January 14, 2026Open Forum Infectious Diseases0 citationsOpen Access

P-1348. Impact of Minocycline Minimum Inhibitory Concentrations on Clinical Outcomes in Stenotrophomonas maltophilia Respiratory and Bloodstream Infections

CKChristine J. KubinNewYork–Presbyterian Hospital NDNicholas DemenagasColumbia University Irving Medical Center ALAdrianna LosquadroNew York Hospital Queens

Key Points

Assess the impact of minocycline minimum inhibitory concentrations on clinical outcomes in Stenotrophomonas maltophilia infections.
Retrospective cohort study of hospitalized patients aged ≥ 18 years
Patients received ≥ 48 hours of minocycline for S. maltophilia infection
Compared treatment failure and secondary outcomes between different minocycline MICs
80 patients included: 63 with MIC ≤ 1 mg/L and 17 with MIC 2-4 mg/L
Treatment failure occurred in 41 (51%): 30 (48%) in the MIC ≤ 1 group and 11 (65%) in the MIC 2-4 group
Higher incidence of mechanical ventilation and ICU admission among treatment failures compared to successes

Abstract

Abstract Background The Clinical 0.2 and including MIC group. Results 80 patients were included: 63 with MIC of ≤ 1 and 17 with MIC of 2-4 mg/L. Majority (91%) were respiratory infections with 48 (60%) of patients being mechanically ventilated, 50 (63%) in the ICU at time of infection, and 35 (44%) were immunosuppressed. There was no difference in characteristics between groups and the Pitt Bacteremia Score was 3 in the MIC ≤ 1 group compared to 4 in the MIC 2-4 group (p=0.938). Treatment failure occurred in 41 (51%): 30 (48%) in the MIC ≤ 1 group and 11 (65%) in the MIC 2-4 group (p=0.328). Mechanical ventilation 30 (73%) vs. 18 (46%); p=0.025, ICU 31 (76%) vs. 19 (49%); p=0.024, and higher median PITT bacteremia score 5 vs. 2; p=0.001 were more common in those who failed compared to those with success. In the multivariable model, MIC 2-4 mg/L was not independently associated with treatment failure [OR 2.26 (95% CI 0.615-8.40; p=0.226). Conclusion In patients who received minocycline for S. maltophilia respiratory and bloodstream infections, treatment failure did not differ between patients who had minocycline MIC of ≤ 1 mg/L compared to 2-4 mg/L. Although the results were not statistically significant, numerically there was a higher percentage of patients who failed treatment that had an MIC of 2-4 mg/L. More data with a larger sample size are needed. Disclosures Nicholas Demenagas, PharmD, Ferring Pharmaceuticals: Advisory Board

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