Stenotrophomonas maltophilia bloodstream infection: Comparison between community-onset and hospital-acquired infections

Chang, Ya-Ting; Lin, Chun‐Yu; Lu, Po‐Liang; Lai, Chih Cheng; Chen, Tun‐Chieh; Chen, Chi-Yu; Wu, Deng‐Chyang; Wang, Tzu-Pin; Lin, Chin‐Jung; Lin, Wei-Che; Chen, Yen-Hsu

doi:10.1016/j.jmii.2012.08.014

Cited by 46 publications

(69 citation statements)

References 29 publications

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“…40 Recent studies, however, reported that the TMPeSXT susceptibility of S. maltophilia in southern Taiwan was only 68.9%. 24 In agreement with these most recent results, we found that 69.6% of our isolates were susceptible to TMPeSXT. Based on recent antimicrobial susceptibility results of blood isolates of S. maltophilia and the results reported here, 24 we suggest that clinicians in Taiwan should use TMPeSXT as empirical therapy with caution for patients when S. maltophilia infections were suspected, because of high frequency of TMPeSXT resistance.…”

Section: Discussionsupporting

confidence: 93%

“…24 In agreement with these most recent results, we found that 69.6% of our isolates were susceptible to TMPeSXT. Based on recent antimicrobial susceptibility results of blood isolates of S. maltophilia and the results reported here, 24 we suggest that clinicians in Taiwan should use TMPeSXT as empirical therapy with caution for patients when S. maltophilia infections were suspected, because of high frequency of TMPeSXT resistance. Continued surveillance and additional research should focus on potentially effective alternatives to TMPeSXT for the treatment of S. maltophilia infections.…”

Section: Discussionsupporting

confidence: 93%

“…1,22,23 Of note, most of our included cases had healthcare-associated and hospital-acquired bacteremia, suggesting that exposure to extensive healthcare system was a major risk factor for S. maltophilia bacteremia. Although our prevalence of hospital-acquired S. maltophilia bacteremia was higher than that in a tertiary hospital in southern Taiwan [165/184 (89.7%) vs. 94/153 (61.4%), respectively], 24 it was similar to those in two hospitals in northern Taiwan [64/84 (76%) and 46/50 (92%), respectively]. 25,26 The primary sources of S. maltophilia bacteremia were the respiratory tract and intravascular catheters, possibly because a high percentage of the included patients were ventilator dependent and had indwelling intravascular catheters.…”

Section: Discussioncontrasting

confidence: 72%

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Comparisons between patients with trimethoprim–sulfamethoxazole-susceptible and trimethoprim–sulfamethoxazole-resistant Stenotrophomonas maltophilia monomicrobial bacteremia: A 10-year retrospective study

Wang

Lin

et al. 2016

Journal of Microbiology, Immunology and Infection

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 72%

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Comparisons between patients with trimethoprim–sulfamethoxazole-susceptible and trimethoprim–sulfamethoxazole-resistant Stenotrophomonas maltophilia monomicrobial bacteremia: A 10-year retrospective study

Wang

Lin

et al. 2016

Journal of Microbiology, Immunology and Infection

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“…However, in our study, nearly 50% of sul -positive S. maltophilia strains were non-susceptible to moxifloxacin and levofloxacin. Moreover, it has been reported that the overuse of fluoroquinolones worldwide has resulted in a higher resistance rate among many pathogenic bacteria, including S. maltophilia (Chang et al, 2014; Pien et al, 2015). Therefore, it would be prudent to use them as initial empirical antibiotics for sul -positive strains.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of Dihydropteroate Synthase Genes in Stenotrophomonas maltophilia by LAMP: Implications for Infection Control and Initial Therapy

