Risk factors for mortality in intensive care unit patients with Stenotrophomonas maltophilia pneumonia in South Korea
Authors:
- Yong Hoon LeeYLYong Hoon Lee
- Jaehee LeeJLJaehee Lee
- Byunghyuk YuBYByunghyuk Yu
- Won Kee LeeWLWon Kee Lee
- Sun Ha ChoiSCSun Ha Choi
- Ji Eun ParkJPJi Eun Park
- Hyewon SeoHSHyewon Seo
- Seung Soo YooSYSeung Soo Yoo
- Shin Yup LeeSLShin Yup Lee
- Seung-Ick ChaSCSeung-Ick Cha
- Chang Ho KimCKChang Ho Kim
- Jae Yong ParkJPJae Yong Park
Open Access
- 30 November 2023
- journal article
- research article
- Published by The Korean Society of Critical Care Medicine in Acute and Critical Care
- Vol. 38 (4) , 442-451
Abstract
Background: Stenotrophomonas maltophilia has been increasingly recognized as an opportunistic pathogen associated with high morbidity and mortality. Data on the prognostic factors associated with S. maltophilia pneumonia in patients admitted to intensive care unit (ICU) are lacking.Methods: We conducted a retrospective analysis of data from 117 patients with S. maltophilia pneumonia admitted to the ICUs of two tertiary referral hospitals in South Korea between January 2011 and December 2022. To assess risk factors associated with in-hospital mortality, multivariable logistic regression analyses were performed.Results: The median age of the study population was 71 years. Ventilator-associated pneumonia was 76.1% of cases, and the median length of ICU stay before the first isolation of S. maltophilia was 15 days. The overall in-hospital mortality rate was 82.1%, and factors independently associated with mortality were age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.00–1.09; P=0.046), Sequential Organ Failure Assessment (SOFA) score (OR, 1.21; 95%; CI, 1.02–1.43; P=0.025), corticosteroid use (OR, 4.19; 95% CI, 1.26–13.91; P=0.019), and polymicrobial infection (OR, 95% CI 0.07–0.69). However, the impact of appropriate antibiotic therapy on mortality was insignificant. In a subgroup of patients who received appropriate antibiotic therapy (n=58), antibiotic treatment modality-related variables, including combination or empirical therapy, also showed no significant association with survival.Conclusions: Patients with S. maltophilia pneumonia in ICU have high mortality rates. Older age, higher SOFA score, and corticosteroid use were independently associated with increased in-hospital mortality, whereas polymicrobial infection was associated with lower mortality. The effect of appropriate antibiotic therapy on prognosis was insignificant.Keywords
This publication has 23 references indexed in Scilit:
- Corticosteroid treatment in critically ill patients with severe influenza pneumonia: a propensity score matching studyIntensive Care Medicine, 2018
- Frequency and antimicrobial susceptibility of Gram-negative bacteria isolated from patients with pneumonia hospitalized in ICUs of US medical centres (2015–17)Journal of Antimicrobial Chemotherapy, 2018
- 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised HostClinical Infectious Diseases, 2013
- Ventilator Associated Pneumonia: Evolving Definitions and Preventive StrategiesRespiratory Care, 2013
- Stenotrophomonas maltophilia in the respiratory tract of medical intensive care unit patientsEuropean Journal of Clinical Microbiology & Infectious Diseases, 2011
- Stenotrophomonas maltophilia: an emerging opportunist human pathogenThe Lancet Infectious Diseases, 2009
- Intensive care unit-acquired Stenotrophomonas maltophilia: incidence, risk factors, and outcomeCritical Care, 2006
- Significance of positiveStenotrophomonas maltophiliaculture in acute respiratory tract infectionEuropean Respiratory Journal, 2005
- The indirect pathogenicity of Stenotrophomonas maltophiliaInternational Journal of Antimicrobial Agents, 2003
- Risk Factors for Late‐Onset Nosocomial Pneumonia Caused byStenotrophomonas maltophiliain Critically Ill Trauma PatientsClinical Infectious Diseases, 2002