&lt;i&gt;Stenotrophomonas (Xanthomonas) maltophilia:&lt;/i&gt; In vitro Susceptibility to Selected Antimicrobial Drugs, Single and Combined, with and without Defibrinated Human Blood

Traub, Walter H.; Leonhard, Birgit; Bauer, Dierk

doi:10.1159/000007126

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…TMP-SMX and carbenicillin and rifampin together have also shown synergy against S. maltophilia (378). Bactericidal activity can be observed when rifampin is used in combination with ofloxacin and ceftazidime (331).…”

Section: New Treatment Strategiesmentioning

confidence: 99%

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

2012

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SUMMARY Stenotrophomonas maltophilia is an emerging multidrug-resistant global opportunistic pathogen. The increasing incidence of nosocomial and community-acquired S. maltophilia infections is of particular concern for immunocompromised individuals, as this bacterial pathogen is associated with a significant fatality/case ratio. S. maltophilia is an environmental bacterium found in aqueous habitats, including plant rhizospheres, animals, foods, and water sources. Infections of S. maltophilia can occur in a range of organs and tissues; the organism is commonly found in respiratory tract infections. This review summarizes the current literature and presents S. maltophilia as an organism with various molecular mechanisms used for colonization and infection. S. maltophilia can be recovered from polymicrobial infections, most notably from the respiratory tract of cystic fibrosis patients, as a cocolonizer with Pseudomonas aeruginosa . Recent evidence of cell-cell communication between these pathogens has implications for the development of novel pharmacological therapies. Animal models of S. maltophilia infection have provided useful information about the type of host immune response induced by this opportunistic pathogen. Current and emerging treatments for patients infected with S. maltophilia are discussed.

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Section: New Treatment Strategiesmentioning

confidence: 99%

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

2012

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“…[54]. Several b-lactams have been reported to have variable activity (40%-70%) against S. maltophilia, including the cephalosporins ceftazidime and cefepime and b-lactam/b-lactamase inhibitor combination agents, such as ticarcillin-clavulanate and piperacillin-tazobactam [55][56][57]. The addition of aztreonam to ticarcillin-clavulanate enhances the in vitro activity compared with ticarcillinclavulanate alone [57].…”

Section: Treatment Considerationsmentioning

confidence: 99%

“…Several authors prefer combination regimens for the treatment of serious S. maltophilia infection, particularly in individuals immunocompromised because of the bacteriostatic mode of action of most agents and the potential for the development of resistance during monotherapy [56]. Strategies for salvage therapy of MDR P. aeruginosa infection include combining agents that individually have limited activity against the organism [74][75][76].…”

Section: Treatment Considerationsmentioning

confidence: 99%

Stenotrophomonas maltophilia: Changing Spectrum of a Serious Bacterial Pathogen in Patients with Cancer

Safdar

Rolston²

2007

Clinical Infectious Diseases

203

125

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Stenotrophomonas maltophilia colonization/infection in patients with cancer has significantly increased over the past 2 decades. Patients with prolonged neutropenia, exposure to broad-spectrum antibiotics, and those requiring mechanical ventilation have higher risk of infection. These micro-organisms are intrinsically resistant to carbapenems, and exposure to these agents has been linked to selection of S. maltophilia. Recently, these infections are being documented in patients without traditional risk factors. The spectrum of infection includes bacteremia, catheter-related infection, pneumonia, complicated biliary and urinary tract infection, and skin and skin-structure infection. Trimethoprim-sulfamethoxazole is the therapeutic agent of choice, but resistance is increasingly being reported. Susceptibility to alternative agents is unpredictable. Combination therapy and alternative routes of drug administration, such as aerosolized aminoglycoside, might be necessary. New insights into the mechanisms of drug resistance might lead to identification of new target sites. Agents that improve outer-membrane permeability and broad-spectrum beta-lactamase inhibitors may favorably impact difficult-to-treat (i.e., multidrug resistant) S. maltophilia infections.

