[Analysis of clinical characteristics and factors associated with mortality in hematological patients infected with Stenotrophomonas maltophilia].

Objective: To investigate the clinical characteristics and factors associated with mortality in hematological patients infected with Stenotrophomonas maltophilia (SMA). Methods: The clinical data of hematological patients with SMA infection who were admitted to the Department of Hematology, Tianjin Medical University General Hospital, from January 2022 to December 2024 were retrospectively collected. Based on the 28-day survival status after the confirmed SMA infection, the patients were divided into the deceased group and the survival group. The clinical characteristics of the two groups were compared, and the factors associated with mortality were analyzed. Results: A total of 130 patients were included, comprising 74 males and 56 females, with a median age [M (Q1, Q3)] of 65 (56, 71) years. There were 54 patients in the deceased group and 76 in the survival group. The proportion of patients with indwelling urinary catheters/gastric tubes/pleural effusion drainage tubes [35.2% (19/54) vs 11.8% (9/76), P=0.001] and the proportion of patients with a history of tigecycline use prior to the current SMA infection diagnosis [51.9% (28/54) vs 22.4% (17/76), P=0.001] were both higher in the death group than those in the survival group. The time interval from hospital admission to etiological confirmation of SMA was longer in the death group than that in the survival group [26 (10, 47) vs 18 (9, 26) days, P=0.015]. In the antimicrobial susceptibility testing, the susceptibility rates of the isolates from the death group to compound sulfamethoxazole [75.9% (41/54) vs 89.5% (68/76), P=0.039] and levofloxacin [72.2% (39/54) vs 89.5% (68/76), P=0.011] were both lower than those in the survival group. The proportion of patients with concurrent fungal infections [46.3% (25/54) vs 21.1% (16/76), P=0.002] and viral infections [25.9% (14/54) vs 9.2% (7/76), P=0.011] was higher in the death group compared to the survival group. The proportion of patients who received tigecycline both before and after the diagnosis of SMA infection was higher in the death group than that in the survival group [48.1% (26/54) vs 17.1% (13/76), P<0.001]. In the death group, the white blood cell count [0.6 (0.2, 3.1)×10⁹/L vs 3.2 (0.3, 6.9)×10⁹/L], platelet count [24 (12, 50)×10⁹/L vs 42 (20, 87)×10⁹/L], absolute neutrophil count [0.2 (0, 2.4)×10⁹/L vs 1.2 (0.1, 4.9)×10⁹/L], and albumin level [28 (26, 31) g/L vs 30 (27, 33) g/L] were all lower than those in the survival group (all P<0.05). The use of indwelling urinary catheter/gastric tube/pleural effusion drainage tube (OR=4.766, 95%CI: 1.686-13.467), complicated fungal infection (OR=2.679, 95%CI: 1.080-6.648), administration of tigecycline both before and after the diagnosis of SMA infection (OR=4.366, 95%CI: 1.732-11.006), and platelet count ≤30×10⁹/L (OR=2.812, 95%CI: 1.170-6.755) were identified as factors associated with mortality in hematological patients infected with SMA. Conclusions: The patients with hematological disease infected with SMA exhibit clinical characteristics such as widespread exposure to broad-spectrum antibiotics, frequent polymicrobial infections, as well as pancytopenia. The use of indwelling urinary/gastric/pleural drainage tubes, complicated fungal infection, administration of tigecycline both before and after SMA diagnosis, and a platelet count ≤30×10⁹/L are factors associated with mortality in hematological patients infected with SMA.