Evidence map›Paper›PMID 40000958›Full record

ArticleBMC infectious diseases2025

Clinical presentation and outcomes of bloodstream infection with intrinsically carbapenem-resistant non-fermenting gram-negative organisms: Stenotrophomonas maltophilia, Elizabethkingia spp. and Chryseobacterium spp. in Singapore, from 2012 to 2024.

Matthew Chung Yi Koh, Jinghao Nicholas Ngiam, Ka Lip Chew, Nares Smitasin, Lionel Hon-Wai Lum, David Michael Allen

Abstract read
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Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Meningitis due to pandrug resistant Chryseobacterium gleum: microbiological cure and clinical response with linezolid-based combination therapy.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  3. Pathogens (Basel, Switzerland) · 2026
    Review
  4. Article
  5. Article
  6. Article
  7. Therapeutic challenges in managingFrontiers in cellular and infection microbiology · 2025
    Review
  8. Multicenter epidemiology ofFrontiers in microbiology · 2025
    Article
  9. Cefiderocol-ResistantCase reports in infectious diseases · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Matthew Chung Yi KohDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore (City), Singapore.
Jinghao Nicholas NgiamDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore (City), Singapore. Nicholas_ngiam@nuhs.edu.sg.
Ka Lip ChewDepartment of Laboratory Medicine, National University Hospital, 1E Kent Ridge Rd, NUHS Tower Block, Level 10, 119228, Singapore (City), Singapore. Ka_lip_chew@nuhs.edu.sg.
Nares SmitasinDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore (City), Singapore.
Lionel Hon-Wai LumDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore (City), Singapore.
David Michael AllenDivision of Infectious Diseases, Department of Medicine, National University Health System, Singapore (City), Singapore. mdcdma@nus.edu.sg.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBloodstream infections with the non-fermenting Gram-negative organisms Stenotrophomonas maltophilia, Elizabethkingia spp. or Chryseobacterium spp. are observed in nosocomial settings. Comparative description of their clinical presentation, microbiological characteristics, treatment options and outcomes remain to be investigated.

methodsWe performed a retrospective single-centre analysis of bloodstream infections with the abovementioned three organisms from 1 Jan 2012 to 30 Jun 2024.

resultsA total of 349 distinct encounters (from 322 unique patients) were identified with bacteraemia. Stenotrophomonas maltophilia was the commonest (197/349, 56.4%), followed by Elizabethkingia spp. (127/349, 36.4%) and Chryseobacterium spp. (25/349, 7.2%). Prior carbapenem exposure was observed in 59.9% of cases. The majority were related to central lines (58.2%). Most cases were nosocomial in onset (82.5%), and a third were from the intensive care unit (32.1%). A significant proportion of our Stenotrophomonas maltophilia (32.8%) and Chryseobacterium spp. (22.7%) isolates were resistant to levofloxacin, while a majority of the organisms retained susceptibility to trimethoprim-sulfamethoxazole (TMP-SMX) and minocycline. Dual antibiotics were used in a minority of encounters (23/349, 6.6%). Mortality was high across infections with the three organisms, but highest amongst those with Stenotrophomonas maltophilia bacteraemia (41.6%), followed by Elizabethkingia spp. (29.9%) and Chryseobacterium spp. (20.0%).

conclusionsStenotrophomonas, Elizabethkingia or Chryseobacterium spp bacteraemia was associated with significant mortality. Most cases were nosocomial in acquisition, with prior carbapenem exposure or indwelling central catheters. Fluoroquinolone resistance was common for Stenotrophomonas maltophilia and Chryseobacterium spp., but less prevalent in Elizabethkingia spp., while TMP-SMX and minocycline retained susceptibility. Monitoring these trends would be critical in guiding empiric therapy for these organisms.

Indexed as

BacteremiaCarbapenemsChryseobacteriumGram-Negative Bacterial InfectionsStenotrophomonas maltophiliaAdolescentAdultAgedAged, 80 and overAnti-Bacterial AgentsCross InfectionDrug Resistance, BacterialFemaleFlavobacteriaceaeFlavobacteriaceae InfectionsHumansAnti-Bacterial AgentsCarbapenemsBacteraemiaChryseobacterium spp.Clinical outcomesElizabethkingia spp.Stenotrophomonas maltophilia

Identifiers

PMID40000958
PMCPMC11863829

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.