Risk factors for mortality in Stenotrophomonas maltophilia bacteremia – a meta-analysis

Abstract

Background

Stenotrophomonas maltophilia (S. maltophilia) is a nosocomial pathogen causing life-threatening invasive infections with a high mortality rate in some patient populations, especially those who are severely ill or immunocompromised. There is a need for data on mortality in patients with S. maltophilia bacteremia.

Objective

In this meta-analysis, we aimed to investigate risk factors for mortality in S. maltophilia bacteremia.

Methods

Studies comparing patients who died from S. maltophilia bacteremia with patients who survived were considered for inclusion. Studies were included if they reported one or more risk factors for mortality. Mortality risk factors included clinical predisposing factors, predisposing comorbidities and appropriateness of antibiotic therapy.

Results

Nineteen studies with 1248 patients were included in the meta-analysis. Five hundred and six (40.5%) patients died. The following risk factors for mortality were identified: ICU admission, septic shock, need for mechanical ventilation, indwelling central venous catheter, neutropenia, comorbid hematological malignancies, chronic kidney disease, inappropriate antimicrobial therapy and prior antibiotic use.

Conclusions

Appropriate antimicrobial therapy had a protective effect against mortality in S. maltophilia bacteremia. Indwelling central venous catheter, neutropenia, hematological malignancies and chronic kidney disease were also risk factors for mortality.

Keywords:

• Stenotrophomonas maltophilia
• bacteremia
• mortality
• inappropriate antimicrobial therapy

Acknowledgements

The meta-analysis was registered at the Prospero international prospective register of systematic reviews (registration: CRD42023447938).

Author contributions

Chienhsiu Huang: conceptualization, investigation, methodology, validation, visualization, writing-original draft, supervision, writing-review and editing. Sufang Kuo: formal analysis, project administration and data curation. Lichen Lin: data curation, resources and methodology.

Ethical approval

This is an article of meta-analysis and no need to apply for IRB.

Consent form

Not applicable.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

Additional information

Funding

There was no funding for this study.