Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia.

Abstract

Stenotrophomonas maltophilia is a nosocomial pathogen associated with high morbidity and mortality, particularly in immunocompromised or critically ill patients. In this study, we investigated the risk factors for mortality in patients with S. maltophilia bacteremia.Retrospectively, medical records from all patients with S. maltophilia bacteremia between December 2005 and 2014 at Severance Hospital, a 2000-bed tertiary care hospital in Seoul, Korea, were reviewed. Analysis was performed to identify factors associated with 28-day mortality.In total, 142 bacteremia patients were enrolled in this study. The overall 28-day mortality rate was 36.6%. Based on the univariate analysis, hematologic malignancy (P = 0.015), Sepsis-related Organ Failure Assessment (SOFA) score (P < 0.001) and the removal of a central venous catheter (CVC) (P = 0.040) were significantly related to mortality. In the intensive care unit patients, the Acute Physiology and Chronic Health Evaluation II score (P = 0.001) also had significance. Based on the multivariate analysis, the SOFA score (odds ratio [OR] = 1.323; 95% confidence interval [CI]: 1.159, 1.509; P < 0.001) and removal of the CVC (OR = 0.330; 95% CI: 0.109, 0.996; P = 0.049) were independent factors associated with mortality.Our results suggest that removing a CVC may considerably reduce mortality in patients with S. maltophilia bacteremia.

• Authors: Yong Duk Jeon, Woo Yong Jeong, Moo Hyun Kim, In Young Jung, Mi Young Ahn, Hea Won Ann, Jin Young Ahn, Sang Hoon Han, Jun Yong Choi, Young Goo Song, June Myung Kim, Nam Su Ku
• Journal: Medicine (Medicine (Baltimore)) Vol. 95 Issue 31 Pg. e4375 (Aug 2016) ISSN: 1536-5964 [Electronic] United States
• PMID: 27495046 (Publication Type: Journal Article)

Topics

• Adult
• Age Factors
• Aged
• Catheterization, Central Venous (adverse effects)
• Cause of Death
• Cohort Studies
• Cross Infection (etiology, mortality)
• Databases, Factual
• Female
• Gram-Negative Bacterial Infections (etiology, mortality, physiopathology)
• Hospital Mortality
• Humans
• Kaplan-Meier Estimate
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Retrospective Studies
• Risk Assessment
• Sex Factors
• Stenotrophomonas maltophilia (immunology)
• Survival Analysis
• Urinary Catheterization (adverse effects)