Untitled

Abstract

Stenotrophomonas maltophilia (S. maltophilia) has recently emerged as an important nosocomial pathogen. Treatment of invasive infections caused by this organism is difficult as the bacterium is frequently resistant to a wide range of commonly used antimicrobials. Trimethoprimsulfamethoxazole (TMP -SXT) is recommended as the agent of choice for the treatment of S. maltophilia infections. However, the development of resistance to this antibiotic represents a real challenge to laboratorians and clinicians.This letter describes the first isolation of S. maltophilia resistant to TMP -SXT from two patients treated at Riyadh Armed Forces Hospital which is a major tertiary hospital in Saudi Arabia.

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

“…In sodium phosphate buffer, Esc(1-8) in combination with amikacin or colistin resulted in synergistic activity against five of six S. maltophilia isolates. Enhanced killing at subbactericidal concentrations [0.5-g/ml concentration of Esc (1)(2)(3)(4)(5)(6)(7)(8) and colistin] was observed for the combination of Esc(1-8) and colistin against two representative S. maltophilia isolates. However, no synergistic effect against these two isolates was observed for the combination of Esc(1-8) and amikacin.…”

“…During 2004 to 2009, S. maltophilia clinical isolates recovered from the adult ICU of a tertiary care center in Saudi Arabia demonstrated major increases in resistance to gentamicin, while Ͼ90% of the isolates were susceptible to TMP-SMX (8). Recently, TMP-SMX was used in combination with ciprofloxacin to treat S. maltophilia meningitis in a preterm baby (284), but the emergence of resistance to TMP-SMX is forcing physicians to consider alternatives (7,245,328,333,357). Results from the SENTRY Antimicrobial Surveillance Program in 2004 showed a level of resistance to TMP-SMX of 3.8% for S. maltophilia (110), and results from the SENTRY Antimicrobial Surveillance Program in 1997 to 1999 showed a level of resistance of up to 10% across Europe (119).…”

“…The activity of Esc (1)(2)(3)(4)(5)(6)(7)(8) in combination with conventional antibiotics used to treat S. maltophilia infections (amikacin, ceftazidime, colistin, and levofloxacin) has been assessed in synergy studies (211). Synergy studies using five clinical S. maltophilia isolates and S. maltophilia ATCC 13637 were performed in the presence of sodium phosphate buffer and human serum.…”

“…The N-terminal region [Esc (1)(2)(3)(4)(5)(6)(7)(8)] of the esculentin-1b peptide isolated from Rana esculenta skin secretions contains the antimicrobial properties of the peptide (214). Esc(1-18) was effective against MDR S. maltophilia clinical isolates at concentrations of 0.5 M, 8 M, and 16 M needed for a bactericidal effect when tested in sodium phosphate buffer (SPB), in 20% heat-inactivated human serum, and in 40% heat-inactivated human serum, respectively (215).…”

Stenotrophomonas maltophilia Bacteraemia: Analysis of 33 Episodes Occurred in the ICU at the University Hospital in Sousse, Tunisia

“…He also observed an increasing trend in the rates of resistance to ciprofloxacin (P < 0.05) from 54% in 1993-1994 to 68.7% in 2001. These patterns of susceptibility reflected the development the antibiotic prophylaxis practices in the hospitals according to some authors [1] [42] [56].…”