Stenotrophomonas maltophilia isolated from patients exposed to invasive devices in a university hospital in Argentina: molecular typing, susceptibility and detection of potential virulence factors

Alcaraz, Eliana; García, Carlos; Papalia, Mariana Andrea; Vay, Carlos; Friedman, Laura; Rossi, Beatriz N. Passerini de

doi:10.1099/jmm.0.000764

Cited by 19 publications

(17 citation statements)

References 39 publications

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“…S. maltophilia has high genetic diversity, as demonstrated with various typing methods (Gherardi et al, 2015;Pompilio et al, 2016;Alcaraz et al, 2018;Guvenir et al, 2018). However, in Mexico, 75-100% similarity has been obtained among strains collected from the same hospital source over a period of 7 years (Flores-Trevino et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Among these genes, dihydropteroate synthase (sul1 and sul2), and dihydrofolate reductase (drfA) are the main mechanisms of SXT resistance in S. maltophilia (Toleman et al, 2007). Some virulence factors have been described in S. maltophilia, including Smf1-fimbrial operon, proteases, hemolysins, exopolysaccharides (EPSs), lipopolysaccharides (LPSs), siderophores, flagella, lipases, putative virulence genes in a pathogenicity island encoding proteins from the RTX (repeats-in-toxin) family, and transmembrane secretion system components (Brooke, 2012;Adamek et al, 2014;Sanchez, 2015;Pompilio et al, 2016;Alcaraz et al, 2018;Trifonova and Strateva, 2019). A few studies have described the colonization of S. maltophilia in cultures of HEp-2 and IB3-1 cells as well as A/J, DBA/2, BALB/c, and C57BL/6 mice (De Vidipo et al, 2001;De Oliveira-Garcia et al, 2003;Pompilio et al, 2008;Lin et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital

Cruz‐Córdova

Mancilla-Rojano

Luna-Pineda

et al. 2020

Front. Cell. Infect. Microbiol.

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Stenotrophomonas maltophilia, an emerging opportunistic pathogen, is widely distributed in the environment the resistance mechanisms, and virulence factors of this bacterium facilitate its dissemination in hospitals. This study aimed to characterize the molecular epidemiology of S. maltophilia strains associated with an outbreak in the Children's Hospital of México Federico Gómez (HIMFG). Twenty-one clinical S. maltophilia strains were recovered from cultures of blood and urine samples from 10 pediatric patients at the emergency department, and nine environmental S. maltophilia strains recovered from faucets in the same area were also included. Two of the 10 patients were related with health care-associated infections (HCAIs), and the other eight patients (8/10) were infected with environmental S. maltophilia strains. The outbreak was controlled by monthly disinfection of the faucets in the emergency department. Typing using pulsedfield gel electrophoresis (PFGE) showed a 52% genetic diversity with seven pulsotypes denoted P1-P7 among all S. maltophilia strains. Three pulsotypes (P2, P3, and P7) were identified among both the clinical and environmental S. maltophilia strains and associated with two type sequences (STs), namely, ST304 and ST24. Moreover, 80% (24/30) of the strains exhibited resistance mainly to tetracycline, 76.66% (23/30) to trimethoprimsulfamethoxazole, and 23.33% (7/30) to the extended-spectrum β-lactamase (ESBL) phenotype. The main resistance genes identified by multiplex PCR were sul1 in 100% (30/30), qnr in 86.66% (26/30), and intl1 in 80% (24/30) of the samples, respectively. Furthermore, the pilU, hlylII, and rmlA genes were identified in 96.6% (29/30), 90% (27/30), and 83.33% (25/30) of the samples, respectively. Additionally, 76.66% (23/30) of the S. maltophilia strains exhibited high swimming motility, 46.66% (14/30) showed moderate biofilm formation capacity, 43.33% (13/30) displayed moderate Cruz-Córdova et al. Outbreak Associated With Stenotrophomonas maltophilia twitching motility, and 20% (6/30) exhibited high adherence. The clinical S. maltophilia strains isolated from blood most strongly adhered to HTB-9 cells. In conclusion, the molecular epidemiology and some of the features such as resistance, and virulence genes associated with colonization patterns are pathogenic attributes that can promote S. maltophilia dissemination, persistence, and facilitate the outbreak that occurred in the HIMFG. This study supports the need for faucet disinfection as a control strategy for clinical outbreaks.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital

Cruz‐Córdova

Mancilla-Rojano

Luna-Pineda

et al. 2020

Front. Cell. Infect. Microbiol.

