Abstract
Stenotrophomonas maltophilia is an important nosocomial pathogen, especially among immunocompromised patients. The objective of this study was to clarify the clinical characteristics, prognosis, and prognostic factors of patients with S. maltophilia bacteremia in Japan. The microbiology records of all patients with S. maltophilia bacteremia between January 1996 and April 2009 at Toranomon Hospital, Tokyo, Japan, were retrospectively reviewed. A total of 53 cases of bacteremia were identified. Thirty patients had an underlying hematological disorder, and 23 were receiving hematopoietic transplantation. The overall mortality rate was 51%. On univariate analysis, neutropenia (p < 0.01), the presence of a central venous catheter, and mixed infection with enterococci (p < 0.05) were significantly related to the mortality. Among these variables, neutropenia (p < 0.01) and mixed infection with enterococci (p < 0.05) were independent factors associated with mortality. In contrast, all eight patients in whom S. maltophilia was the etiologic agent of catheter-related infection survived following catheter removal. S. maltophilia is an important pathogen among immunocompromised patients, especially in the neutropenic phase or mixed infection with enterococci. If a central venous catheter was present at the onset of S. maltophilia bacteremia, the prompt removal of the catheter was important.
References
Safdar A, Rodriguez GH, Balakrishnan M, Tarrand JJ, Rolston KV (2006) Changing trends in etiology of bacteremia in patients with cancer. Eur J Clin Microbiol Infect Dis 25:522–526. doi:10.1007/s10096-006-0173-4
Elting LS, Bodey GP, Fainstein V (1986) Polymicrobial septicemia in the cancer patient. Medicine 65:218–225
Micozzi A, Venditti M, Monaco M, Friedrich A, Taglietti F, Santilli S, Martino P (2000) Bacteremia due to Stenotrophomonas maltophilia in patients with hematologic malignancies. Clin Infect Dis 31:705–711. doi:10.1086/314043
Lai CH, Chi CY, Chen HP, Chen TL, Lai CJ, Fung CP, Yu KW, Wong WW, Liu CY (2004) Clinical characteristics and prognostic factors of patients with Stenotrophomonas maltophilia bacteremia. J Microbiol Immunol Infect 37:350–358
Khan IA, Mehta NJ (2002) Stenotrophomonas maltophilia endocarditis: a systematic review. Angiology 53:49–55
Papadakis KA, Vartivarian SE, Vassilaki ME, Anaissie EJ (1997) Stenotrophomonas maltophilia meningitis. Report of two cases and review of the literature. J Neurosurg 87:106–108
Friedman ND, Korman TM, Fairley CK, Franklin JC, Spelman DW (2002) Bacteraemia due to Stenotrophomonas maltophilia: an analysis of 45 episodes. J Infect 45:47–53
Vartivarian SE, Anaissie EJ, Kiwan EN, Papadakis KA (2000) The clinical spectrum of Stenotrophomonas (Xanthomonas) maltophilia respiratory infection. Semin Respir Crit Care Med 21:349–355. doi:10.1055/s-2000-9859
Apisarnthanarak A, Mayfield JL, Garison T, McLendon PM, DiPersio JF, Fraser VJ, Polish LB (2003) Risk factors for Stenotrophomonas maltophilia bacteremia in oncology patients: a case–control study. Infect Control Hosp Epidemiol 24:269–274. doi:10.1086/502197
Labarca JA, Leber AL, Kern VL, Territo MC, Brankovic LE, Bruckner DA, Pegues DA (2000) Outbreak of Stenotrophomonas maltophilia bacteremia in allogenic bone marrow transplant patients: role of severe neutropenia and mucositis. Clin Infect Dis 30:195–197. doi:10.1086/313591
Author information
Authors and Affiliations
Corresponding author
Additional information
Financial support was not received.
There is no conflict to declare.
Rights and permissions
About this article
Cite this article
Araoka, H., Baba, M. & Yoneyama, A. Risk factors for mortality among patients with Stenotrophomonas maltophilia bacteremia in Tokyo, Japan, 1996–2009. Eur J Clin Microbiol Infect Dis 29, 605–608 (2010). https://doi.org/10.1007/s10096-010-0882-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-010-0882-6