1. Infections With Stenotrophomonas maltophilia in Children Undergoing Anticancer Therapy or Hematopoietic Cell Transplantation: A Multicenter Nationwide Study.
- Author
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Richert-Przygonska M, Czyzewski K, Dziedzic M, Zalas-Wiecek P, Gryniewicz-Kwiatkowska O, Gietka A, Malas Z, Semczuk K, Chelmecka L, Zak I, Salamonowicz-Bodzioch M, Fraczkiewicz J, Zajac-Spychala O, Bien E, Irga-Jaworska N, Plonowski M, Wawrykow P, Bartnik M, Pierlejewski F, Gamrot Z, Badowska W, Stolpa W, Musial J, Szmydki-Baran A, Hutnik L, Tomaszewska R, Urbanek-Dadela A, Zaucha-Prazmo A, Gozdzik J, and Styczynski J
- Subjects
- Anti-Bacterial Agents therapeutic use, Child, Humans, Retrospective Studies, Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use, Gram-Negative Bacterial Infections diagnosis, Gram-Negative Bacterial Infections drug therapy, Gram-Negative Bacterial Infections epidemiology, Hematopoietic Stem Cell Transplantation adverse effects, Stenotrophomonas maltophilia
- 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., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2022
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