Clinical presentation and outcomes in non-maltophilia Stenotrophomonas spp. bloodstream infections
Abstract
Stenotrophomonas maltophilia complex is an important nosocomial cause of bacteraemia. The complex comprises multiple species, but their relative clinical and genomic significance remains unclear. We examined clinical and genomic differences between S. maltophilia and non-S. maltophilia species to better understand their virulence and implications for patient care. Hospitalized adult patients (≥ 21 years) between January 2022 and June 2024 with Stenotrophomonas species bacteraemia were examined. Clinical data were extracted from electronic medical records. Whole-genome sequencing was performed on all isolates, with species assignment confirmed by average nucleotide identity. S. maltophilia and non-S. maltophilia species were compared. Fifty-three S. maltophilia complex isolates were identified, of which 45 had clinical data. S. maltophilia predominated (n = 32), followed by S. pavanii (n = 7), S. sepilia (n = 4), S. muris (n = 1), and S. geniculata (n = 1). S. maltophilia isolates formed multiple clades with diverse sequence types, consistent with both clonal expansion and ongoing diversification. Virulence genes, including stmPr, smoR, and iron acquisition-associated genes were conserved across S. maltophilia lineages, but stmPr1 was less frequently observed in non-S. maltophilia. Most infections were line-related. Pneumonia-associated bacteraemia appeared more frequently among with S. maltophilia infections. Polymicrobial bacteraemia appeared more commonly in non-S.…
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