et al. 2016

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Stenotrophomonas maltophilia is a common nosocomial pathogen that causes high morbidity and mortality. Because of its inherent extended antibiotic resistance, therapeutic options for S. maltophilia are limited, and sulfamethoxazole/trimethoprim (SXT) is the only first-line antimicrobial recommended. However, with the spread of dihydropteroate synthase (sul1 and sul2) genes, global emergence of SXT resistance has been reported. There is an urgent need to develop a rapid and sensitive but cost-efficient method to monitor the dissemination of sul genes. In this study, we developed loop-mediated isothermal amplification (LAMP) assays for sul1 and sul2 using real-time turbidity and hydroxy naphthol blue coloration methods. The assays could quickly detect sul genes with high sensitivity and specificity. The LAMP detection limit was 0.74 pg/reaction of extracted genomic DNA for sul1 and 2.6 pg/reaction for sul2, which were both 10-fold more sensitive than the corresponding traditional PCR assays. Additionally, the LAMP assays could positively amplify DNA from sul1-producing strains, but not from the negative controls. We then used the LAMP assays to investigate the dissemination of sul genes among S. maltophilia isolates from patients in three hospitals in Beijing, China. Among 450 non-duplicated samples collected during 2012–2014, 56 (12.4%) strains were SXT-resistant. All these SXT-resistant strains were positive for sul genes, with 35 (62.5%) carrying sul1, 17 (30.4%) carrying sul2, and 4 (7.1%) carrying both sul1 and sul2, which indicated that sul genes were the predominant resistance mechanism. Of 394 SXT-susceptible strains, 16 were also sul-positive. To provide epidemiological data for the appropriate choice of antimicrobials for treatment of sul-positive S. maltophilia, we further tested the susceptibility to 18 antimicrobials. Among these, sul-positive strains showed the highest susceptibility to tetracycline derivatives, especially minocycline (MIC50/MIC90, 0.5/4; susceptibility rate, 95.4%). Ticarcillin-clavulanate and new fluoroquinolones (moxifloxacin and levofloxacin) also showed some in vitro activity. Apart from these three kinds of antimicrobials, other agents showed poor activity against sul-positive strains.

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“…(4,(13)(14)(15). Stenotrophomonas maltophilia bacteremia was reported as 21% -51% (8,(16)(17)(18)(19)(20). Lai et al (21) found that while S. maltophilia bacteremia originating from respiratory tract was associated with higher mortality, CVC-related bacteremia was inversely associated with mortality.…”

Section: Discussionmentioning

confidence: 99%

Stenotrophomonas maltophilia Infections in Adults: Primary Bacteremia and Pneumonia

Gözel

Çelik

Elaldı

2015

Jundishapur J Microbiol

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Background: Stenotrophomonas maltophilia is the third most frequent non-fermentative Gram-negative bacilli in nosocomial infections, and usually causes severe infections such as primary bacteremia and pneumonia. Objectives: The current study aimed to compare the demographic and clinical characteristics, microbiological findings and final outcomes of the patients with primary bacteremia and nosocomial pneumonia caused by S. maltophilia. Patients and Methods: The current study retrospectively evaluated patients aged 18 years and above with primary bacteremia and nosocomial pneumonia caused by S. maltophilia from January 2006 to December 2013. Medical records of patients, including reports of clinical microbiology and hospital infection control committee, were evaluated. Results: A total of 71 patients with S. maltophilia nosocomial infections, 35 (49.3%) primary bacteremia and 36 (50.7%) pneumonia, were diagnosed. There were no significant differences in gender, age, and co-morbid diseases, except chronic obstructive pulmonary disease; this infection was significantly higher in patients with pneumonia. A slightly higher 14-day mortality was found in patients with pneumonia, but the difference was not statistically significant. Inappropriate antibiotic use and presence of multiple organ dysfunction syndrome were found as independent risk factors for 14-day mortality in multivariate analysis. Conclusions: A slightly higher mortality in patients with pneumonia, caused by S. maltophilia, was strived to explain by advanced age, higher acute physiology and chronic health evaluation (APACHE II) and sepsis related organ failure assessment (SOFA) score, and also higher inappropriate antibiotic use.

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Stenotrophomonas maltophilia bloodstream infection: Comparison between community-onset and hospital-acquired infections

Cited by 46 publications

References 29 publications

Comparisons between patients with trimethoprim–sulfamethoxazole-susceptible and trimethoprim–sulfamethoxazole-resistant Stenotrophomonas maltophilia monomicrobial bacteremia: A 10-year retrospective study

Comparisons between patients with trimethoprim–sulfamethoxazole-susceptible and trimethoprim–sulfamethoxazole-resistant Stenotrophomonas maltophilia monomicrobial bacteremia: A 10-year retrospective study

Surveillance of Dihydropteroate Synthase Genes in Stenotrophomonas maltophilia by LAMP: Implications for Infection Control and Initial Therapy

Stenotrophomonas maltophilia Infections in Adults: Primary Bacteremia and Pneumonia

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