TY  - JOUR
TI  - Stenotrophomonas maltophilia Bacteremia:  From Diagnosis to Treatment
AB  - Objective: There are many difficulties in diagnosing and treating Stenotrophomonas maltophil ia bacteremia. In this study, we aimed to evaluate “true” and “false-positive bacteremia” and  assess mortality risk factors and the impact of different treatment regimens.  Materials and Methods: Hospitalized adult patients with S. maltophilia-positive blood cul tures were assessed by a two-stage analysis. First, the clinical significance of blood cultures  was assessed, and patients were divided into “true” and “false-positive bacteremia” groups.  Then, excluding false positives, we analyzed the antimicrobial regimens and the factors  associated with 28-day mortality in true bacteremia cases performing univariate and mul tivariate analyses. Results: The study included 127 out of 138 patients with S. maltophilia bacteremia. True  bacteremia was identified in 51.2% and false-positive bacteremia in 48.8% of patients. In  the true bacteremia group, hypotension, nosocomial bacteremia, concomitant infections,  a source of bacteremia, two positive blood culture sets, and 28-day mortality were more  common. The 28-day mortality was 50.7% among true bacteremia cases. In multivariate  analysis, age and solid tumor were the independent predictors of 28-day mortality. Early  effective antimicrobial therapy and different antimicrobial regimens, including trimeth oprim-sulfamethoxazole (SXT), fluoroquinolones (FQs), and tigecycline (TGC), did not have  any significant impact on survival. Conclusion: Patients with S. maltophilia bacteremia should first be assessed regarding clin ical significance. Clinical findings, the presence of multiple positive blood culture sets and  the primary sources of bacteremia are useful parameters while discriminating true from  false-positive bacteremia. Patients with advanced age and solid tumors should be followed  carefully in terms of mortality. Antimicrobial regimens, including SXT, FQs, or TGC, can be  preferred in patients with S. maltophilia bacteremia considering antimicrobial resistance  and adverse effects or toxicity.
AU  - Dizbay, Murat
AU  - AYSERT-YILDIZ, PINAR
AU  - Yildiz, Yesim
AU  - Habibi, Hamid
AU  - eser, sedanur
AU  - ozgen top, ozge
AU  - Ozger, H.Selcuk
DO  - 10.36519/idcm.2022.187
PY  - 2022
JO  - Infectious diseases and clinical microbiology (Online)
VL  - 4
IS  - 4
SN  - 2667-646X
SP  - 258
EP  - 267
DB  - TRDizin
UR  - http://search/yayin/detay/1171542
ER  -