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Characteristics of Stenotrophomonas maltophilia bacteremia in children
Author(s) -
Furuichi Munehiro,
Ito Kenta,
Miyairi Isao
Publication year - 2016
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12745
Subject(s) - stenotrophomonas maltophilia , bacteremia , medicine , antibiotics , pseudomonas aeruginosa , microbiology and biotechnology , bacteria , biology , genetics
Background Empiric antimicrobial coverage in compromised hosts commonly includes pseudomonal coverage but often lacks coverage against Stenotrophomonas maltophilia . Identification of risk factors specific for S . maltophilia infection may lead to prompt initiation of appropriate antibiotics and improved outcome. Methods We conducted a retrospective analysis of pediatric patients with bacteremia due to S . maltophilia or Pseudomonas aeruginosa from April 2002 to July 2014 at a tertiary children's hospital. Patient demographics, underlying disease, clinical course, and treatment were compared between S . maltophilia and P . aeruginosa cases. Results Nineteen children with S . maltophilia bacteremia and 49 children with P . aeruginosa bacteremia were identified. On multivariate logistic regression analysis, use of carbapenems within 7 days prior to onset (OR, 5.00; 95%CI: 1.25–20.07; P = 0.02) and previous intensive care unit stay (OR, 3.75; 95%CI: 1.13–12.47; P = 0.03) were significantly associated with S . maltophilia bacteremia compared with P . aeruginosa bacteremia. The majority of the S . maltophilia bacteremia patients had central line‐associated bloodstream infection (79%), compared with the P . aeruginosa bacteremia patients (37%, P = 0.002). There were nine children (47%) who had polymicrobial infection in the S . maltophilia bacteremia group, in contrast to four (8%) in the P . aeruginosa bacteremia group (OR, 10.13; 95%CI: 2.59–39.56; P = 0.001). Consultation with an infectious diseases physician was associated with a lower rate of persistent S . maltophilia bacteremia ( P = 0.04). Conclusions Stenotrophomonas maltophilia should be considered in breakthrough bacteremia in pediatric patients who receive carbapenems within 7 days prior to onset.