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. 2023 Feb 28;13(1):3392.
doi: 10.1038/s41598-023-28438-x.

Stenotrophomonas maltophilia pneumonia in critical COVID-19 patients

Marc Raad  1 , Marc Abou Haidar  2 , Racha Ibrahim  3 , Rouba Rahal  1 , Jocelyne Abou Jaoude  1 , Carine Harmouche  1 , Bassem Habr  1 , Eliane Ayoub  2 , Gebrayel Saliba  3 , Ghassan Sleilaty  4 , Karam Mounzer  5 , Rindala Saliba  6 , Moussa Riachy  7
Affiliations

Stenotrophomonas maltophilia pneumonia in critical COVID-19 patients

Marc Raad et al. Sci Rep. .

Abstract

Stenotrophomonas maltophilia, an environmental aerobic non-fermentative Gram-negative bacilli, has gained attention in many nosocomial outbreaks. COVID-19 patients in intensive care unit have extended hospital stay and are severely immunosuppressed. This study aimed to determine the prevalence and risk factors of S. maltophilia pneumonia in critical COVID-19 patients. A total of 123 COVID-19 patients in ICU admitted between March 2020 and March 2021 were identified from the authors' institutional database and assessed for nosocomial pneumonia. Demographic data and factors predisposing to S. maltophilia pneumonia were collected and analyzed. The mean age was 66 ± 13 years and 74% were males. Median APACHE and SOFA scores were 13 (IQR = 8-19) and 4 (3-6), respectively. The Median NEWS2 score was 6 (Q1 = 5; Q3 = 8). The Median ICU stay was 12 (Q1 = 7; Q3 = 22) days. S. maltophilia was found in 16.3% of pneumonia patients, leading to a lengthier hospital stay (34 vs. 20 days; p < 0.001). Risk factors for S. maltophilia pneumonia included previous treatment with meropenem (p < 0.01), thrombopenia (p = 0.034), endotracheal intubation (p < 0.001), foley catheter (p = 0.009) and central venous catheter insertion (p = 0.016). S. maltophilia nosocomial pneumonia is frequent in critical COVID-19 patients. Many significant risk factors should be addressed to reduce its prevalence and negative impact on outcomes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Distribution of critical COVID-19 patients (123 patients) all along the year from March 2020 till March 2021. White dot: Critical COVID-19; Blue dot: non-SM HAP; Red dot: SM HAP.
Figure 2
Figure 2
Relation between the probability of acquiring S. maltophilia pneumonia and the number of central lines installed during ICU stay.
Figure 3
Figure 3
In Vitro resistance of S. maltophilia pathogen to antibiotics (Trimethoprim-sulfamethoxazole and Levofloxacine) during first and second hit.
Figure 4
Figure 4
Difference in clinical outcome (in terms of mortality, need for tracheostomy and oxygen dependence) between ICU COVID patients with and without S. maltophilia superinfection.
See this image and copyright information in PMC

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