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Volume 47, Number 1, February 2014

Stenotrophomonas maltophilia bloodstream infection: Comparison between community-onset and hospital-acquired infections 


Ya-Ting Chang, Chun-Yu Lin, Po-Liang Lu, Chung-Chih Lai, Tun-Chieh Chen, Chi-Yu Chen, Deng-Chyang Wu, Tzu-Pin Wang, Chiu-Mei Lin, Wei-Ru Lin, Yen-Hsu Chen


Received: April 30, 2012    Revised: July 13, 2012    Accepted: August 14, 2012   

 

Background and purpose: 

Stenotrophomonas maltophilia has been recognized as an important nosocomial pathogen, but few reports have discussed S. maltophilia infection in the community settings. This study aimed to reveal characteristics of patients with community-onset S. maltophilia bloodstream infection (SMBSI), to specify the subgroup of healthcare-associated (HCA) infection in the community-onset group and to compare them with hospital-acquired (HA) SMBSI patients.
 



 

Methods:

Medical charts of adult patients with SMBSI presenting to a medical center in southern Taiwan from May 2008 to October 2011 were reviewed and analyzed retrospectively. 



 

Results:

Among 153 patients, we observed a high percentage (38.6%) of SMBSI to be community onset. Among community-onset SMBSI, 45.8% were community-acquired (CA) and 54.2% were HCA. The crude mortality rates were 11.1%, 18.8%, and 60.6% in the CA, HCA, and HA groups, respectively. Structural/mechanical abnormalities were observed in 32.7% of all cases, and 60% of those were related to malignancy. Independent risk factors for mortality in community-onset SMBSI were liver cirrhosis, liver metastasis, and a high Pitt bacteremia score, whereas structural/mechanical abnormalities and a high Pitt bacteremia score related to increased mortality in HA SMBSI. 



 

Conclusion:

Community-onset S. maltophilia infection deserves attention. Patients with community-onset SMBSI have reduced disease severity and lower mortality rate when compared to HA SMBSI. Underlying structural/mechanical abnormalities, especially those caused by malignancies, are common in SMBSI cases and should be investigated when bacteremia occurs. 



 

Key words:

Bacteremia, Bloodstream infection, Community, Healthcare, Mortality, Stenotrophomonas maltophilia