BACTEREMIA DUE TO STENOTROPHOMONAS (XANTHOMONAS) MALTOPHILIA - A PROSPECTIVE, MULTICENTER STUDY OF 91 EPISODES

We identified 91 cases of bacteremia due to Stenotrophomonas (Xanthomo nas) maltophilia in a prospective, multicenter observational study, Th e patients were highly compromised; the majority had an underlying mal ignancy, had received immunosuppressive therapy, and had indwelling ve nous catheters. Although 94% of patients received an antimicrobial age nt to which the blood isolate was susceptible, the mortality among the se patients 14 days after the onset of bacteremia was 21%. Mortality w as significantly correlated with the presence of a hematologic maligna ncy or neutropenia or transplantation, immunosuppressive therapy, and a severity-of-illness score of >4. S. maltophilia infection is associa ted with substantial morbidity and mortality among highly compromised patients. The organism is typically resistant to expanded spectrum bet a-lactam agents and aminoglycoside antibiotics. Trimethoprim-sulfameth oxazole should be administered if the isolate is susceptible to this c ombination; addition of another agent to which the isolate is suscepti ble should be considered in treating patients who are neutropenic, imm unocompromised, or critically ill.