Stenotrophomonas maltophilia sm plays an important role as an opportunistic pathogen in immunocompromised individuals. Stenotrophomonas maltophilia is a motile, gramnegative nonfermentative bacillus previously known as pseudomonas maltophilia and xanthomonas maltophilia. Stenotrophomonas maltophilia, formerly known as xanthomonas maltophilia or pseudomonas maltophilia, has increasingly become an important nosocomial pathogen. Methods from january 1993 to june 2003, the medical charts of. Jul 08, 2011 colonies of stenotrophomonas maltophilia on macconkey agar, incubation period 3 days at 3035c dr. Stenotrophomonas maltophilia is an emerging multidrugresistant opportunistic pathogen with an increasing incidence of nosocomial and communityacquired infection cases, mainly in. Frontiers antibiotic resistance in the opportunistic.
Falagas me, kastoris ac, vouloumanou ek, dimopoulos g. May 23, 2008 stenotrophomonas maltophilia is an environmental bacterium increasingly involved in nosocomial infections and resistant to most antibiotics. This organism is the most commonfound pseudomonad after p aeruginosa, s. Of the 6 cases of stenotrophomonas maltophilia bacteraemia seen in the paediatric oncology patients from year 2000 to 2004 at our hospital, only 1 case developed metastatic skin lesions.
Global emergence of trimethoprimsulfamethoxazole resistance. Oct 25, 2018 belvisi v, fabietti p, del borgo c, marocco r, di vincenzo e, soscia f, et al. Doctor answers on symptoms, diagnosis, treatment, and more. It is also an opportunistic pathogen now causing an increasing number of nosocomial infections. Stenotrophomonas maltophilia is an aerobic, nonfermentative, gramnegative bacterium. Treatment of stenotrophomonas maltophilia infection. Chronic stenotrophomonas maltophilia infection and. Tap water can harbor opportunistic pathogens at levels that are significant for. Stenotrophomonas maltophilia joe flashcards quizlet. Therapeutic options for stenotrophomonas maltophilia. We present a case of stenotrophomonas maltophilia prosthetic valve endocarditis secondary to an indwelling catheter infection. Legionella pneumophilia is the bacteria that causes legionaires disease. Burns, in principles and practice of pediatric infectious diseases fourth edition, 2012.
Voluntary data reported to phe for bacteraemias due to pseudomonas species spp. Skin manifestation of stenotrophomonas maltophilia infection. It is important to recognize and efficiently treat infections with this bacterium as soon as possible. This organism has significant resistance to broadspectrum antibiotics, leading to only limited treatment options. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. Although an uncommon pathogen in humans, s maltophilia infection in humans, especially nosocomial, has been increasingly recognized. Resistant to most antimicrobial classes develops resistance quickly during infection trimethoprimsulfamethoxazole sxt is. Stenotrophomonas maltophilia colony morphology and. Stenotrophomonas maltophilia previously pseudomonas and xanthomonas maltophilia is a nonfermenting gramnegative rod, which represents one of the more prominent emerging pathogens in the cf airway. Demographic data, intervention methods and antibiotic treatment courses were analyzed for possible risk factors of mortality in bacteremic children. Stenotrophomonas maltophilia is a nonfermentative gramnegative bacillus that has been isolated from multiple environmental sources apsiarnthanarak et al. If you have problems viewing pdf files, download the latest version of adobe reader. Antibiotics are used only when removal of prosthesis isnt possible. Patients with prolonged neutropenia, exposure to broadspectrum antibiotics, and those requiring mechanical ventilation have higher risk of infection.
The increasing incidence of nosocomial and communityacquired s. Stenotrophomonas maltophilia is a gramnegative bacterium found in a variety of environments including soil, water, and plants. Adherence of this organism to abiotic surfaces such as medical implants and catheters represen. Apr 30, 2014 the antimicrobial treatment of stenotrophomonas maltophilia infections is complicated by intrinsic multidrug resistance and a lack of reliable susceptibility data. Concomitant nosocomial pathogens were present in 30% of patients 3. Stenotrophomonas maltophilia in salad volume 11, number 7.
Stenotrophomonas maltophilia has emerged as an important nosocomial pathogen, especially in debilitated and immunocompromised persons. Factors that predispose these patients to nosocomial infections include very low birth weight, small size for gestational age, immunologic immaturity, and exposure to invasive procedures, including insertion of intravascular catheters and assisted ventilation. Stenotrophomonas xanthomonas maltophilia is an aerobic gramnegative bacillus that is found in various aquatic environments. Stenotrophomonas maltophilia initially classified as pseudomonas maltophilia, later xenotrophomonas maltophilia is an aerobic, gramnegative bacillus. Stenotrophomonas xanthomonas maltophilia is a multidrugresistant gramnegative bacillus that is an opportunistic pathogen, particularly among hospitalized patients. Communityacquired stenotrophomonas maltophilia infections. Stenotrophomonas maltophilia infection symptoms, treatments. Stenotrophomonas maltophilia infection genetic and rare. It is an obligate aerobe, and is capable of growth between 5o and 40oc. It is a freeliving organism present in most aquatic and humid environments. Stenotrophomonas maltophilia is a motile nonfermentative, gram negative bacillus that is readily isolated from environmental sources and water. As mentioned earlier, stenotrophomonas maltophilia is very difficult to treat due to its natural resistance to many antibiotics. Update on stenotrophomonas maltophilia infection in the icu. Stenotrophomonas maltophilia an overview sciencedirect.
