Bacterial colonisation withXanthomonas maltophilia — A retrospective study in a cystic fibrosis patient population

Abstract

Xanthomonas maltophilia was isolated from 25 of 150 patients with cystic fibrosis during a period of 10 years (1983-1992). Twelve patients harboured X. maltophilia chronically, i.e. repeatedly for more than 6 months. No predisposing factors for the colonisation could be identified by studying the clinical and laboratory data of the patients, including preceding and concurrent bacterial colonisation with other bacteria, antibacterial treatments, pulmonary function and biochemical markers. Up to 2 years after the chronic colonisation was established no clinical deterioration could be verified, but the patients with X. maltophilia generally had a worse lung function at the latest follow-up (2-7 years after colonisation) than controls colonised with Pseudomonas aeruginosa (p < 0.05). Our data imply that X. maltophilia is a pathogen and the colonisation appears to follow the same pattern as the colonisation by P. aeruginosa. The development of resistance to different antibiotics, as revealed by analysis of the inhibition zones, was related to antibacterial treatment courses. X. maltophilia showed reduced sensitivity to the most commonly used antibiotics, ceftazidime and tobramycin.

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

“…The intermittent delivery of aerosolized tobramycin by a nebulizer (cycles of 300 mg tobramycin or taste-masked placebo twice daily for 28 days followed by 28 days without treatment) did not increase the selection of tobramycin-resistant S. maltophilia and resulted in persistent treatment-emergent S. maltophilia in a very low number of patients (43,276). A retrospective study of tobramycin in two placebo-controlled trials revealed that most S. maltophilia isolates occurred intermittently and were rarely persistent isolates (131); this occasional appearance of S. maltophilia in CF patients has been reported by several studies (76,168,338). As S. maltophilia has been recovered from nebulizers of CF patients (80,157), a small study tested the biofilm-forming abilities of environmental and clinical S. maltophilia isolates after exposure to tobramycin at a concentration (16,000 g/ml) found inside the nebulizers (234).…”

Challenging and emerging pathogens in cystic fibrosis

“…The risk associated with the use of inhaled antibiotics is not yet fully known. The trials investigating the efficacy and safety of the use of inhaled tobramycin have shown increases in mic values over time, but this did not correlate with therapeutic success 42 . In another cohort study however, the use of inhaled tobramycin was an independent risk factor for acquisition of multiple antibiotic resistant P. aeruginosa (marpa).…”

“…It has been reported that S. maltophilia negatively impacts cf lung function 42 . In a number of case-control and cohort studies, S. maltophilia positive patients did generally have decreased respiratory virus season.…”

Role of Excessive Inflammatory Response to Stenotrophomonas maltophilia Lung Infection in DBA/2 Mice and Implications for Cystic Fibrosis

“…An increasing incidence of S. maltophilia isolates has been reported in some CF centers during the last decade (2,9,15,22,30). In the United States, the frequency of S. maltophilia isolation from CF patients increased rapidly, from around 3% in 1993 to 12.1% in 2006 (21).…”