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Supportive Care in Cancer

, Volume 26, Issue 6, pp 1953–1960 | Cite as

Stenotrophomonas maltophilia bacteremia and pneumonia at a tertiary-care oncology center: a review of 16 years

  • Consuelo Velázquez-Acosta
  • Sugehily Zarco-Márquez
  • Mari Carmen Jiménez-Andrade
  • Patricia Volkow-Fernández
  • Patricia Cornejo-JuárezEmail author
Original Article

Abstract

Purpose

The aim of this study was to describe the clinical characteristics and antimicrobial patterns of Stenotrophomonas maltophilia bloodstream infections (BSI) and pneumonia episodes in patients with cancer.

Methods

Patients with S. maltophilia BSI or pneumonia admitted from 1 Jan. 2000 to 31 Dec. 2016 were identified at the Instituto Nacional de Cancerología (INCan), a tertiary-care oncology hospital in Mexico City.

Results

During the study period, there were 171 isolates identified. The mean age of the whole group was 46.9 ± 17.4 years; 99 (57.9%) were women. There were 95 BSI: 64 ambulatory catheter-related BSI (CRBSI), 20 nosocomial CRBSI, and 11 secondary BSI. Mortality was higher in nosocomial CRBSI (40%) vs. that in ambulatory CRBSI (7.8%) (p = 0.001). There were 76 pneumonia episodes; all were nosocomial acquired; 46 (60.5%) ventilator-associated. From all the group, nine strains (5.2%) were resistant to sulfamethoxazole/trimethoprim/(SMX/TMP). At the first month, 54 patients (31.6%) have died, 38 due to pneumonia (70%) and 16 due to BSI (30%, p < 0.001). Multivariate analysis showed that removal of central venous catheter was associated with a favorable outcome in patients with bacteremia. For patients with pneumonia, age ≥ 65 years and inappropriate antimicrobial treatment were risk factors associated with 30-day mortality.

Conclusions

S. maltophilia related with ambulatory CRBSI have a better prognosis than other sources of BSI. Older patients with pneumonia who do not receive appropriate antibiotics have higher mortality. SMX/TMP is still the antibiotic of choice.

Keywords

Stenotrophomonas maltophilia Bloodstream infection Pneumonia Mortality Bacterial resistance 

Notes

Acknowledgments

We thank the Microbiology Laboratory personnel who are responsible for processing all culture specimens at INCan, Mexico City.

Compliance with ethical standards

The study was approved by the Institutional Review Board (INCAN/Rev/10/17).

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 2018

Authors and Affiliations

  1. 1.Laboratorio de MicrobiologíaInstituto Nacional de Cancerología (INCan)Mexico CityMexico
  2. 2.Departamento de InfectologíaINCanMexico CityMexico

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