A prospective study of microbiological characterization and clinical facets of Stenotrophomonas maltophilia infections
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Abstract
Background and Objectives: Stenotrophomonas maltophilia is a multidrug resistant opportunistic pathogen, which is normally present in hospital settings and has very high mortality rates.
Materials and Methods: A prospective study was conducted over a period of two years. The specimens were processed by Gram staining and aerobic culture. The bacteria were isolated using standard protocols. The extent of antibiotic resistance of commonly used antimicrobials and biofilm production were studied in the isolates.
Results: A total of 80 strains of Stenotrophomonas maltophilia were isolated. The maximum sensitivity (93.8%) of these isolates was noticed for cotrimoxazole. 63.7% of strains were strong biofilm producers. The group given pathogen specific antibiotic showed better prognosis (P value ≤ 0.05).
Conclusion: Early diagnosis and proper management of cases infected with Stenotrophomonas maltophilia is important to avoid therapeutic failures.
1. Lewis SS, Zaas A. Stenotrophomonas maltophilia. In: Sexton DJ, Bloom A, editors. UpToDate (2014). Topic 13961, version 8.0: pages:1–8. Topic last updated: Jan 28, 2014.
2. Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogens. Clin Microbiol Rev 2012; 25:2-41.
3. Kampmeier S, Pillukat MH, Pettke A, Kossow A, Idelevich EA, Mellmann A. Evaluation of a Stenotrophomonas maltophilia bacteremia cluster in hematopoietic stem cell transplantation recipients using whole genome sequencing. Antimicrob Resist Infect Control 2017: 6:115.
4. Adegoke AA, Stenström TA, Okoh AI. Stenotrophomonas maltophilia as an emerging ubiquitous pathogen: looking beyond contemporary antibiotic therapy. Front Microbiol 2017;8:2276.
5. Kim HR, Lee D, Eom YB. Anti-biofilm and anti-virulence efficacy of celastrol against Stenotrophomonas maltophilia. Int J Med Sci 2018;15:617-627.
6. Neela V, Rankouhi SZ, van Belkum A, Goering RV, Awang R. Stenotrophomonas maltophilia in Malaysia: molecular epidemiology and trimethoprim–sulfamethoxazole resistance. Int J Infect Dis 2012;16(8):e603-7.
7. Brooke, JS. New strategies against Stenotrophomonas maltophilia: a serious worldwide intrinsically drug-resistant opportunistic pathogen. Expert Rev Anti Infect Ther 2014;12:1-4.
8. Rajkumari N, Mathur P, Gupta AK, Sharma K, Misra MC. Epidemiology and outcomes of Stenotrophomonas maltophilia and Burkholderia cepacia infections among trauma patients of India: a five year experience. J Infect Prev 2015;16:103-110.
9. Denton M, Kerr KG. Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia. Clin Microbiol Rev 1998;11:57-80.
10. Gilardi GL. Pseudomonas maltophilia infections in man. Am J Clin Pathol 1969;51:58-61.
11. Gales AC, Jones RN, Forward KR, Liñares J, Sader HS, Verhoef J. Emerging importance of multidrug-resistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients: geographic patterns, epidemiological features, and trends in the SENTRY antimicrobial surveillance program (1997-1999). Clin Infect Dis 2001;32 Suppl 2:S104-113.
12. Siegel JD, Rhinehart E, Jackson M, Chiarello L, Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in healthcare settings, 2006. Am J Infect Control 2007;35(10 Suppl 2):S165-193.
13. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; Twenty-third informational supplement. Clinical and Laboratory Standards Institute, Wayne, PA, 2012.
14. Gopalakrishnan R, Hawley HB, Czachor JS, Markert RJ. Stenotrophomonas maltophilia infection and colonisation in the intensive care units of two community hospitals: A study of 143 patients. Heart Lung 1999;28:134-141.
15. Wang WS, Liu CP, Lee CM, Huang FY. Stenotrophomonas maltophilia bacteremia in adults: four years' experience in a medical center in northern Taiwan. J Microbiol Immunol Infect 2004;37:359-365.
16. Jang TN, Wang FD, Wang LS, Liu CY, Liu IM. Xanthomonas maltophilia bacteremia: an analysis of 32 cases. J Formos Med Assoc 1992;91:1170-1176.
17. Marchenay P, Blasco G, Navellou JC, Leroy J, Cholley P, Talon D, et al. Acquisition of carbapenem-resistant Gram-negative bacilli in intensive care unit: predictors and molecular epidemiology. Med Mal Infect 2015;45:34-40.
