Antimicrobial Susceptibility of<i>Stenotrophomonas maltophilia</i>Isolates from Korea, and the Activity of Antimicrobial Combinations against the Isolates

Chung, Hae Sun; Hong, Seong Geun; Kim, Young Ree; Shin, Kyeong Seob; Whang, Dong Hee; Ahn, Jee Young; Park, Yeon Joon; Uh, Young; Chang, Chulhun L.; Shin, Jong Hee; Lee, Hye Soo; Lee, Kyungwon; Chong, Yunsop

doi:10.3346/jkms.2013.28.1.62

Cited by 47 publications

(38 citation statements)

References 30 publications

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“…22 Resistance rates may vary between different regions but, in general, they are <10%. 23,24 One study from Poland on a set of 80 STM clinical isolates showed that only 71.3% of the strains were susceptible to SXT. 25 Here, we detected only 1 resistant strain, which is not consistent with previous reports.…”

Section: Discussionmentioning

confidence: 99%

Severe infections caused by multidrug-resistant non-fermentative bacilli in southern Poland

Chmielarczyk¹,

Pobiega²,

Ziółkowski³

et al. 2018

Adv Clin Exp Med

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Our results indicate serious potential therapeutic problems related to high antibiotic resistance of ACI isolates. The stratification of drug resistance (MDR/XDR/PDR) may become an important tool for the assessment of public health epidemiology and microbiological hazards at the local, national, and international level. It allows clear presentation of the issues concerning the epidemiology of highly resistant bacilli, and the exchange of information between medical staff and local representatives of public health for the implementation of effective measures to reduce drug resistance.

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Section: Discussionmentioning

confidence: 99%

Severe infections caused by multidrug-resistant non-fermentative bacilli in southern Poland

Chmielarczyk¹,

Pobiega²,

Ziółkowski³

et al. 2018

Adv Clin Exp Med

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“…The susceptibility to TMP/SMX, a first-line drug for S. maltophilia infection, is known to vary between regions. For example, almost all strains were susceptible in Korea and Switzerland, while resistant strains were frequently isolated in Turkey (15%), Taiwan (25%), and Spain (27%) (27,28). However, the combination drug is the only known antimicrobial to which the emergence of resistance to S. maltophilia during the administration has not yet been reported (29).…”

Section: Discussionmentioning

confidence: 99%

“…However, the combination drug is the only known antimicrobial to which the emergence of resistance to S. maltophilia during the administration has not yet been reported (29). Thus, TMP/SMX is recommended as the first choice for treating S. maltophilia infections in Western countries (14,27,30,31), still not covered by Japanese medical insurance. Although the susceptibility to TMP/SMX was evaluated in only 4 cases (10.5%) at OUH, we believe that it should be implemented at every medical laboratory when S. maltophilia is isolated.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of <i>Stenotrophomonas maltophilia</i> Bacteremia: A Regional Report and a Review of a Japanese Case Series

et al. 2017

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Objective Stenotrophomonas maltophilia is an emerging nosocomial pathogen that causes fatal infections in critically ill or immunocompromised patients. S. maltophilia bacteremia (SMB) is a rare condition, and its clinical characteristics in Japanese settings are not well known. Methods The medical charts of patients with SMB were retrospectively reviewed at two medical facilities (Okayama University Hospital and Tsuyama Chuo Hospital) for seven years. The data were analyzed along with those previously reported from other Japanese facilities. Result A total of 181 patients (110 men and 71 women) were evaluated. The major underlying diseases included hematologic malignancy (36.5%), solid organ malignancy (25.4%), and neutropenia (31.5%). The recent use of carbapenem was seen in 56.9% of the cases in total, and more than one-third of the patients in our hospitals were treated with carbapenem at the onset of SMB. Of 28 (63.6%) of 44 cases treated for S. maltophilia, those who did not survive were more likely to have been treated with broad-spectrum antibiotics. A multivariate analysis revealed that a higher updated Charlson Comorbidity Index [odds ratio (95% confidence interval), 1.75 (1.11-2.75); p=0.015] and intubation [odds ratio (95% confidence interval), 12.6 (1.62-97.9); p=0.016] were associated with mortality in our cases. Pathogens were often resistant to ceftazidime but susceptible to minocycline, trimethoprim/sulfamethoxazole, and fluoroquinolones. The overall mortality rates within 30 and 90 days were 37.5% and 62.5%, respectively. Conclusion The clinical characteristics of SMB in Japanese cases were similar to those reported from other countries. Clinicians should be aware that breakthrough infection by S. maltophilia may occur during administration of carbapenem.

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“…Trimethoprim-sulfamethoxazole and minocycline were found to be the drugs of choice with susceptibility rates of 96 and 99%, respectively. Combinations of trimethoprim-sulfamethoxazole with ticarcillin-clavulanate, ceftazidime with amikacin and ticarcillin-clavulanate with amikacin were synergistic for the majority of trimethoprim-sulfamethoxazole-resistant isolates [60].…”

Section: Stenotrophomonas Maltophiliamentioning

confidence: 99%

Combination therapy for Gram-negative bacteria: what is the evidence?

Kmeid

Youssef

Kanafani

et al. 2013

Expert Review of Anti-infective Therapy

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The treatment of infections caused by multidrug-resistant Gram-negative bacteria is challenging given the limited options for effective therapy. Combination therapy has garnered great interest recently, with the goals of ensuring appropriate therapy with at least one active agent, and achieving synergistic activity among the anti-microbials used. In this review, we evaluate the data supporting the use of combination therapy against Pseudomonas aeruginosa, carbapenem-resistant Enterobacteriaceae, Acinetobacter species and Stenotrophomonas maltophilia. Various regimens have been tried with promising results; however, the data are mostly derived from in vitro synergy studies. While these reports suggest an advantage of combination therapy over monotherapy, clinical data are scarce, and are comprised of retrospective and a few prospective observational studies. Well-designed randomized trials are needed to better elucidate the efficacy of the various combination regimens. Until then, this review offers a critical appraisal of the published literature and provides recommendations based on the available evidence.

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Antimicrobial Susceptibility ofStenotrophomonas maltophiliaIsolates from Korea, and the Activity of Antimicrobial Combinations against the Isolates

Cited by 47 publications

References 30 publications

Severe infections caused by multidrug-resistant non-fermentative bacilli in southern Poland

Severe infections caused by multidrug-resistant non-fermentative bacilli in southern Poland

Clinical Characteristics of <i>Stenotrophomonas maltophilia</i> Bacteremia: A Regional Report and a Review of a Japanese Case Series

Combination therapy for Gram-negative bacteria: what is the evidence?

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