Risk Factors for Infection and Mortality Associated With Stenotrophomonas maltophilia Bloodstream Infections in Children; Comparison With Pseudomonas aeruginosa Bloodstream Infections

被引：7

作者：

Bilen, Nimet Melis ^{[1
]}

Bal, Zumrut Sahbudak ^{[1
]}

Ozenen, Gizem Guner ^{[1
]}

Arslan, Sema Yildirim ^{[1
]}

Ozek, Gulcihan ^{[2
]}

Karadas, Nihal Ozdemir ^{[3
]}

Yazici, Pinar ^{[4
]}

Cilli, Feriha ^{[5
]}

Kurugol, Zafer ^{[1
]}

机构：

[1] Ege Univ, Dept Pediat, Div Infect Dis, Med Sch, Izmir, Turkiye

[2] Ege Univ, Med Sch, Div Pediat Hematol & Oncol & Bone Marrow Transpla, Dept Pediat, Izmir, Turkiye

[3] Ege Univ, Dept Pediat, Div Pediat Hematol & Oncol, Med Sch, Izmir, Turkiye

[4] Ege Univ, Med Sch, Div Pediat Intens Care, Dept Pediat, Izmir, Turkiye

[5] Ege Univ, Med Sch, Dept Med Microbiol, Izmir, Turkiye

来源：

PEDIATRIC INFECTIOUS DISEASE JOURNAL | 2023年 / 42卷 / 05期

关键词：

Stenotrophomonas maltophilia; Bloodstream infections; mortality; children; Pseudomonas aeruginosa; CLINICAL CHARACTERISTICS; BACTEREMIA;

D O I：

10.1097/INF.0000000000003845

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Introduction: The increasing incidence of Stenotrophomonas maltophilia (S. maltophilia) infections raises concern because of the high fatality/case ratio. This study aimed to evaluate the risk factors for infection and mortality associated with S. maltophilia bloodstream infections (BSIs) in children and compare them with Pseudomonas aeruginosa BSIs. Methods: All BSIs caused by S. maltophilia (n:73) and P. aeruginosa (n:80) were enrolled in this study between January 2014 and December 2021 at the Medical School of Ege University. Results: Previous Pediatric Intensive Care Unit (PICU) admission, prior glycopeptide, and carbapenem use were significantly more common in patients with S. maltophilia BSIs (P = 0.044, P = 0.009, and P = 0.001, respectively) than with P. aeruginosa BSIs. C-reactive protein (CRP) levels were significantly higher in S. maltophilia BSIs (P = 0.002). Multivariate analysis showed that prior carbapenem use was associated with S. maltophilia BSIs (P = 0.014, adjusted odds ratio [AOR]: 2.710; 95% confidence interval [CI]: 1.225-5.992). PICU admission because of BSI, prior carbapenem and glycopeptide use, neutropenia, and thrombocytopenia were significantly more common in patients with mortality because of S. maltophilia BSIs (P < 0.001, P = 0.010, P = 0.007, P = 0.008, P = 0.004, respectively), while only PICU admission because of BSI, and prior glycopeptide use were significant in multivariate analysis (AOR, 19.155; 95% CI: 2.337-157.018; P = 0.006 and AOR, 9.629; 95% CI: 1.053-88.013; P = 0.045, respectively). Conclusion: Prior carbapenem use is a significant risk factor for developing S. maltophilia BSIs. PICU admission because of BSI and prior glycopeptide use are risk factors associated with the mortality rate in patients with S. maltophilia BSIs. Therefore, S. maltophilia should be considered in patients with these risk factors, and empirical treatment should include antibiotics for S. maltophilia.

引用

页码：374 / 380

页数：7

共 22 条

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