Trimethoprimsulfamethoxazole cotrimoxazole sensitivity is used as an identification test for s. Stenotrophomonas maltophilia johns hopkins abx guide. It can survive a very minimal nutrient concentration. Stenotrophomonas maltophilia urinary tract infections in. Stenotrophomonas maltophilia has previously been referred to as pseudomonas maltophilia and subsequently xanthomonas maltophilia. Stenotrophomonas maltophilia infections of intact skin. Stenotrophomonas maltophilia is an emerging nosocomial pathogen associated with opportunistic infections in patients with cystic fibrosis, cancer, and hiv. Xanthomonas maltophilia peritonitis in a patient undergoing peritoneal dialysis. It is an uncommon bacterium and human infection is difficult to treat.
Detecting stenotrophomonas maltophilia does not reduce. We assessed the activity of colistin col, rifampicin rif and tigecycline tgc alone and in combination using a range of in vitro susceptibility testing methodologies and a simple invertebrate model of s. Special pathogens laboratory, the legionella experts about. It is an environmental organism found in water and soil and on plants and has emerged as an important nosocomially acquired pathogen 1. A rare case of stenotrophomonas maltophilia resistant to.
Stenotrophomonas maltophilia, formerly known as pseudomonas or xanthomonas maltophilia, is an aerobic, glucose nonfermentative, gramnegative bacillus 14 that is frequently isolated from water, soil, animals, plant materials and hospital equipment. For language access assistance, contact the ncats public information officer. Jun 30, 2015 stenotrophomonas maltophilia is an environmental bacterium found in the soil, associated with plants and animals, and in aquatic environments. Successful treatment of stenotrophomonas maltophilia. A nosocomial pathogen, of special importance in intensive care units in part because of its resistance to most penicillins and to cephalosporins and aminoglycosides. Stenotrophomonas maltophilia is an emerging multidrugresistant global opportunistic pathogen. Stenotrophomonas maltophilia prosthetic valve endocarditis. Stenotrophomonas maltophilia is an aerobic, nonfermentative, gramnegative bacillus formerly called xanthomonas maltophilia or pseudomonas maltophilia. High dose bactrim 1520 mgkgday of trimethoprim component, divided q6h or q8h, iv or po. Initially classified as bacterium bookeri, then renamed pseudomonas maltophilia, s. Atenafu b, juliana giraldo salazar c, annie lu a, yvonne yau d, larissa matukas e, elizabeth tullis f, felix ratjen c a divisionofinfectiousdiseases,departmentofpediatrics,thehospitalforsickchildren,universityoftoronto,555universityavenue. While stenotrophomonas maltophilia is an aerobe, it can still grow using nitrate as a terminal electron acceptor in the absence of oxygen 5. Stenotrophomonas maltophilia definition of stenotrophomonas. Stenotrophomonas maltophilia is a gramnegative, multidrugresistant organism that is typically hospitalacquired and associated with high morbidity and mortality 1, 2.
Dec 15, 2007 stenotrophomonas maltophilia colonizationinfection in patients with cancer has significantly increased over the past 2 decades. However, comparatively little is known of the epidemiology of this bacterium, and sources and routes of transmission of s. The bacterium is an obligate aerobe that is common throughout the environment, particularly in water. Stenotrophomonas maltophilia bacteremia in pediatric. Patients with chronic illnesses are more susceptible to this type of infection. New fluoroquinolones seem to be an encouraging option for treatment and may become very useful in the treatment of severe infections due to s. Stenotrophomonas maltophilia is a topic covered in the johns hopkins abx guide to view the entire topic, please sign in or purchase a subscription official website of the johns hopkins antibiotic abx, hiv, diabetes, and psychiatry guides, powered by unbound medicine.
It is an obligate aerobe, and is capable of growth between 5o and 40oc 18. Nontraditional therapy for stenotrophomonas maltophilia. Much remains to be understood of the epidemiology of s. Authors sarah s lewis, md assistant professor of medicine duke university medical center aimee zaas, md, mhs associate professor of medicine. Infection and colonization by stenotrophomonas maltophilia. Activity of colistin in combination with tigecycline or. It is a bacterium that can be present in almost any aquatic or humid environment and may persist for extended periods in such locations. Successful treatment of stenotrophomonas maltophilia soft tissue infection with tigecycline. Stenotrophomonas maltophilia is a gramnegative, motile, multitrichous flagellated bacillus that is aerobic and nonfermenting 1. It also occurs in the hospital environment and may cause bloodstream. The most effective treatment involves the removal of prosthetic devices. Suggest treatment for stenotrophomonas maltophilia pseudomonas md stenotrophomonas maltophilia pseudomonas i had a urine culture came back postive for thisim a self cath patient and my urologist sending me to a infectios disease doctor but the nurse dint get me.
Stenotrophomonas maltophilia is an important cause of hospital acquired infection particularly among severely debilitated and immunosuppressed patients. A stenotrophomonas maltophilia is an infection pathogen that is present mostly in aqueous environments, e. Gram, nonlactose fermenter, oxidase treatment options drug of choice. It was first recognized when it caused an epidemic of pneumonia at a pennsylvania state american legion convention in philadelphia in 1976. Stenotrophomonas maltophilia infectious disease and. Stenotrophomonas maltophilia pneumonia answers on healthtap. Our patient had several risk factors as described above. Stenotrophomonas bacteremia antibiotic susceptibility and. Stenotrophomonas maltophilia is a ubiquitous environmental bacterium that has also emerged as an important nosocomial pathogen contributing substantially to morbidity and mortality of immunocompromised patients, particularly in the icu setting.
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