Stenotrophomonas maltophilia: antimicrobial resistance and molecular typing of an emerging pathogen in a Turkish university hospital

Abstract

Despite its limited pathogenicity, Stenotrophomonas maltophilia is an emerging nosocomial pathogen. This study investigated the isolation frequency, antimicrobial resistance and genotypic relationships of 205 S. maltophilia isolates from 188 patients in a university hospital between 1998 and 2003. Susceptibility profiles for 11 antimicrobial agents were determined by the NCCLS agar dilution method for non-fermentative bacteria, while enterobacterial repetitive intergenic consensus sequence (ERIC)-PCR and pulsed-field gel electrophoresis (PFGE) were used for genotyping of the isolates. Of the 205 isolates, 56.1% were isolated in the last 2 years of the study. The risk of S. maltophilia isolation was higher in intensive care units, S. maltophilia was isolated mostly (86.8%) after hospitalisation for >or= 48 h, and 90.4% of the patients had underlying diseases. Resistance levels were>60% for all antimicrobial agents tested except co-trimoxazole. High genetic diversity was found among the S. maltophilia isolates, and cross-infection with S. maltophilia was not common. Although ERIC-PCR revealed fewer genotypes than PFGE, it proved to be a rapid and easy method for S. maltophilia genotyping, and was more economical than PFGE.

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

“…S. maltophilia isolates exhibit differences in antimicrobial susceptibility to aminoglycosides when tested at different temperatures (e.g., 30°C and 37°C, with resistance typically observed at 37°C) (275). Differences in resistance rates for S. maltophilia have also been reported for observations after 24 h and 48 h of incubation (TMP-SMX, ciprofloxacin, ceftazidime, cefepime, piperacillin, and piperacillin-tazobactam demonstrated significant differences [P Ͻ 0.05]) (134). It is important to recognize that currently, there is no worldwide standardized guideline for antimicrobial agent testing.…”

“…maltophilia has been coisolated with other microorganisms (e.g., Pseudomonas aeruginosa, Burkholderia species, Staphylococcus aureus, methicillin-resistant S. aureus, Acinetobacter baumannii, Escherichia coli, Klebsiella species, Enterobacter species, Enterococcus species, Bacteroides species, Corynebacterium species, and Candida albicans) in samples recovered from patients (14,134,187,333,357). The nonfermenting Gram-negative bacteria P. aeruginosa, A. baumannii, and S. maltophilia are all pathogens of the human respiratory tract.…”

Investigation of the Presence of Class 1, 2, 3 Integrons and Their Relationships with Antibiotic Resistance in Clinical Stenotrophomonas maltophilia Isolates

“…Çalışmamızda elde ettiğimiz seftazidim ve SXT için dirençlilik oranları ve MİK 90 değerleri yurt dışındaki bazı çalışmala-ra göre daha yüksek bazılarına göre ise düşük bulunmuştur [11][12][13] . Ülkemizde yapılan çalış-malarda SXT ve seftazidim için değişken sayılar olmasına rağmen, çalışmamızla karşılaş-tırıldığında MİK 90 değeri ve direnç oranları benzerdir [14][15][16] . Levofloksasin ve kloramfenikol için yurt içi çalışmalarda herhangi bir veri bulunmamaktadır (MİK 50 ve MİK 90 değerleri levofloksasin için < 0.125-32 µg/ml ve kloramfenikol için < 0.125-32 µg/ml).…”

Recurrent <i>Stenotrophomonas maltophilia</i> Bacteremia after Iliac Crest Bone Graft Harvest

“…Such predisposing risk factors include malignancy (18), the presence of indwelling de- vices (18,19), chronic respiratory disease, immunocompromised status (18), the use of broad-spectrum antibiotics (19,20), long-term hospitalization (mean duration of hospitalization before isolation reported to be approximately one month) (14), intensive care unit (ICU) stay (21), and the breakdown of mucocutaneous defence barriers (14). The present patient had a prolonged hospitalization and breakdown of mucocutaneous defense barriers due to repeated operations.…”

“…Enterobacterial repetitive intergenic consensus (ERIC)-PCR was performed to genotype the isolates. After DNA was extracted from both the clinical and environmental isolates, amplification reactions using a primer (5'-AAG TAA GTG ACT GGG GTG AGC G-3') were performed according to a previous report (14). The results showed the amplicon patterns to be identical in the blood and wound samples, but they were different from all environmental isolates (Fig.…”