Stenotrophomonas maltophilia (SM) has emerged as an important nosocomial pathogen with high morbidity and mortality. Because of its unique antimicrobial susceptibility pattern, appropriate antimicrobial
therapy for SM
bacteremia is still challenging, especially in immunocompromised patients. The present study was performed to assess clinical predictors of SM
bacteremia in adult patients with
hematologic malignancy. From 2006 through 2016, a case-control study was performed at a tertiary-care hospital. Case patients were defined as SM
bacteremia in patients with
hematologic malignancy. Date- and location-matched controls were selected from among patients with gram-negative
bacteremia (GNB) other than SM. A total of 118 cases of SM
bacteremia were identified and compared to 118 controls. While
pneumonia was the most common source of SM
bacteremia, centralline-associated
infection was most common in the controls. The overall 30-day mortality rate of cases with SM
bacteremia was significantly higher than that of the controls (61.0 and 32.2%, respectively; P < 0.001). A multivariable analysis showed that
polymicrobial infection, previous SM isolation, the number of
antibiotics previously used ≥ 3, and breakthrough
bacteremia during
carbapenem therapy were significantly associated with SM
bacteremia (all P < 0.01). Previous use of
trimethoprim/sulfamethoxazole (
TMP/SMX) was negatively association with SM
bacteremia (P = 0.002). Our data suggest that SM is becoming a significant pathogen in patients with
hematologic malignancy. Several clinical predictors of SM
bacteremia can be used for appropriate antimicrobial
therapy in hematologic patients with suspected GNB.