Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates
Background: Stenotrophomonas maltophilia is a cause of infection most commonly in the opportunistic host. Trimethoprim-sulfamethoxazole and levofloxacin are considered first-line treatment agents. With reports of increasing resistance to these first-line agents, it is important to determine risk fac...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-03-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716522000352 |
| _version_ | 1818774231335305216 |
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| author | Bruce M. Jones Jamie L. Wagner Daniel B. Chastain P. Brandon Bookstaver Kayla Stover Jason Lin Hannah Matson Noah White Madalyn Motesh Christopher M. Bland |
| author_facet | Bruce M. Jones Jamie L. Wagner Daniel B. Chastain P. Brandon Bookstaver Kayla Stover Jason Lin Hannah Matson Noah White Madalyn Motesh Christopher M. Bland |
| author_sort | Bruce M. Jones |
| collection | DOAJ |
| description | Background: Stenotrophomonas maltophilia is a cause of infection most commonly in the opportunistic host. Trimethoprim-sulfamethoxazole and levofloxacin are considered first-line treatment agents. With reports of increasing resistance to these first-line agents, it is important to determine risk factors associated with a non-susceptible isolate. Methods: This was a real-world, multicentre, retrospective case-control study from five centres in the southeast United States evaluating S. maltophilia. The primary outcome was risk factors associated with non-susceptibility of S. maltophilia isolates to ≥1 antimicrobial agents. Secondary outcomes include incidence of S. maltophilia non-susceptibility, all-cause mortality, and 30-day readmission rates. Results: There were 325 patients included in the study. For the primary outcome, the only factor associated with non-susceptibility per univariate analysis was isolation from urine culture (13.3% vs. 5.4%; P = 0.014), whereas the presence of mechanical ventilation (37.7% vs. 21.5%) and intensive care unit admission (35.3% vs. 18.4%) were associated with susceptibility (P < 0.001). For the secondary outcomes, non-susceptibility was present in 49% of isolates with 43 of 325 (13.2%), 53 of 324 (16.4%), and 105 of 172 (61%) to TMP-SMX, levofloxacin, and ceftazidime, respectively. Resistance to chloramphenicol and tigecycline was observed among 5/26 and 11/16 of tested isolates, respectively. Sixty-six patients (20%) experienced all-cause, inpatient mortality (18% susceptible vs. 23% non-susceptible; P = 0.280) and 44 patients (17%) were readmitted within 30 days of discharge (16% susceptible vs. 18% non-susceptible; P = 0.673). Conclusion: S. maltophilia non-susceptibility had a prevalence of ∼50% to at least one first-line or commonly used agent. More research is needed to delineate risk factors for non-susceptible isolates. |
| first_indexed | 2024-12-18T10:37:51Z |
| format | Article |
| id | doaj.art-7d7e7e2a17294ec3896145f2f01eea37 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-12-18T10:37:51Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-7d7e7e2a17294ec3896145f2f01eea372022-12-21T21:10:42ZengElsevierJournal of Global Antimicrobial Resistance2213-71652022-03-0128282287Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolatesBruce M. Jones0Jamie L. Wagner1Daniel B. Chastain2P. Brandon Bookstaver3Kayla Stover4Jason Lin5Hannah Matson6Noah White7Madalyn Motesh8Christopher M. Bland9St. Joseph's/Candler Health System, Inc., 5353 Reynolds Street, Savannah, GA 31405; Corresponding author.University of Mississippi School of Pharmacy, Jackson, MississippiUniversity of Georgia College of Pharmacy Albany, GeorgiaUniversity of South Carolina College of Pharmacy, Columbia, South CarolinaUniversity of Mississippi School of Pharmacy, Jackson, MississippiMemorial University Medical Center, Savannah, GeorgiaHuntsville Hospital, Huntsville, AlabamaMunster Community Hospital, Munster, IndianaNortheast Georgia Health System, Gainesville, GAUniversity of Georgia College of Pharmacy, Savannah, GeorgiaBackground: Stenotrophomonas maltophilia is a cause of infection most commonly in the opportunistic host. Trimethoprim-sulfamethoxazole and levofloxacin are considered first-line treatment agents. With reports of increasing resistance to these first-line agents, it is important to determine risk factors associated with a non-susceptible isolate. Methods: This was a real-world, multicentre, retrospective case-control study from five centres in the southeast United States evaluating S. maltophilia. The primary outcome was risk factors associated with non-susceptibility of S. maltophilia isolates to ≥1 antimicrobial agents. Secondary outcomes include incidence of S. maltophilia non-susceptibility, all-cause mortality, and 30-day readmission rates. Results: There were 325 patients included in the study. For the primary outcome, the only factor associated with non-susceptibility per univariate analysis was isolation from urine culture (13.3% vs. 5.4%; P = 0.014), whereas the presence of mechanical ventilation (37.7% vs. 21.5%) and intensive care unit admission (35.3% vs. 18.4%) were associated with susceptibility (P < 0.001). For the secondary outcomes, non-susceptibility was present in 49% of isolates with 43 of 325 (13.2%), 53 of 324 (16.4%), and 105 of 172 (61%) to TMP-SMX, levofloxacin, and ceftazidime, respectively. Resistance to chloramphenicol and tigecycline was observed among 5/26 and 11/16 of tested isolates, respectively. Sixty-six patients (20%) experienced all-cause, inpatient mortality (18% susceptible vs. 23% non-susceptible; P = 0.280) and 44 patients (17%) were readmitted within 30 days of discharge (16% susceptible vs. 18% non-susceptible; P = 0.673). Conclusion: S. maltophilia non-susceptibility had a prevalence of ∼50% to at least one first-line or commonly used agent. More research is needed to delineate risk factors for non-susceptible isolates.http://www.sciencedirect.com/science/article/pii/S2213716522000352Stenotrophomonas maltophiliaResistanceNon-susceptibleTrimethoprim-sulfamethoxazoleLevofloxacin |
| spellingShingle | Bruce M. Jones Jamie L. Wagner Daniel B. Chastain P. Brandon Bookstaver Kayla Stover Jason Lin Hannah Matson Noah White Madalyn Motesh Christopher M. Bland Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates Journal of Global Antimicrobial Resistance Stenotrophomonas maltophilia Resistance Non-susceptible Trimethoprim-sulfamethoxazole Levofloxacin |
| title | Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates |
| title_full | Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates |
| title_fullStr | Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates |
| title_full_unstemmed | Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates |
| title_short | Real-world, multicentre evaluation of the incidence and risk factors for non-susceptible Stenotrophomonas maltophilia isolates |
| title_sort | real world multicentre evaluation of the incidence and risk factors for non susceptible stenotrophomonas maltophilia isolates |
| topic | Stenotrophomonas maltophilia Resistance Non-susceptible Trimethoprim-sulfamethoxazole Levofloxacin |
| url | http://www.sciencedirect.com/science/article/pii/S2213716522000352 |
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