Stenotrophomonas maltophilia [Neurosurgery Wiki]

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====== Stenotrophomonas maltophilia ======

Stenotrophomonas maltophilia is an [[aerobic]], nonfermentative, [[Gram negative bacteria]].

Initially classified as Bacterium bookeri, then renamed Pseudomonas maltophilia, S. maltophilia was also grouped in the genus Xanthomonas before eventually becoming the type species of the genus Stenotrophomonas in 1993.

===== Epidemiology =====

It is an uncommon bacterium 

===== Stenotrophomonas maltophilia meningitis =====

[[Stenotrophomonas maltophilia meningitis]].

===== Brain abscess =====

[[Stenotrophomonas maltophilia brain abscess]].

===== Pituitary Abscess =====

A 30-year-old woman experienced nasal stuffiness followed by a progressive headache and reduced visual acuity for 3 weeks. She underwent an endoscopic endonasal transsphenoidal approach for pituitary spindle cell oncocytoma 13 months before the present admission. Magnetic resonance imaging revealed an intrasellar cystic lesion with a suprasellar extension. After endoscopic endonasal transsphenoidal approach for tumor removal, the histologic findings of inflammatory infiltration showed a pituitary abscess. Microscopy revealed mites and fungal hyphae. Cultures from the abscess showed Staphylococcus hyicus, Stenotrophomonas maltophilia, and Aspergillus sp. The patient received a 6-week antibiotic treatment, which completely resolved the clinical symptoms and cleared the magnetic resonance imaging findings.
((Yang YC, Liao WC. Secondary Pituitary Abscess from Mite. World Neurosurg.
2021 Jul;151:21-22. doi: 10.1016/j.wneu.2021.03.158. Epub 2021 Apr 8. PMID:
33839335.)).

===== Treatment =====

[[Stenotrophomonas maltophilia treatment]].

===== Outcome =====

Chen et al. collected data on [[ventilator-associated pneumonia]] (VAP) and [[hospital-acquired pneumonia]] (HAP) induced by [[Stenotrophomonas maltophilia]] (SM) and [[Klebsiella pneumoniae]] (KP) and compared differences between two [[bacteria]] in [[mortality]], duration of [[ventilator]] use, [[length of stay]], and risk factors for [[infection]].

This study aimed to evaluate the [[prognosis]] and to find [[risk factor]]s of SM-HAP/VAP versus KP-HAP/VAP in the [[intensive care unit]] (ICU).

This [[retrospective]] [[cohort]] [[study]] included patients admitted to the ICU between June 2019 and June 2021 and diagnosed with SM-HAP/VAP or KP-HAP/VAP. The [[primary outcome]] was 28-day mortality.

Ninety-two HAP/VAP patients (48 with SM-HAP/VAP and 44 with KP-HAP/VAP) were included. The 28-day mortality was 16.7% (8/48 patients) in SM-HAP/VAP and 15.9% (7/44 patients) in KP-HAP/VAP (P = 0.922). After adjustment for potential [[confounder]]s, the hazard ratios for 28-day mortality in SM-HAP/VAP were 1.3 (95% CI:0.5-3.7), 1.0 (95% CI:0.4-3.0), 1.4 (95% CI:0.5-4.0), and 1.1 (95% CI:0.4-3.4), respectively.

SM-HAP/VAP and KP-HAP/VAP patients in [[ICU]] might have a similar prognosis in [[mortality]], the total duration of the [[artificial airway]] and ventilator use, the total length of ICU [[stay]], and [[hospital stay]]. The risk factors of SM-HAP/VAP versus KP-HAP/VAP might be the [[artificial airway]], [[ventilator]] use, [[gastric tube]] placement, [[acid suppressant]] and [[antibiotic]]s (especially [[carbapenem]])
((Chen S, Zou D. Prognosis of hospital-acquired pneumonia/ventilator-associated pneumonia with Stenotrophomonas maltophilia versus Klebsiella pneumoniae in intensive care unit: A retrospective cohort study. Clin Respir J. 2022 Aug 31. doi: 10.1111/crj.13537. Epub ahead of print. PMID: 36045483.)).