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
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. 1).
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 factors 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 confounders, 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 antibiotics (especially carbapenem) 2).