In vitro susceptibility of Stenotrophomonas maltophilia to various antimicrobial combinations

Krueger, Todd S; Clark, Erin A.S.; Nix, David E.

doi:10.1016/s0732-8893(01)00281-4

Cited by 61 publications

(41 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Combinations of ticarcillin/clavulanate plus aztreonam have been reported by other workers as having synergistic activity against S. maltophilia (4,11,14) and have proved to be our most synergistic combination to date. The resistance of S. maltophilia to ␤-lactam antimicrobials is due to the expression of two ß-lactamases, L1 and L2.…”

Section: Discussionmentioning

confidence: 73%

“…The resistance of S. maltophilia to ␤-lactam antimicrobials is due to the expression of two ß-lactamases, L1 and L2. The metallo-␤-lactam L1 is inhibited by aztreonam but not by clavulanic acid, and the serine ß-lactamase L2 is inhibited by clavulanic acid, thus inactivating the bacterium's ␤-lactam resistance mechanisms (14). However, by median SBPI the combination of ticarcillin/clavulanate plus aztreonam ranked only 11th in our league table of combinations tested Ն10 times.…”

Section: Discussionmentioning

confidence: 92%

“…Co-trimoxazole, ticarcillin/clavulanate, minocycline, doxycycline, levofloxacin, and chloramphenicol have all been reported as being the most active single agent against S. maltophilia isolated from individuals with and without CF (6,9,11,18,22,27,29). Co-trimoxazole is often the drug of first choice for therapy, although increasing in vitro resistance is being reported (2,9,14). Of the patients in our study, 24.2% had co-trimoxazole-resistant S. maltophilia, and, like Valdezate et al, we also found a bimodal distribution of MICs (29).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Combination Antimicrobial Susceptibility Testing of Multidrug-Resistant Stenotrophomonas maltophilia from Cystic Fibrosis Patients

Milne

Gould

2012

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Stenotrophomonas maltophilia is increasingly being isolated from the respiratory tract of individuals with cystic fibrosis, and, because of its multidrug-resistant nature, the selection of suitable treatment regimens can be problematical. Etest methodology was used to facilitate MIC and antimicrobial combination testing on 80 isolates of S. maltophilia cultured from the respiratory tract of Scottish individuals with cystic fibrosis between 2001 and 2010. The overall rate of susceptibility for the 1,410 MIC tests was 23.1%, and resistance was 68.9%. The most active antimicrobials were minocycline, co-trimoxazole, and doxycycline, with 92.4%, 87.3%, and 58.8% of isolates being susceptible, respectively. Of the 517 combinations, 13.2% were synergistic, with the most synergistic being ticarcillin/clavulanate plus aztreonam (91.7% synergistic), ticarcillin/clavulanate plus colistin (40%), and ticarcillin/clavulanate plus levofloxacin (19.4%). Colistin plus tobramycin was the only antagonistic combination (0.2%). By the median susceptible breakpoint index, the most active combinations were minocycline plus co-trimoxazole (median index, 20), minocycline plus piperacillin-tazobactam (median, 20), and co-trimoxazole plus ceftazidime (median, 16.5). The increasing problem of multidrug resistance in organisms recovered from the respiratory tracts of individuals with cystic fibrosis is not going to go away. Current susceptibility testing methods do not address the slow-growing organisms associated with chronic infection, and interpretive standards are based on achievable blood levels of antimicrobials. Addressing these issues specifically for organisms recovered from the respiratory tracts of individuals with cystic fibrosis should lead to better therapeutic outcomes and improved wellbeing of individuals with cystic fibrosis.

show abstract

Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Combination Antimicrobial Susceptibility Testing of Multidrug-Resistant Stenotrophomonas maltophilia from Cystic Fibrosis Patients

Milne

Gould

2012

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…In clinical studies, the frequency of viral infections was similar in cf patients when compared to healthy controls, but these infections were more frequently associated with lower respiratory tract symptoms 43 . Furthermore, epidemiological studies showed a seasonal pattern of first P. aeruginosa acquisition 44 and development of chronic P. aeruginosa infection and a rise in P. aeruginosa antibodies with rsv infections suggesting the influence of respiratory viruses 45 .…”

Section: Co-infectionsmentioning

confidence: 93%

Challenging and emerging pathogens in cystic fibrosis

Vrankrijker

Wolfs

Ent

2010

Paediatric Respiratory Reviews

View full text Add to dashboard Cite

“…Until recently, quinolone antibiotics have been some of the few antibacterial agents that show relatively good activity against S. maltophilia. However, resistance to quinolones has now been reported (Krueger et al, 2001). …”

Section: Introductionmentioning

confidence: 99%

Detection of the Smqnr quinolone protection gene and its prevalence in clinical isolates of Stenotrophomonas maltophilia in China

Zhang

Sun

et al. 2012

Journal of Medical Microbiology

View full text Add to dashboard Cite

The aim of this study was to detect novel variants of the Stenotrophomonas maltophilia Smqnr gene family and analyse the prevalence of Smqnr genes in clinical isolates of S. maltophilia in China. In total, 442 clinical isolates of S. maltophilia were collected from nine hospitals in four provinces in China. Antimicrobial susceptibility testing against six commonly used antibiotics was performed on these isolates. The sequences of the Smqnr genes amplified by PCR were aligned with those of known Smqnr genes in GenBank and an Smqnr database. The resistance rate against co-trimoxazole was highest at 48.6 %, followed by resistance rates against ceftazidime, chloramphenicol, ticarcillin/clavulanate and tigecycline at 28.7, 21.3, 19.0 and 16.1 %, respectively. The highest susceptibility was shown to levofloxacin, with a resistance rate of just 6.1 %. Smqnr genes were detected in 114 isolates, and comprised 11 previously identified genes and 20 new variants, bringing the total number of known Smqnr genes to 47. The 20 novel Smqnr genes were designated Smqnr28-47 and the encoded proteins showed only 1-12 amino acid differences among each other. The most common Smqnr genes in China were Smqnr8 and its variant Smqnr35 with prevalences of 17.5 % (20/114) and 13.2 % (15/114), respectively. Both the known and the novel Smqnr genes were discovered in both quinolone non-sensitive and sensitive isolates with similar frequency, suggesting that the Smqnr gene makes little contribution to quinolone resistance in this organism.

show abstract

In vitro susceptibility of Stenotrophomonas maltophilia to various antimicrobial combinations

Cited by 61 publications

References 14 publications

Combination Antimicrobial Susceptibility Testing of Multidrug-Resistant Stenotrophomonas maltophilia from Cystic Fibrosis Patients

Combination Antimicrobial Susceptibility Testing of Multidrug-Resistant Stenotrophomonas maltophilia from Cystic Fibrosis Patients

Challenging and emerging pathogens in cystic fibrosis

Detection of the Smqnr quinolone protection gene and its prevalence in clinical isolates of Stenotrophomonas maltophilia in China

Contact Info

Product

Resources

About