Stenotrophomonas maltophilia: A marker of lung disease severity

Abstract

BackgroundWhile the prevalence of Stenotrophomonas maltophilia lung infection in cystic fibrosis (CF) patients has increased in the last decades, its pathogenicity remains controversial. The aim of this study was to investigate the effects of S. maltophilia initial infection on the progression of lung disease in CF children.MethodsThis case‐control retrospective study took place in a pediatric CF center. A total of 23 cases defined by at least one sputum culture positive for S. maltophilia, were matched for age, sex, and CFTR mutations to 23 never infected CF controls. The clinical data were collected for 2 years before and after S. maltophilia initial infection and comprised lung function analyses, rates of exacerbations and of antibiotic courses.ResultsCompared with controls, cases had lower lung function (P = 0.05), more frequent pulmonary exacerbations (P = 0.01), hospitalizations (P = 0.02), and intravenous antibiotic courses (P = 0.04) before S. maltophilia acquisition. In the year following S. maltophilia initial infection, lung function decline was similar in cases and controls but cases remained more severe, with more frequent pulmonary exacerbations (P = 0.01), hospitalizations (P = 0.02) and intravenous antibiotic courses (P = 0.02).Conclusions S. maltophilia seems to be a marker of CF lung disease severity and international recommendations to reduce lung infection by this pathogen should rapidly emerge.

Electrochemically Synthesized Silver Nanoparticles Are Active Against Planktonic and Biofilm Cells of Pseudomonas aeruginosa and Other Cystic Fibrosis-Associated Bacterial Pathogens

“…Staphylococcus aureus and Pseudomonas aeruginosa are the most prevalent respiratory pathogens, respectively, in younger and adult CF patients ( Cox et al, 2010 ). Other pathogens, such as Burkholderia cepacia complex and Stenotrophomonas maltophilia , are less frequently recovered but particularly troublesome in these patients due to their multidrug-resistant phenotypes and can cause a severe decline in lung function ( Speert et al, 2002 ; Berdah et al, 2018 ). The frequency of respiratory tract infection by these species increases with patient age, posing a significant health risk to CF patients surviving to adulthood.…”

Cooperativity between Stenotrophomonas maltophilia and Pseudomonas aeruginosa during Polymicrobial Airway Infections

“…However, the significance of S. maltophilia as an opportunistic pathogen in patients with CF remains uncertain (11,12). While it is clear that S. maltophilia is frequently isolated from patients with lower lung function (as measured by predicted median forced expiratory volume in 1 s (FEV 1 )), at present it remains uncertain whether S. maltophilia merely colonizes a profoundly damaged lung environment or is the causative agent of the destruction (13)(14)(15)(16).…”

“…Distinct from acute respiratory infections, thickened mucus and a decrease in mucociliary clearance in CF patients predispose them to bacterial colonization of the lung in the form of a chronic, complex polymicrobial biofilm (7). Epidemiologic data clearly show that S. maltophilia participates in polymicrobial infections in concert with many important pathogens in CF, including Staphylococcus aureus and P. aeruginosa (13,15,16). During late-stage disease, P. aeruginosa predominates within the CF lung environment, and many studies have shown that P. aeruginosa can interact with other microbes within the lung to alter infection dynamics (17)(18)(19)(20).…”

Cystic fibrosis year in review 2017

“…Infected patients had an increased rate of decline in median annual FEV1 and more exacerbations and hospitalizations compared to the time period before infection, after adjusting for other clinical and demographic factors. In a European pediatric CF program, a case‐control retrospective study compared 23 children with CF who had at least one sputum culture positive for SM to 23 never infected CF controls matched for age, sex, and CFTR mutations for 2 years before and after SM initial infection . Compared with controls, cases had lower lung function ( P = 0.05), more frequent pulmonary exacerbations ( P = 0.01), hospitalizations ( P = 0.02), and intravenous antibiotic courses ( P = 0.04) before SM acquisition.…”