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<p><i>Stenotrophomonas maltophilia</i> complex is an important nosocomial cause of bacteraemia. The complex comprises multiple species, but their relative clinical and genomic significance remains unclear. We examined clinical and genomic differences between <i>S. maltophilia</i> and non-<i>S. maltophilia</i> species to better understand their virulence and implications for patient care. Hospitalized adult patients (≥ 21&#xa0;years) between January 2022 and June 2024 with <i>Stenotrophomonas</i> species bacteraemia were examined. Clinical data were extracted from electronic medical records. Whole-genome sequencing was performed on all isolates, with species assignment confirmed by average nucleotide identity. <i>S. maltophilia</i> and non-<i>S. maltophilia</i> species were compared. Fifty-three <i>S. maltophilia</i> complex isolates were identified, of which 45 had clinical data. <i>S. maltophilia</i> predominated (n = 32), followed by <i>S. pavanii</i> (n = 7), <i>S. sepilia</i> (n = 4), <i>S. muris</i> (n = 1), and <i>S. geniculata</i> (n = 1). <i>S. maltophilia</i> isolates formed multiple clades with diverse sequence types, consistent with both clonal expansion and ongoing diversification. Virulence genes, including <i>stmPr</i>, <i>smoR</i>, and iron acquisition-associated genes were conserved across <i>S. maltophilia</i> lineages, but <i>stmPr1</i> was less frequently observed in non-<i>S. maltophilia</i>. Most infections were line-related. Pneumonia-associated bacteraemia appeared more frequently among with <i>S. maltophilia</i> infections. Polymicrobial bacteraemia appeared more commonly in non-<i>S. maltophilia</i> infections. Mortality was similar between groups, but recurrence of infection within one year occurred only in <i>S. maltophilia</i>. Compared with non-<i>S. maltophilia, S. maltophilia</i> appeared to be associated with pneumonia and recurrent bacteraemia episodes, although mortality was similar. These exploratory findings suggest potential differences within the complex, but require validation in larger studies.</p>

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Clinical presentation and outcomes in non-maltophilia Stenotrophomonas spp. bloodstream infections

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Matthew Chung Yi Koh,
  • Jinghao Nicholas Ngiam,
  • Jeanette Teo,
  • Ka Lip Chew

摘要

Stenotrophomonas maltophilia complex is an important nosocomial cause of bacteraemia. The complex comprises multiple species, but their relative clinical and genomic significance remains unclear. We examined clinical and genomic differences between S. maltophilia and non-S. maltophilia species to better understand their virulence and implications for patient care. Hospitalized adult patients (≥ 21 years) between January 2022 and June 2024 with Stenotrophomonas species bacteraemia were examined. Clinical data were extracted from electronic medical records. Whole-genome sequencing was performed on all isolates, with species assignment confirmed by average nucleotide identity. S. maltophilia and non-S. maltophilia species were compared. Fifty-three S. maltophilia complex isolates were identified, of which 45 had clinical data. S. maltophilia predominated (n = 32), followed by S. pavanii (n = 7), S. sepilia (n = 4), S. muris (n = 1), and S. geniculata (n = 1). S. maltophilia isolates formed multiple clades with diverse sequence types, consistent with both clonal expansion and ongoing diversification. Virulence genes, including stmPr, smoR, and iron acquisition-associated genes were conserved across S. maltophilia lineages, but stmPr1 was less frequently observed in non-S. maltophilia. Most infections were line-related. Pneumonia-associated bacteraemia appeared more frequently among with S. maltophilia infections. Polymicrobial bacteraemia appeared more commonly in non-S. maltophilia infections. Mortality was similar between groups, but recurrence of infection within one year occurred only in S. maltophilia. Compared with non-S. maltophilia, S. maltophilia appeared to be associated with pneumonia and recurrent bacteraemia episodes, although mortality was similar. These exploratory findings suggest potential differences within the complex, but require validation in larger studies.