Risk Factors for Mortality in Hospitalized Patients with Stenotrophomonas maltophilia Bacteremia

Abstract

Objective: Stenotrophomonas maltophilia (S. maltophilia) is an opportunistic and nosocomial pathogen with high mortality. And it has intrinsic resistance to a number of antibiotics classes. In this study, we investigated risk factors for death due to S. maltophilia bacteremia. Methods: A retrospective cohort study was conducted at a tertiary-care hospital in Beijing, China. The patients from the hospital database with S. maltophilia bacteremia between January 2011 and December 2020 were investigated. Univariate and multivariate analyses were performed to identify factors associated with mortality. Results: 51 patients with S. maltophilia bacteremia were identified. The mortality rate was 37.3%. Based on the univariate analysis, pulmonary disease (P=0.019), chronic kidney disease (P=0.014), shock (P=0.002), foley catheter (P=0.011), the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (P<0.001), procalcitonin (PCT) (P=0.045) and using antifungal agent (P=0.033) were significantly related to mortality. Based on the multivariate analysis, the APACHE II score (odds ratio [OR] =1.211; 95% confidence interval [CI]: 1.061, 1.382; P=0.005) was independent factor associated with mortality. S. maltophilia was the most susceptible to minocycline (94.7%), followed by trimethoprim and sulfamethoxazole (TMP/SMX, 92.2%). Conclusion: Our findings suggested that the APACHE II score was a significantly independent predictor in S. maltophilia bacteremia patients. The use of TMP/SMX or minocycline might be the first choice for the treatment of S. maltophilia bacteremia.