Stenotrophomonas maltophilia infection during allogeneic hematopoietic stem cell transplantation: a single-center experience

To examine risk factors for Stenotrophomonas maltophilia (S.maltophilia) infection during allogeneic hematopoietic stem cell transplantation (allo-HSCT), we retrospectively analyzed 259 patients who underwent allo-HSCT. Not only S.maltophilia infection but also S.maltophilia colonization was associated with mortality during allo-HSCT. Among 52 episodes in 39 patients in whom S.maltophilia was detected, documented infection developed in 33 episodes (25 patients). The onset of S.maltophilia infection in the period from the conditioning regimen to engraftment was associated with a high mortality rate. Breakthrough S.maltophilia infection developed in 24% of the patients during prophylactic administration of fluoroquinolones, to which S.maltophilia is sensitive. Reinsertion of a central venous catheter (CVC) immediately after removal was suggested to be a risk for persistent S.maltophilia infection in the period of neutropenia. Our results indicated that (i) onset of S.maltophilia infection in the period from the conditioning therapy to engraftment and (ii) removal and immediate reinsertion of a CVC as treatment after the onset of S.maltophilia infection are possible risk factors for S.maltophilia-related mortality during allo-HSCT.