Gezer Yakup, Tayşi Muhammet Rıdvan, Tarakçı Arzu, Gökçe Özlem, Danacı Gamze, Altunışık Toplu Sibel, Erdal Karakaş Ezgi, Alkan Sevil, Kuyugöz Gülbudak Sibel, Şahinoğlu Mustafa Serhat, Gürbüz Esra, Oğuz Ayarcı Ayşe, Bulut Rukiyye, Ural Onur
Infectious Diseases and Clinical Microbiology Clinic. Konya City Hospital, University of Health Sciences, Konya, Türkiye.
Infectious Diseases and Clinical Microbiology Clinic, Basaksehir Cam and Sakura City Hospital, İstanbul, Türkiye.
BMC Infect Dis. 2024 Dec 5;24(1):1387. doi: 10.1186/s12879-024-10293-4.
Stenotrophomonas maltophilia, a pathogen that colonizes medical equipment and causes nosocomial infections due to its ability to form biofilms, has high mortality rates. This study investigated the risk factors related to mortality in patients who were diagnosed with S. maltophilia bacteremia.
It is a multi-center, retrospective ad observational cohort study. The demographic characteristics, clinical findings, microbiological data, and risk factors for patients were obtained from the medical records of patients at ten different hospitals between January 1, 2018, and June 30, 2023.
The study included a total of 321 patients. The observed thirty-day mortality rate was 46.1%. A central venous catheter (CVC) was present in 276 patients (86%), and in 66 of these patients (23.9%) the CVC was removed. While only 18 patients (5.6%) received appropriate empirical antibiotics, 242 (75.4%) patients received appropriate antibiotics according to antimicrobial susceptibility test (AST) results and treatment revisions. Multivariate analysis revealed that advanced age (hazard ratio [HR] = 1.02; 95% confidence interval [CI]: 1.00- 1.03), appropriate antibiotic treatment (HR = 0.35; 95% CI: 0.23-0.52), and removal of central venous catheters (HR = 0.31; 95% CI: 0.16-0.60) were significantly related to reduced mortality.
S. maltophilia is a significant pathogen, and to reduce its high mortality rate, removal of the CVC and switching to appropriate antibiotics should be performed as soon as possible.
嗜麦芽窄食单胞菌是一种可在医疗设备上定殖并因其形成生物膜的能力而导致医院感染的病原体，死亡率很高。本研究调查了被诊断为嗜麦芽窄食单胞菌血症患者的死亡相关危险因素。
这是一项多中心、回顾性观察队列研究。从2018年1月1日至2023年6月30日期间十家不同医院的患者病历中获取患者的人口统计学特征、临床表现、微生物学数据和危险因素。
该研究共纳入321例患者。观察到的30天死亡率为46.1%。276例患者（86%）存在中心静脉导管（CVC），其中66例患者（23.9%）的CVC被拔除。虽然只有18例患者（5.6%）接受了适当的经验性抗生素治疗，但242例（75.4%）患者根据抗菌药敏试验（AST）结果和治疗调整接受了适当的抗生素治疗。多因素分析显示，高龄（风险比[HR]=1.02；95%置信区间[CI]：1.00-1.03）、适当的抗生素治疗（HR=0.35；95%CI：0.23-0.52）和拔除中心静脉导管（HR=0.31；95%CI：0.16-0.60）与死亡率降低显著相关。
嗜麦芽窄食单胞菌是一种重要的病原体，为降低其高死亡率，应尽快拔除CVC并改用适当的抗生素。
