Risk factors associated with Stenotrophomonas maltophilia Bacteremia: A matched case-control study

Kosuke Sumida, Yong Jeong, Noriko Miyake, Tomohiko Akahoshi, Mitsuhiro Yasuda, Nobuyuki Shimono, Shinji Shimoda, Yoshihiko Maehara, Koichi Akashi

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Abstract

Stenotrophomonas maltophilia is an important nosocomial bacterial pathogen, as is Pseudomonas aeruginosa. Differentiation of these bacteria as bacteremic agents is critical in the clinical setting and to define a therapeutic strategy; however, the associated factors and prognosis for S. maltophilia bacteremia have not been fully evaluated to adequately characterize these factors. We first conducted a matched case-control study to clarify these questions. A total of 30 case patients with S. maltophilia bacteremia were compared with 30 control patients with P. aeruginosa bacteremia between January 2005 and August 2014, according to matching criteria based on underlying disease, age, and gender. The 30-day mortality rate for the case patients (53.3%) was significantly higher than that of the control group (30.0%) (P = 0.047, using the log-rank test). Conditional logistic regression analysis showed that the predisposing factors specific for the detection of S. maltophilia bacteremia were indwelling artificial products other than a central venous catheter, ICU stay, and previous use of anti-MRSA drugs. The high severity of illness was associated with mortality in both case and control patients. Interestingly, inappropriate antimicrobial treatment was an additional independent risk factor for mortality in only the case patients with S. maltophilia bacteremia (odds ratio = 13.64, P = 0.048). Monotherapy with fluoroquinolones inactive against the S. maltophiliaisolates was mainly responsible for the inappropriate treatment. These results suggest that more precise prediction and more appropriate treatment might improve the prognosis of patients with S. maltophilia bacteremia.

Original languageEnglish
Article numbere0133731
JournalPloS one
Volume10
Issue number7
DOIs
Publication statusPublished - Jul 24 2015

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Stenotrophomonas maltophilia
bacteremia
case-control studies
Case-Control Studies
risk factors
Pseudomonas aeruginosa
Intensive care units
prognosis
Mortality
Catheters
Fluoroquinolones
Pathogens
Regression analysis
Logistics
Bacteria
fluoroquinolones
Central Venous Catheters
Therapeutics
Methicillin-Resistant Staphylococcus aureus
Bacteremia

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Risk factors associated with Stenotrophomonas maltophilia Bacteremia : A matched case-control study. / Sumida, Kosuke; Jeong, Yong; Miyake, Noriko; Akahoshi, Tomohiko; Yasuda, Mitsuhiro; Shimono, Nobuyuki; Shimoda, Shinji; Maehara, Yoshihiko; Akashi, Koichi.

In: PloS one, Vol. 10, No. 7, e0133731, 24.07.2015.

Research output: Contribution to journalArticle

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