18. Hotta G, Matsumura Y, Kato K, Nakano S, Yunoki T, Yamamoto M, et al. Risk factors and outcomes of Stenotrophomonas maltophilia bacteraemic: a comparision with bacteraemia caused by Pseudomonas aeruginosa and Acinetobacter species. PLoS One 2014;9(11):e112208.
19. Rutter WC, Burgess DR, Burgess DS. Increasing incidence of multidrug resistance among cystic fibrosis respiratory bacterial isolates. Microb Drug Resist 2017;23:51-55.
20. Chawla K, Vishwanath S, Gupta A. Stenotrophomonas maltophilia in lower respiratory tract infections. J Clin Diagn Res 2014;8:DC20-DC22.
21. Madi H, Lukić J, Vasiljević Z, Biočanin M, Kojić M, Jovčić B, et al. Genotypic and phenotypic characterization of Stenotrophomonas maltophilia strains from a pediatric tertiary care hospital in Serbia. PLoS One 2016;11(10):e0165660.
22. Nayyar C, Thakur P, Tak V, Saigal K. Stenotrophomonas maltophilia: an emerging pathogen in paediatric population. J Clin Diagn Res 2017;11:DC08-DC11.
23. Gajdács M, Urbán E. Prevalence and antibiotic resistance of Stenotrophomonas maltophilia in respiratory tract samples: a 10-year epidemiological snapshot. Health Serv Res Manag Epidemiol 2019;6:2333392819870774.
24. Cikman A, Parlak M, Bayram Y, Guducuoqlu H, Berktas M. Antibiotic resistance of Stenotrophomonas maltophilia strains isolated from various clinical specimen. Afr Health Sci 2016;16:149-152.
25. Chung HS, Hong SG, Kim YR, Shun KS, Whang DH, Ahn JY, et al. Antimicrobial susceptibility of Stenotrophomonas maltophilia isolates from Korea, and the activity of antimicrobial combination against the isolates. J Korean Med Sci 2013; 28: 62-66.
26. Flores-Treviño S, Gutierrez-Ferman JL, Morfín-Otero R, Rodríguez-Noriega E, Estrada-Rivadeneyra D, Rivas-Morales C, et al. Stenotrophomonas maltophilia in Mexico: antimicrobial resistance, biofilm formation and clonal diversity. J Med Microbiol 2014;63:1524-1530.
27. Sun E, Liang G, Wang L, Wei W, Lei M, Song S, et al. Antimicrobial susceptibility of hospital acquired Stenotrophomonas maltophilia isolate biofilms. Braz J Infect Dis 2016;20:365-373.
28. Victor MA, Arpi M, Bruun B, Jønsson V, Hansen MM. Xanthomonas maltophilia bacteremia in immunocompromised hematological patients. Scand J Infect Dis 1994;26:163-170.
2. Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogens. Clin Microbiol Rev 2012; 25:2-41.
3. Kampmeier S, Pillukat MH, Pettke A, Kossow A, Idelevich EA, Mellmann A. Evaluation of a Stenotrophomonas maltophilia bacteremia cluster in hematopoietic stem cell transplantation recipients using whole genome sequencing. Antimicrob Resist Infect Control 2017: 6:115.
4. Adegoke AA, Stenström TA, Okoh AI. Stenotrophomonas maltophilia as an emerging ubiquitous pathogen: looking beyond contemporary antibiotic therapy. Front Microbiol 2017;8:2276.
5. Kim HR, Lee D, Eom YB. Anti-biofilm and anti-virulence efficacy of celastrol against Stenotrophomonas maltophilia. Int J Med Sci 2018;15:617-627.
6. Neela V, Rankouhi SZ, van Belkum A, Goering RV, Awang R. Stenotrophomonas maltophilia in Malaysia: molecular epidemiology and trimethoprim–sulfamethoxazole resistance. Int J Infect Dis 2012;16(8):e603-7.
7. Brooke, JS. New strategies against Stenotrophomonas maltophilia: a serious worldwide intrinsically drug-resistant opportunistic pathogen. Expert Rev Anti Infect Ther 2014;12:1-4.
8. Rajkumari N, Mathur P, Gupta AK, Sharma K, Misra MC. Epidemiology and outcomes of Stenotrophomonas maltophilia and Burkholderia cepacia infections among trauma patients of India: a five year experience. J Infect Prev 2015;16:103-110.
9. Denton M, Kerr KG. Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia. Clin Microbiol Rev 1998;11:57-80.
10. Gilardi GL. Pseudomonas maltophilia infections in man. Am J Clin Pathol 1969;51:58-61.
11. Gales AC, Jones RN, Forward KR, Liñares J, Sader HS, Verhoef J. Emerging importance of multidrug-resistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients: geographic patterns, epidemiological features, and trends in the SENTRY antimicrobial surveillance program (1997-1999). Clin Infect Dis 2001;32 Suppl 2:S104-113.
