Molecular epidemiology of Xanthomonas maltophilia colonization and infection in the hospital environment

Abstract

Xanthomonas maltophilia isolates were collected from 63 patients in three acute-care hospitals in Calgary, Alberta, Canada. On the basis of Centers for Disease Control and Prevention definitions, 48 patients had nosocomial and 15 had community-acquired X. maltophilia. Thirty-eight of the patients were colonized and 25 were infected. Sixty-four percent of patients who acquired X. maltophilia in the intensive care unit (ICU) became infected, whereas 32% of patients in a non-ICU setting became infected. ICU patients tended to be hospitalized for a shorter period of time than non-ICU patients before the onset of X. maltophilia infection. Regardless of being colonized or infected, all patients had debilitating conditions, with respiratory disease being the most common underlying illness (35%). Forty-two patients (88%) with hospitalacquired X. maltophilia received prior antibiotic therapy which included gentamicin, tobramycin, ceftazidime, piperacillin, and imipenem. Agar dilution MICs showed that patient isolates were resistant to these antimicrobial agents that patients had received. Pulsed-field gel electrophoresis of SpeI-digested genomic DNA revealed that six epidemiologically linked patient isolates from the ICU of one acute-care hospital had identical DNA profiles. In contrast, isolates from patients from the other two hospitals had unique genotype profiles (n ‫؍‬ 57) regardless of the presence or absence of an epidemiologic association. In these patients there was genetic evidence against the acquisition of a resident hospital clone. These results indicate that pulsed-field gel electrophoresis can resolve genotypically distinct strains of X. maltophilia and, consequently, is a useful tool for evaluating nosocomial infections caused by X. maltophilia.

Infection With Transmissible Strains of Pseudomonas aeruginosa and Clinical Outcomes in Adults With Cystic Fibrosis

“…Genomic DNA was prepared using a modification of a described method. 15 The restriction fragment profiles were compared visually and also using BioNumerics computer software (Applied Maths, Kortrijk, Belgium), and were interpreted based on guidelines recommended by Tenover et al 16 Isolates with identical restriction fragment profiles were considered to represent a single strain. Isolates with restriction profiles that differed by 1 to 3 fragments were considered to be closely related strains evolving from a single clone.…”

Stenotrophomonas maltophilia bacteremia in end‐stage renal disease patients receiving maintenance hemodialysis

“…Besides peritonitis,2 S. maltophilia has been reported to cause a variety of infections9–16 listed in Table II. Although S. maltophilia infection is rare in patients receiving peritoneal dialysis, 23 cases have been reported so far.…”

Endocarditis por Stenotrophomonas maltophilia: presentación de un caso y revisión de la literatura

“…La Stenotrophomonas maltophilia, después de la P. aeruginosa, representa el bacilo gramnegativo que con más frecuencia se aísla en especímenes clínicos (28)(29)(30). Aunque es un patógeno preferentemente nosocomial, en los últimos años se ha puesto de manifiesto que la infección adquirida en la comunidad es más habitual de lo que, en un principio, se pensaba (31)(32)(33). Se reconocen como fuentes potenciales de la infección hospitalaria los siguientes factores: agua destilada, agua de los servicios, nebulizadores, catéteres, esfingomanómetros, termómetros, soluciones desinfectantes, máquinas de diálisis, fluidos intravenosos, ventiladores, máquinas de hielo y las manos del personal sanitario (34)(35)(36)(37)(38)(39).…”