Clinical challenges treating Stenotrophomonas maltophilia infections: an update

Author:

Mojica Maria F.1234ORCID,Humphries Romney5ORCID,Lipuma John J.6,Mathers Amy J.78,Rao Gauri G.9,Shelburne Samuel A.101112ORCID,Fouts Derrick E.13,Van Duin David14ORCID,Bonomo Robert A.23151617

Affiliation:

1. Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University , Cleveland, OH, USA

2. Case Western Reserve University-Cleveland VA Medical Center for Antimicrobial Resistance and Epidemiology (Case VA CARES) , Cleveland, OH, USA

3. Research Service, VA Northeast Ohio Healthcare System , Cleveland, OH, USA

4. Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque , Bogotá, Colombia

5. Department of Pathology, Immunology and Microbiology, Vanderbilt University Medical Center , Nashville, TN, USA

6. University of Michigan Medical School, Pediatric Infectious Disease , Ann Arbor, MI, USA

7. Division of Infectious Disease and International Health, Department of Medicine, University of Virginia Health System , Charlottesville, VA, USA

8. Clinical Microbiology Laboratory, Department of Pathology, University of Virginia Health System , Charlottesville, VA, USA

9. Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill , Chapel Hill, NC, USA

10. Department of Infectious Diseases Infection Control and Employee Health, University of Texas MD Anderson Cancer Center , Houston, TX, USA

11. Department of Genomic Medicine, University of Texas MD Anderson Cancer Center , Houston, TX, USA

12. Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health Science Center McGovern Medical School , Houston, TX, USA

13. Genomic Medicine, The J. Craig Venter Institute , Rockville, MD, USA

14. Department of Medicine, University of North Carolina School of Medicine , Chapel Hill, NC, USA

15. Senior Clinician Scientist Investigator, Veterans Affairs Northeast Ohio Healthcare System , Cleveland, OH, USA

16. Medical Service and Geriatric Research, Education, and Clinical Center (GRECC), Veterans Affairs Northeast Ohio Healthcare System , Cleveland, OH, USA

17. Departments of Medicine, Biochemistry, Pharmacology, Molecular Biology and Microbiology, and Proteomics and Bioinformatics, School of Medicine, Case Western Reserve University , Cleveland, OH, USA

Abstract

Abstract Stenotrophomonas maltophilia is a non-fermenting, Gram-negative bacillus that has emerged as an opportunistic nosocomial pathogen. Its intrinsic multidrug resistance makes treating infections caused by S. maltophilia a great clinical challenge. Clinical management is further complicated by its molecular heterogeneity that is reflected in the uneven distribution of antibiotic resistance and virulence determinants among different strains, the shortcomings of available antimicrobial susceptibility tests and the lack of standardized breakpoints for the handful of antibiotics with in vitro activity against this microorganism. Herein, we provide an update on the most recent literature concerning these issues, emphasizing the impact they have on clinical management of S. maltophilia infections.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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