Ventilator-Associated Pneumonia Caused by Stenotrophomonas maltophilia in ICU Patients: Clinical Characteristics, Antimicrobial Therapy, and Outcomes from a Multicenter Cohort
Abstract
Background: Ventilator-associated pneumonia (VAP) is a common nosocomial infection in intensive care units, associated with high morbidity and mortality. Stenotrophomonas maltophilia has emerged as an opportunistic pathogen in critically ill patients, particularly following prolonged mechanical ventilation and prior antibiotic exposure. Methods: We conducted a retrospective multicenter study over a 4-year period in three intensive care units in France. Adult patients with VAP caused by S. maltophilia were included. Clinical, microbiological, and therapeutic data were collected. The primary outcome was 28-day mortality. Results: Among 293 VAP episodes caused by non-fermenting Gram-negative bacilli, 28 (9.55%) were due to S. maltophilia. Patients were elderly, highly comorbid, and severely ill, with a high rate of septic shock (71.1%). Polymicrobial infections were frequent (75%), mainly involving Enterobacterales. Empirical antibiotic therapy was active in only 14.3% of cases. Targeted therapy mainly relied on trimethoprim–sulfamethoxazole or levofloxacin. The 28-day mortality rate was 60.7%, with early deaths observed after diagnosis. Conclusion: S. maltophilia VAP occurs in high-risk ICU patients and is associated with frequent polymicrobial infections, inadequate empirical therapy, and high mortality, highlighting the need for improved management strategies.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Quality evaluation and in vitro interaction studies between levofloxacin 250mg and diclofenac sodium 50mg tablets
- Molecular Epidemiology of mcr-1 -Positive Polymyxin B-Resistant Escherichia coli Producing Extended-Spectrum β-Lactamase (ESBL) in a Tertiary Hospital in Shandong, China
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.