Kanchanasuwan Siripen, Rongmuang Jakkapan, Siripaitoon Pisud, Kositpantawong Narongdet, Charoenmak Boonsri, Hortiwakul Thanaporn, Nwabor Ozioma Forstinus, Chusri Sarunyou
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
Natural Product Research Center of Excellence, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
J Clin Med. 2022 May 30;11(11):3085. doi: 10.3390/jcm11113085.
This study aimed to establish the clinical features, outcomes, and factors associated with mortality in patients with Stenotrophomonas maltophilia (S. maltophilia) septicemia. The characteristics and outcome data used in this retrospective study were collected from medical records at Songklanagarind Hospital. Risk factors for survival were analyzed using χ2-tests, Kaplan−Meier curves, and Cox regression. A total of 117 patients with S. maltophilia bacteremia were analyzed. The patients’ median age was 45 years, 77 (70%) were male, 105 (90%) had comorbidities, 112 (96%) had previously undergone carbapenem therapy, and over half of the patients were on invasive medical devices. Trimethoprim-sulfamethoxazole (TMP-SMX) and fluoroquinolone showed high susceptibility rates to S. maltophilia, with 93% and 88% susceptibility, respectively. Patients who received appropriate empirical antibiotic treatment had significantly reduced 14-day, 30-day, and in-hospital mortality rates than those who did not (p < 0.001). The days of hospital stay and costs for those who received appropriate and inappropriate empirical antimicrobial treatment were 21 and 34 days (p < 0.001) and 142,463 and 185,663 baht, respectively (p < 0.002). Our results suggest that an appropriate empirical antibiotic(s) is significantly associated with lower 30-day mortality in hospitalized patients with S. maltophilia septicemia.
本研究旨在确定嗜麦芽窄食单胞菌败血症患者的临床特征、预后及与死亡率相关的因素。本回顾性研究中使用的特征和预后数据来自宋卡纳卡林医院的病历。使用χ2检验、Kaplan-Meier曲线和Cox回归分析生存的危险因素。共分析了117例嗜麦芽窄食单胞菌菌血症患者。患者的中位年龄为45岁，77例（70%）为男性，105例（90%）有合并症，112例（96%）曾接受碳青霉烯治疗，超过一半的患者使用侵入性医疗设备。甲氧苄啶-磺胺甲恶唑（TMP-SMX）和氟喹诺酮对嗜麦芽窄食单胞菌显示出较高的敏感率，分别为93%和88%。接受适当经验性抗生素治疗的患者14天、30天和住院死亡率明显低于未接受治疗的患者（p<0.001）。接受适当和不适当经验性抗菌治疗的患者的住院天数和费用分别为21天和34天（p<0.001），以及142,463泰铢和185,663泰铢（p<0.002）。我们的结果表明，适当的经验性抗生素与嗜麦芽窄食单胞菌败血症住院患者较低的30天死亡率显著相关。
