Risk factors for mortality in Stenotrophomonas maltophilia bacteremia - a meta-analysis

Infect Dis (Lond). 2024 May;56(5):335-347. doi: 10.1080/23744235.2024.2324365. Epub 2024 Mar 4.

Abstract

Background: Stenotrophomonas maltophilia (S. maltophilia) is a nosocomial pathogen causing life-threatening invasive infections with a high mortality rate in some patient populations, especially those who are severely ill or immunocompromised. There is a need for data on mortality in patients with S. maltophilia bacteremia.

Objective: In this meta-analysis, we aimed to investigate risk factors for mortality in S. maltophilia bacteremia.

Methods: Studies comparing patients who died from S. maltophilia bacteremia with patients who survived were considered for inclusion. Studies were included if they reported one or more risk factors for mortality. Mortality risk factors included clinical predisposing factors, predisposing comorbidities and appropriateness of antibiotic therapy.

Results: Nineteen studies with 1248 patients were included in the meta-analysis. Five hundred and six (40.5%) patients died. The following risk factors for mortality were identified: ICU admission, septic shock, need for mechanical ventilation, indwelling central venous catheter, neutropenia, comorbid hematological malignancies, chronic kidney disease, inappropriate antimicrobial therapy and prior antibiotic use.

Conclusions: Appropriate antimicrobial therapy had a protective effect against mortality in S. maltophilia bacteremia. Indwelling central venous catheter, neutropenia, hematological malignancies and chronic kidney disease were also risk factors for mortality.

Keywords: Stenotrophomonas maltophilia; bacteremia; inappropriate antimicrobial therapy; mortality.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia*
  • Cross Infection* / drug therapy
  • Gram-Negative Bacterial Infections* / drug therapy
  • Hematologic Neoplasms* / complications
  • Humans
  • Neutropenia* / complications
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / drug therapy
  • Retrospective Studies
  • Risk Factors
  • Stenotrophomonas maltophilia* / immunology*

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Stenotrophomonas maltophilia bacteremia