Prior carbapenem use ups S. maltophilia bloodstream infection in children

Children with prior use of carbapenem are at increased risk of developing Stenotrophomonas maltophilia bloodstream infection (BSI), suggests a study. In addition, admission to the paediatric intensive care unit (PICU) due to BSI and prior glycopeptide use are significantly 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,” the authors said.

This study examined all BSIs caused by S. maltophilia (n=73) and P. aeruginosa (n=80) between January 2014 and December 2021 at the Medical School of Ege University in Bornova, Turkey.

Patients with S. maltophilia BSI were significantly more likely to have been previously admitted to PICU (p=0.044), prior glycopeptide (p=0.009), and carbapenem use (p=0.001) than those with P. aeruginosa BSI. In addition, C-reactive protein levels were markedly higher in S. maltophilia BSIs (p=0.002).

In multivariate analysis, prior carbapenem use correlated with S. maltophilia BSIs (p=0.014; adjusted odds ratio [aOR], 2.719, 95 percent confidence interval [CI], 1.225‒5.992).

Additionally, PICU admission due to BSI (p<0.001), prior carbapenem (p=0.010) and glycopeptide use (p=0.007), neutropenia (p=0.008), and thrombocytopenia (p=0.004) were more common among patients who died because of S. maltophilia BSIs.

In multivariate analysis, only PICU admission due to BSI (aOR, 19.155, 95 percent CI, 2.337‒157.018; p=0.006) and prior glycopeptide use (aOR, 9.629, 95 percent CI, 1.053‒88.013; p=0.045) remained significantly associated with mortality because of S. maltophilia BSIs.