Risk factors for bacteremia due to Stenotrophomonas maltophilia associated with a central venous catheter:
(1) prolonged admission to the intensive care unit
(2) exposure to multiple antibiotics (with selection for multi-resistant organisms)
(3) prolonged use of the central venous catheter
(4) history of cancer
It is not uncommon for a blood culture containing Stenotrophomonas maltophilia to contain other organisms as well (polymicrobial).
Differential diagnosis:
(1) contamination of skin used to take a superficial culture
(2) colonization along the catheter
(3) cellulitis around the catheter without bacteremia
Complications may include:
(1) hematogenous skin lesions
(2) endocarditis
(3) liver or other occult abscesses
(4) meningitis
(5) endophthalmitis
Removal of the infected catheter is key to resolution of the bacteremia. Stenotrophomonas is resistant to most antibiotics and finding a suitable agent can be difficult.
