Characteristics of Stenotrophomonas maltophilia infection in children in Sichuan, China, from 2010 to 2017

Medicine (Baltimore). 2020 Feb;99(8):e19250. doi: 10.1097/MD.0000000000019250.

Abstract

Stenotrophomonas maltophilia (S. maltophilia) is an important nosocomial bacterial pathogen. However, the clinical features of children with S. maltophilia infection, the predisposing factors, and the antibiotic susceptibility of the bacteria have not been fully evaluated.In this study, the data of children with S. maltophilia infection from the West China Second University Hospital of Sichuan University (Chengdu, China) between July 2010 and October 2017 were collected and analyzed. The clinical features of enrolled children, the predisposing factors, and the antibiotic susceptibility were reported.In total, infection of S. maltophilia was identified in 128 patients. Most of these patients were under 1 year old (67.2%) and were mainly diagnosed as pneumonia (69%). A large proportion had underlying diseases (45.3%), received immunosuppressive therapy (53.1%), had undergone invasive operations (41.4%), had a history of carbapenem antibiotics use within 7 days before culture acquisition (54.7%), history of intensive care unit (ICU) hospitalization within previous 30 days (34.4%), and other risk factors. In particular, invasive operation (95% confidence interval [CI]: 1.125-14.324, P = .032), especially mechanical ventilation (95% CI: 1.277-20.469, P = .021), and ICU admission (95% CI: 1.743-22.956, P = .005) were independent risk factors for the children to develop severe S. maltophilia infection. As for antibiotic susceptibility, trimethoprim sulfamethoxazole (TMP-SMX), piperacillin tazobactam, ticarcillin clavulanate, and ceftazidime exhibited strong antibacterial activities against S. maltophilia, the susceptibility rates were 97.5%, 86.7%, 92.9%, and 81.5%, respectively.We report the clinical features of children with S. maltophilia infection, the predisposing factors and the antibiotic susceptibility. TMP-SMX can continue to be the first choice for the treatment of S. maltophilia infection. Piperacillin tazobactam, ticarcillin clavulanate, and the third generation cephalosporins can be used as alternative drugs.

MeSH terms

  • Age Distribution
  • Anti-Bacterial Agents / therapeutic use
  • Carbapenems / therapeutic use
  • Ceftazidime / therapeutic use
  • Child, Preschool
  • China / epidemiology
  • Clavulanic Acids / therapeutic use
  • Comorbidity
  • Female
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / epidemiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Intensive Care Units, Pediatric
  • Length of Stay / statistics & numerical data
  • Male
  • Piperacillin, Tazobactam Drug Combination / therapeutic use
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Stenotrophomonas maltophilia*
  • Surgical Procedures, Operative / statistics & numerical data
  • Ticarcillin / therapeutic use
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Clavulanic Acids
  • Immunosuppressive Agents
  • Piperacillin, Tazobactam Drug Combination
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • ticarcillin-clavulanic acid
  • Ceftazidime
  • Ticarcillin