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“…Strains that are resistant to all known aminoglycosides, quinolones, ␤-lactams, chloramphenicol, rifampin, tetracycline, and trimethoprim have been reported (1,26,27). Resistance to these agents is by a combination of intrinsic and acquired determinants.…”

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confidence: 99%

“…A prime example of such an emergent pathogen is Stenotrophomonas maltophilia (6,11,25,26,28). Its tolerance to silverlined catheters (28) and its inherent resistance to many antibacterial drugs, including most, if not all, ␤-lactams (1,26,27), give it a survival advantage over other potential pathogens in the hospital environment. Its incidence as a cause of nosocomial bacteremias caused by gram-negative organisms is now second only to that of bacteremia caused by Pseudomonas aeruginosa, and the frequency of its isolation is increasing (25).…”

mentioning

confidence: 99%

Plasmid Location and Molecular Heterogeneity of the L1 and L2 β-Lactamase Genes of Stenotrophomonas maltophilia

Avison

Higgins

Heldreich

et al. 2001

Antimicrob Agents Chemother

119

105

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An approximately 200-kb plasmid has been purified from clinical isolates of Stenotrophomonas maltophilia. This plasmid was found in all of the 10 isolates examined and contains both the L1 and the L2 ␤-lactamase genes. The location of L1 and L2 on a plasmid makes it more likely that they could spread to other gram-negative bacteria, potentially causing clinical problems. Sequence analysis of the 10 L1 genes revealed three novel genes, L1c, L1d, and L1e, with 8, 12, and 20% divergence from the published strain IID 1275 L1 (L1a), respectively. The most unusual L1 enzyme (L1e) displayed markedly different kinetic properties, with respect to hydrolysis of nitrocefin and imipenem, compared to those of L1a (250-and 100-fold lower k cat /K m ratios respectively). L1c and L1d, in contrast, displayed levels of hydrolysis very similar to that of L1a. Several nonconservative amino acid differences with respect to L1a, L1b, L1c, and L1d were observed in the substrate binding-catalytic regions of L1e, and this could explain the kinetic differences. Three novel L2 genes (L2b, L2c, and L2d) were sequenced from the same isolates, and their sequences diverge from the published sequence of strain IID 1275 L2 (L2a) by 4, 9, and 25%, respectively. Differences in L1 and L2 gene sequences were not accompanied by similar divergences in 16S rRNA gene sequences, for which differences of <1% were found. It is therefore apparent that the L1 and L2 genes have evolved relatively quickly, perhaps because of their presence on a plasmid.In recent years there have been major increases in the frequencies with which certain, previously rare bacterial species have been identified as the causes of hospital-acquired bacteremias (26). Three principle factors have combined to bring about this change: (i) increased numbers of hospitalized patients who are severely immunosuppressed; (ii) an increase in complicated surgical procedures, such as transplant and oncology surgery, and the use of intravenous catheters; and (iii) the prophylactic use of antibiotics, particularly ␤-lactams (26). A prime example of such an emergent pathogen is Stenotrophomonas maltophilia (6,11,25,26,28). Its tolerance to silverlined catheters (28) and its inherent resistance to many antibacterial drugs, including most, if not all, ␤-lactams (1, 26, 27), give it a survival advantage over other potential pathogens in the hospital environment. Its incidence as a cause of nosocomial bacteremias caused by gram-negative organisms is now second only to that of bacteremia caused by Pseudomonas aeruginosa, and the frequency of its isolation is increasing (25). It is also a significant cause of bacterial infection among young adults with cystic fibrosis (10).The mechanisms of antibacterial drug resistance in S. maltophilia have not been studied in detail, but it is expected that many of the acquired mechanisms found in P. aeruginosa and other gram-negative bacteria are likely to be present. Strains that are resistant to all known aminoglycosides, quinolones, ␤-lactams, chloramphenicol, ri...

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<i>Stenotrophomonas (Xanthomonas) maltophilia:</i> In vitro Susceptibility to Selected Antimicrobial Drugs, Single and Combined, with and without Defibrinated Human Blood

Cited by 9 publications

References 22 publications

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

Stenotrophomonas maltophilia: Changing Spectrum of a Serious Bacterial Pathogen in Patients with Cancer

Plasmid Location and Molecular Heterogeneity of the L1 and L2 β-Lactamase Genes of Stenotrophomonas maltophilia

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