloxacin (CIP) (84%), Trimethoprim-sulfamethoxazole (SXT) (71%) and to Colistin (CS) (58%). Twenty three percent (23%) episodes were polymicrobial. A probable portal of entry was identified in 27.3% of bacteraemic episodes and 57% were catheter-related. Fifty eight percent (58%) of the episodes were treated with monotherapy specifically CIP (35%). Our results were similar to those described by others in the last 20 years. These studies have been mostly retrospective. Conclusion: Prevention of S. maltophilia infection relies on the cornerstones of modern infection control, such as higher emphasis on control of antimicrobial consumption and consideration of environmental reservoirs.