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Annals of Hematology

, Volume 97, Issue 2, pp 343–350 | Cite as

Clinical predictors of Stenotrophomonas maltophilia bacteremia in adult patients with hematologic malignancy

  • Si-Ho Kim
  • Sun Young Cho
  • Cheol-In KangEmail author
  • Hyeri Seok
  • Kyungmin Huh
  • Young Eun Ha
  • Doo Ryeon Chung
  • Nam Yong Lee
  • Kyong Ran Peck
  • Jae-Hoon Song
Original Article

Abstract

Stenotrophomonas maltophilia (SM) has emerged as an important nosocomial pathogen with high morbidity and mortality. Because of its unique antimicrobial susceptibility pattern, appropriate antimicrobial therapy for SM bacteremia is still challenging, especially in immunocompromised patients. The present study was performed to assess clinical predictors of SM bacteremia in adult patients with hematologic malignancy. From 2006 through 2016, a case-control study was performed at a tertiary-care hospital. Case patients were defined as SM bacteremia in patients with hematologic malignancy. Date- and location-matched controls were selected from among patients with gram-negative bacteremia (GNB) other than SM. A total of 118 cases of SM bacteremia were identified and compared to 118 controls. While pneumonia was the most common source of SM bacteremia, centralline-associated infection was most common in the controls. The overall 30-day mortality rate of cases with SM bacteremia was significantly higher than that of the controls (61.0 and 32.2%, respectively; P < 0.001). A multivariable analysis showed that polymicrobial infection, previous SM isolation, the number of antibiotics previously used ≥ 3, and breakthrough bacteremia during carbapenem therapy were significantly associated with SM bacteremia (all P < 0.01). Previous use of trimethoprim/sulfamethoxazole (TMP/SMX) was negatively association with SM bacteremia (P = 0.002). Our data suggest that SM is becoming a significant pathogen in patients with hematologic malignancy. Several clinical predictors of SM bacteremia can be used for appropriate antimicrobial therapy in hematologic patients with suspected GNB.

Keywords

Stenotrophomonas maltophilia Hematologic malignancy Bacteremia Predictor 

Notes

Compliance with ethical standards

This study was approved by the institutional review board at our institution (number: 2017-08-016-001). All procedures were performed in accordance with the principles of the Declaration of Helsinki.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Si-Ho Kim
    • 1
  • Sun Young Cho
    • 1
  • Cheol-In Kang
    • 1
    Email author
  • Hyeri Seok
    • 1
  • Kyungmin Huh
    • 1
  • Young Eun Ha
    • 1
  • Doo Ryeon Chung
    • 1
  • Nam Yong Lee
    • 2
  • Kyong Ran Peck
    • 1
  • Jae-Hoon Song
    • 1
  1. 1.Division of Infectious Diseases, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Laboratory Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea

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