Stenotrophomonas isolates in a tertiary care centre in South India
Amita Jacob, Ramya Iyadurai, J.V. Punitha, Binila Chacko, Sudha Jasmine, Muruga Bharathy, Divya Mathew, Balaji Veeraraghavan
Abstract
PURPOSE: Stenotrophomonas maltophilia is an emerging multi-drug resistant pathogen increasingly isolated in India. This study aimed to identify patients from whom Stenotrophomonas maltophilia had been isolated and assess predictors of mortality in this population. METHODS: This was a retrospective cohort study of hospitalized patients with a positive culture for S. maltophilia over a 3-year period. Clinical details and laboratory results were assessed from hospital records. Bivariate and multivariate analysis was used to identify risk factors for mortality. RESULTS: (P/F) ratio, vasopressor use, thrombocytopenia, and hypoalbuminemia at the time of positive isolate. Multivariate analysis showed that autoimmune disease [OR 27.38; 95% CI (1.39-540)], a P/F ratio of less than 300 [OR 7.58; 95% CI (1.52-37.9)], vasopressor requirement [OR 39.50; 95% CI (5.49-284)] and thrombocytopenia [OR 11.5; 95% CI (2.04-65.0)] were statistically significantly associated with increased mortality, while recent surgery and receipt of antibiotics [OR 0.16; 95% CI (0.03-0.8)] targeted against S. maltophilia were associated with decreased mortality. CONCLUSION: Stenotrophomonas maltophilia is primarily isolated in patients in the intensive care unit. In our study the need for vasopressors, autoimmune disease, lower P/F ratios and thrombocytopenia were associated with higher mortality. The association of targeted antibiotics with reduced mortality suggests that the pathogenic role of S. maltophilia should not be underestimated. This finding needs to be confirmed with larger, prospective studies.