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Background   Stenotrophomonas maltophilia  is an important nosocomial pathogen. This pathogen has intrinsic or acquired resistance to a number of antibiotics classes. Furthermore,  Stenotrophomonas  infections have been associated with high mortality, mainly in immunocompromised patients. Accordingly, we conducted a retrospective cohort study on the clinical data, microbiological characteristics, and outcomes of patients with  S. maltophilia  (SM) bacteremia.    Methods  A retrospective cohort study was conducted at two tertiary care referral hospitals in Seoul, South Korea. Data were collected between January 2006 and December 2015 from electric medical records .  Our analysis aimed to identify the risk factors associated with crude mortality, as well as the predictive factors of quinolone-resistant strains in SM bacteremia patients.    Results  A total of 126 bacteremia patients were enrolled in the study. The mortality rate was 65.1%. On multivariable analysis, hypoalbuminemia (odds ratio [OR], 5.090; 95% confidence interval [CI], 1.321–19.621;  P  = 0.018), hematologic malignancy (OR, 35.567; 95% CI, 2.517–502.515;  P  = 0.008) and quinolone-resistant strains (OR, 7.785; 95% CI, 1.278–47.432;  P  = 0.026) were independent risk factors for mortality. Alternatively, usage of an empirical regimen with quinolone (OR, 0.172; 95% CI, 0.034–0.875;  P  = 0.034) was an independent protective factor for mortality. The multivariable analysis of predictive factors revealed that high Charlson comorbidity index (OR, 1.190; 95% CI, 1.040–1.361;  P  = 0.011) and indwelling of a central venous catheter (CVC) (OR, 3.303; 95% CI, 1.194–9.139;  P  = 0.021) were independent predisposing factors associated with quinolone-resistant strains in SM bacteremia patients.    Conclusions  Our findings suggest that a high Charlson comorbidity score and indwelling of a CVC were significantly independent predictors of quinolone-resistant strains in SM bacteremia patients .  Therefore, we need to carefully consider the antibiotic use in SM bacteremia patients with these predictive factors.    Electronic supplementary material  The online version of this article (10.1186/s12879-019-4394-4) contains supplementary material, which is available to authorized users.

Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia and clinical impact of quinolone–resistant strains