Bacteremia Due to Stenotrophomonas (Xanthomonas) maltophilia: A Prospective, Multicenter Study of 91 Episodes

Authors:
  • AHAnn P. Harris
    Ann P. Harris
  • SMSharon Muller
    Sharon Muller
  • JCJoseph W. Chow
    Joseph W. Chow
  • KPKonstantinos Papadakis
    Konstantinos Papadakis
  • MWMarilyn W. Wagener
    Marilyn W. Wagener
  • GBGerald P. Bodey
    Gerald P. Bodey
  • JSJames M. Steckelberg
    James M. Steckelberg
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Abstract
We identified 91 cases of bacteremia due to Stenotrophomonas (Xanthomonas) maltophilia in a prospective, multicenter observational study. The patients were highly compromised; the majority had an underlying malignancy, had received immunosuppressive therapy, and had indwelling venous catheters. Although 94% of patients received an antimicrobial agent to which the blood isolate was susceptible, the mortality among these patients 14 days after the onset of bacteremia was 21%. Mortality was significantly correlated with the presence of a hematologic malignancy or neutropenia or transplantation, immunosuppressive therapy, and a severity-of-illness score of >4. S. maltophilia infection is associated with substantial morbidity and mortality among highly compromised patients. The organism is typically resistant to expanded spectrum β-lactam agents and aminoglycoside antibiotics. Trimethoprim-sulfamethoxazole should be administered if the isolate is susceptible to this combination; addition of another agent to which the isolate is susceptible should be considered in treating patients who are neutropenic, immunocompromised, or critically ill.