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. 2019 Nov-Dec;24(6):510-516.
doi: 10.5863/1551-6776-24.6.510.

Evaluation of the Treatment of Stenotrophomonas maltophilia in Tracheostomy-Dependent Pediatric Patients

Emma M Tillman, Sarah E Firmani, Veda L Ackerman, James E Slaven, A Ioana Cristea

Evaluation of the Treatment of Stenotrophomonas maltophilia in Tracheostomy-Dependent Pediatric Patients

Emma M Tillman et al. J Pediatr Pharmacol Ther. 2019 Nov-Dec.

Abstract

Objective: Tracheostomy-dependent pediatric patients will often have respiratory cultures positive for Stenotrophomonas maltophilia (multidrug-resistant Gram-negative rod). There are limited data available to guide treatment in this population. The objective of this single-center, retrospective study was to evaluate if antibiotic treatment of S maltophilia improved clinical outcomes in tracheostomy-dependent pediatric patients.

Methods: We included tracheostomy-dependent pediatric patients who had a respiratory culture positive for S maltophilia. Patients were divided into 2 groups: 1) treatment and 2) no treatment.

Results: Forty patients with 55 encounters were included in this study. S maltophilia was treated with sulfamethoxazole-trimethoprim in 20 encounters (19 patients) and no antimicrobial treatment was given in 35 encounters (30 patients). The time to return to stable respiratory status was 5 days (0-10) (median [range]) in the treated group and 4 days (0-19) in the untreated group (p = 0.52). There was no statistically significant difference in time to baseline respiratory status between patients treated and those not treated for S maltophilia. There was no difference in hospital length of stay between patients who were or not treated.

Conclusions: Based on these results, these data would suggest that there might not be a benefit to treating cultures positive for S maltophilia in tracheostomy-dependent pediatric patients.

Keywords: Stenotrophomonas maltophilia; child; gram-negative bacterial infections; lung diseases; tracheostomy.

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Conflict of interest statement

Disclosure The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. The authors had full access to all the data and take responsibility for the integrity and accuracy of the data analysis.

Figures

Figure 1.
Figure 1.
Concentration of Stenotrophomonas maltophilia in respiratory cultures (p=0.45).
Figure 2.
Figure 2.
Treatment of patients with Stenotrophomonas maltophilia infections categorized by presence or absence of mechanical ventilation.
Figure 3.
Figure 3.
Time to return to baseline respiratory settings (p=0.87).
Figure 4.
Figure 4.
Length of hospital stay (p=0.42)
See this image and copyright information in PMC

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