Evaluation of treatment outcomes for Stenotrophomonas maltophilia bacteraemia

B. Lakatos, B. Jakopp,A. Widmer,R. Frei, H. Pargger,L. Elzi,M. Battegay

Infection(2014)

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Abstract
Objective The goal of this study was to retrospectively collect data about treatment outcomes in patients diagnosed with Stenotrophomonas maltophilia bacteraemia over a period of 20 years and evaluate these data with respect to the efficacy of treatment options. Methods The setting was a 700-bed tertiary care hospital in a large urban area. Hospital databases and medical records provided information about episodes of S. maltophilia , patient characteristics and treatment outcomes. Patients with at least one positive blood culture for S. maltophilia were included in the study. Data were analysed with respect to clinical improvement and mortality ≤30 days after the onset of infection. We compared patient characteristics, laboratory values and treatments by using the Chi-square or Fisher’s exact tests and the Mann–Whitney test. Results We investigated 27 patients with S. maltophilia bacteraemia. The focus of infection was a central venous catheter in 18 (67 %) cases. The 30-day mortality rate was 11 %. All patients who were treated with an antibiotic that was effective in vitro against the pathogen recovered clinically and survived ≥30 days after the onset of infection. The most frequently used antibiotic was trimethoprim–sulfamethoxazole administered alone or in combination with a fluoroquinolone. Conclusions Despite the fact that S. maltophilia is resistant to multiple antibiotics, the prognosis for patients with S. maltophilia bacteraemia is good when they are treated with antibiotics that are effective against this pathogen in vitro.
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Key words
Stenotrophomonas maltophilia,Bacteraemia,Antimicrobial therapy,Trimethoprim–sulfamethoxazole,Bacteraemia mortality
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