12. Siegel JD, Rhinehart E, Jackson M, Chiarello L, Healthcare Infection Control Practices Advisory Committee. Management of multidrug-resistant organisms in healthcare settings, 2006. Am J Infect Control 2007;35(10 Suppl 2):S165-193.
13. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; Twenty-third informational supplement. Clinical and Laboratory Standards Institute, Wayne, PA, 2012.
14. Gopalakrishnan R, Hawley HB, Czachor JS, Markert RJ. Stenotrophomonas maltophilia infection and colonisation in the intensive care units of two community hospitals: A study of 143 patients. Heart Lung 1999;28:134-141.
15. Wang WS, Liu CP, Lee CM, Huang FY. Stenotrophomonas maltophilia bacteremia in adults: four years' experience in a medical center in northern Taiwan. J Microbiol Immunol Infect 2004;37:359-365.
16. Jang TN, Wang FD, Wang LS, Liu CY, Liu IM. Xanthomonas maltophilia bacteremia: an analysis of 32 cases. J Formos Med Assoc 1992;91:1170-1176.
17. Marchenay P, Blasco G, Navellou JC, Leroy J, Cholley P, Talon D, et al. Acquisition of carbapenem-resistant Gram-negative bacilli in intensive care unit: predictors and molecular epidemiology. Med Mal Infect 2015;45:34-40.
18. Hotta G, Matsumura Y, Kato K, Nakano S, Yunoki T, Yamamoto M, et al. Risk factors and outcomes of Stenotrophomonas maltophilia bacteraemic: a comparision with bacteraemia caused by Pseudomonas aeruginosa and Acinetobacter species. PLoS One 2014;9(11):e112208.
19. Rutter WC, Burgess DR, Burgess DS. Increasing incidence of multidrug resistance among cystic fibrosis respiratory bacterial isolates. Microb Drug Resist 2017;23:51-55.
20. Chawla K, Vishwanath S, Gupta A. Stenotrophomonas maltophilia in lower respiratory tract infections. J Clin Diagn Res 2014;8:DC20-DC22.
21. Madi H, Lukić J, Vasiljević Z, Biočanin M, Kojić M, Jovčić B, et al. Genotypic and phenotypic characterization of Stenotrophomonas maltophilia strains from a pediatric tertiary care hospital in Serbia. PLoS One 2016;11(10):e0165660.
22. Nayyar C, Thakur P, Tak V, Saigal K. Stenotrophomonas maltophilia: an emerging pathogen in paediatric population. J Clin Diagn Res 2017;11:DC08-DC11.
23. Gajdács M, Urbán E. Prevalence and antibiotic resistance of Stenotrophomonas maltophilia in respiratory tract samples: a 10-year epidemiological snapshot. Health Serv Res Manag Epidemiol 2019;6:2333392819870774.
24. Cikman A, Parlak M, Bayram Y, Guducuoqlu H, Berktas M. Antibiotic resistance of Stenotrophomonas maltophilia strains isolated from various clinical specimen. Afr Health Sci 2016;16:149-152.
25. Chung HS, Hong SG, Kim YR, Shun KS, Whang DH, Ahn JY, et al. Antimicrobial susceptibility of Stenotrophomonas maltophilia isolates from Korea, and the activity of antimicrobial combination against the isolates. J Korean Med Sci 2013; 28: 62-66.
26. Flores-Treviño S, Gutierrez-Ferman JL, Morfín-Otero R, Rodríguez-Noriega E, Estrada-Rivadeneyra D, Rivas-Morales C, et al. Stenotrophomonas maltophilia in Mexico: antimicrobial resistance, biofilm formation and clonal diversity. J Med Microbiol 2014;63:1524-1530.
27. Sun E, Liang G, Wang L, Wei W, Lei M, Song S, et al. Antimicrobial susceptibility of hospital acquired Stenotrophomonas maltophilia isolate biofilms. Braz J Infect Dis 2016;20:365-373.
28. Victor MA, Arpi M, Bruun B, Jønsson V, Hansen MM. Xanthomonas maltophilia bacteremia in immunocompromised hematological patients. Scand J Infect Dis 1994;26:163-170.
| Files | ||
| Issue | Vol 12 No 4 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v12i4.3934 | |
| Keywords | ||
| Stenotrophomonas maltophilia; Antibiotic resistance; Minimum inhibitory concentration; Biofilm | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Biswas S, Berwal A, Chawla K. A prospective study of microbiological characterization and clinical facets of Stenotrophomonas maltophilia infections. Iran J Microbiol. 2020;12(4):313-318.
