Infections With Stenotrophomonas maltophilia in Children Undergoing Anticancer Therapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study. Issue 10 (8th July 2022)

• Record Type: Journal Article
• Authors: Richert-Przygonska, Monika; Czyzewski, Krzysztof; Dziedzic, Magdalena; Zalas-Wiecek, Patrycja; Gryniewicz-Kwiatkowska, Olga; Gietka, Agnieszka; Malas, Zofia; Semczuk, Katarzyna; Chelmecka, Liliana; Zak, Iwona; Salamonowicz-Bodzioch, Malgorzata; Fraczkiewicz, Jowita; Zajac-Spychala, Olga; Bien, Ewa; Irga-Jaworska, Ninela; Plonowski, Marcin; Wawrykow, Pawel; Bartnik, Magdalena; Pierlejewski, Filip; Gamrot, Zuzanna; Badowska, Wanda; Stolpa, Weronika; Musial, Jakub; Szmydki-Baran, Anna; Hutnik, Lukasz; Tomaszewska, Renata; Urbanek-Dadela, Agnieszka; Zaucha-Prazmo, Agnieszka; Gozdzik, Jolanta; Styczynski, Jan
• Is Part Of: Pediatric infectious disease journal. Volume 41:Issue 10(2022)
• Page Start: 846
• Page End: 850
• Publication Date: 2022-07-08
• Subjects: acute leukemia -- children -- hematopoietic cell transplantation -- Stenotrophomonas maltophilia; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000003633
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Background: Infections caused by Stenotrophomonas maltophilia (SM) have documented high mortality rate in immunocompromised patients. Aim: This nationwide multicenter study was performed to analyze the epidemiology of SM infections in children undergoing anticancer therapy (pediatric hematology and oncology [PHO]) or hematopoietic cell transplantation (HCT) over 2012–2019, including incidence and outcome of SM infections, as well as treatment regimens and multidrug resistance. Methods: Cumulative incidence of SM infections was calculated using the competing risk analysis from the day of diagnosis (PHO setting) or from the day of transplantation (HCT setting). The Kaplan-Meier method was used to determine survival from infection. Results: During the study period of 8 years, a total number of 1356 HCTs and 7337 children newly diagnosed for malignancy were analyzed. Diagnosis of acute leukemia was a predisposing factor for SM infection. The cumulative incidence of SM infections was comparable in HCT patients in comparison to PHO (0.81% vs. 0.76%). High rate of trimethoprim/sulfamethoxazole susceptibility among SM isolates was observed in both groups of patients (80.8%). Although this was the drug of choice, survival rates from SM infections were significantly lower in HCT than in PHO (45% vs. 85%, P = 0.001, log-rank test). We found the transplant procedure and lack of clinical resolution after 18 days of antibiotic therapy to be independent mortality risk factors. Conclusions: The risk of SM infections and the occurrence of resistant bacterial strains in allo-HCT patients were comparable to PHO patients. Irrespective of target antibiotic therapy, the outcome of SM infections was better in the PHO setting.