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“…Phenotypic typing of the isolates was performed using API20NE test kits (bioMérieux, France) according to the manufacturer's instructions. Genotypic typing was assessed by RAPD-PCR as described previously [36]. Briefly, amplification reactions were performed in a 25 µl final volume containing 2 U of GoTaq DNA polymerase (Promega) in 5× GoTaq reaction buffer, 4 mM MgCl 2 , dimethyl sulfoxide 10 %, 0.4 mM of each dNTP, 50 pmol of primer ERIC-2 (5′-AAGT AAGT GACT GGGG TGAGCG-3′) and 3 µl of The antimicrobial susceptibility for minocycline, trimethoprim-sulfamethoxazole (SXT) and levofloxacin (LEV) was assessed using the disc diffusion method according to CLSI recommendations.…”

Section: Phenotypic and Genotypic Typingmentioning

confidence: 99%

“…PCR product patterns were considered identical when the positions of all bands matched, regardless of band intensity [37]. Isolates were also genotyped by PFGE using the restriction enzyme XbaI (Thermo Fisher Scientific) as reported previously [36]. Gels were stained with ethidium bromide and digitized (Molecular Imager Gel Doc XR, Bio-Rad).…”

Section: Phenotypic and Genotypic Typingmentioning

confidence: 99%

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Stenotrophomonas maltophilia phenotypic and genotypic features through 4-year cystic fibrosis lung colonization

Alcaraz

Centrón

Camicia

et al. 2021

Journal of Medical Microbiology

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Introduction. Stenotrophomonas maltophilia has emerged as one of the most common multi-drug-resistant pathogens isolated from people with cystic fibrosis (CF). However, its adaptation over time to CF lungs has not been fully established. Hypothesis. Sequential isolates of S. maltophilia from a Brazilian adult patient are clonally related and show a pattern of adaptation by loss of virulence factors. Aim. To investigate antimicrobial susceptibility, clonal relatedness, mutation frequency, quorum sensing (QS) and selected virulence factors in sequential S. maltophilia isolates from a Brazilian adult patient attending a CF referral centre in Buenos Aires, Argentina, between May 2014 and May 2018. Methodology. The antibiotic resistance of 11 S. maltophilia isolates recovered from expectorations of an adult female with CF was determined. Clonal relatedness, mutation frequency, QS variants (RpfC–RpfF), QS autoinducer (DSF) and virulence factors were investigated in eight viable isolates. Results. Seven S. maltophilia isolates were resistant to trimethoprim–sulfamethoxazole and five to levofloxacin. All isolates were susceptible to minocycline. Strong, weak and normomutators were detected, with a tendency to decreased mutation rate over time. XbaI PFGE revealed that seven isolates belong to two related clones. All isolates were RpfC–RpfF1 variants and DSF producers. Only two isolates produced weak biofilms, but none displayed swimming or twitching motility. Four isolates showed proteolytic activity and amplified stmPr1 and stmPr2 genes. Only the first three isolates were siderophore producers. Four isolates showed high resistance to oxidative stress, while the last four showed moderate resistance. Conclusion. The present study shows the long-time persistence of two related S. maltophilia clones in an adult female with CF. During the adaptation of the prevalent clones to the CF lungs over time, we identified a gradual loss of virulence factors that could be associated with the high amounts of DSF produced by the evolved isolates. Further, a decreased mutation rate was observed in the late isolates. The role of all these adaptations over time remains to be elucidated from a clinical perspective, probably focusing on the damage they can cause to CF lungs.

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Stenotrophomonas maltophilia: Genotypic Characterization of Virulence Genes and The Effect of Ascorbic Acid on Biofilm Formation

ElBaradei

Yakout

2022

Curr Microbiol

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Stenotrophomonas maltophilia is an environmental bacterium that has gained a lot of attention, as a nosocomial pathogen associated with significant mortality rates. Biofilm formation is considered the corner stone for establishing infections in many bacteria including S. maltophilia. The aim of this study was the genotypic characterization of the different virulence-associated genes and the investigation of the effect of ascorbic acid on S. maltophilia biofilm formation. A total of 20 S. maltophilia isolates from different sources were included in this study. Genes encoding different virulence factors were investigated genotypically. These included stmPr1, stmPr2, smlt3773 locus, smf-1, rpfF, rmlA and spgM. Biofilm formation was investigated phenotypically. The effect of ascorbic acid on biofilm formation was investigated using MIC as well as sub-inhibitory concentrations. Many of the isolates harbored both serine proteases genes stmPr-1 and stmPr-2. Fourteen (70%) of the 20 isolates carried stmPr-1 and 15 (75%) had stmPr-2. Most of the isolates (95%) possessed smlt-3773 locus. Genes linked to biofilm formation such as smf-1, rpfF, rmlA and spgM, were found in (90%), (45%), (85%) and (30%) of the isolates, respectively. Phenotypically, all S. maltophilia isolates (100%) were biofilm producers. Fifteen (75%) were strong biofilm producers and 5 (25%) were moderate biofilm producers. In attempts to seek a non-chemotherapeutic alternative that can hinder biofilm formation without provoking antimicrobial resistance, the results, herein, showed that ascorbic acid inhibits biofilm formation in a dose-dependent manner.

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Stenotrophomonas maltophilia isolated from patients exposed to invasive devices in a university hospital in Argentina: molecular typing, susceptibility and detection of potential virulence factors

Cited by 19 publications

References 39 publications

Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital

Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated With an Outbreak in a Mexican Tertiary Care Hospital

Stenotrophomonas maltophilia phenotypic and genotypic features through 4-year cystic fibrosis lung colonization

Stenotrophomonas maltophilia: Genotypic Characterization of Virulence Genes and The Effect of Ascorbic Acid on Biofilm Formation

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