Epidemiological and physiological characteristics of clinical isolates of Stenotrophomonas maltophilia: 10 years study
DOI:
https://doi.org/10.34019/1982-8047.2019.v45.27338Keywords:
Stenotrophomonas maltophilia, Anti-Bacterial AgenstAbstract
Introduction: Stenotrophomonas maltophilia is an emerging opportunistic pathogen, mainly associated with nosocomial infections. Therapeutic options for the treatment of S. maltophilia infections are limited because of their resistance to a wide variety of antibiotics. Objective: To investigate the prevalence and antibiotic resistance of isolates identified as S. maltophilia from hospitalized patients recovered from a clinical laboratory located in Juiz de Fora - Minas Gerais, as well as to analyze epidemiological data of these patients. Materials and Methods: Consecutive, non duplicate isolates of S. maltophilia (n=58) for the 10-year period were analyzed. All samples were identified using the automated Vitek 2® Compact system (BioMérieux/France). Antibiotic resistance standards were performed using the disk diffusion method. Patient records were evaluated and data such as age, gender, clinical specimen, and in-hospital death rate attributed to S. maltophilia infection were also analyzed. Results: From a total of 39,547 (100%) clinical specimens analyzed, 58 (0,14%) unreplicated isolates were identified as S. maltophilia. 70,6% of S. maltophilia isolates were isolated from tracheal secretion and 15,5% from blood. All samples were sensitive in vitro to the antibiotics tested. In-hospital death frequency associated with S. maltophilia infection was 44,7%. Individuals from a wide age range (0-100 years) were affected by S. maltophilia infection, with females being the most prevalent (56,9%). Conclusion: Pneumonia and Bacteremia were the most frequent clinical syndromes caused by S. maltophila. A moderate mortality rate associated with S. maltophila infections was observed, despite the high sensitivity in vitro to the antibiotics tested. New studies are necessary in order to generate data and information that may be useful in early diagnosis, management and correct treatment of infections associated with S. maltophila, especially those with a profile of antibiotic resistance.
Downloads
References
Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogens. Clin Microbiol Rev. 2012; 25(1):2-41. doi: 10.1128/CMR.00019-11.
Anđelković MV, Janković SM, Kostić MJ, Živković Zarić RS, Opančina VD, Živić MŽ et al. Antimicrobial treatment of Stenotrophomonas maltophilia invasive infections: systematic review. J Chemoter. 2019; 31(6):297-306. doi: 10.1080/1120009X.2019.1620405. Epub 2019 May 25.
Osawa K, Shigemura K, Kitagawa K, Tokimatsu I, Fujisawa M. Risk factors for death from Stenotrophomonas maltophilia bacteremia. J Infect Chemother. 2018; 24(8):632-6. doi: 10.1016/j.jiac.2018.03.011. Epub 2018 Apr 16.
Lipuma JJ, Currie BJ, Peacock SJ, Vandamme PAR. Burkholderia, Stenotrophomonas, Ralstonia, Cupriavidus, Pandoraea, Brevundimonas, Comamonas, Delftia, and Acidovorax. In: Jorgensen JH. Manual of clinical microbiology. 11. ed. Washington: ASM Press; 2015.p. 791-812. (vol. 1)
Ebara H, Hagiya H, Haruki Y, Kondo E,Otsuka F. Clinical characteristics of Stenotrophomonas maltophilia bacteremia: a regional report and a review of a Japanese case series. Intern Med. 2017; 56(2):137-42. doi: 10.2169/internalmedicine.56.6141
Cho SY, Kang CL, Kim J, Ha YE, Chung DR, Lee NY et al. Can levofloxacin be a useful alternative to trimethoprim-sulfamethoxazole for treating Stenotrophomonas maltophilia bacteremia? Antimicrob Agents Chemother. 2014; 58(1):581-3. doi: 10.1128/AAC.01682-13. Epub 2013 Oct 14.
Wang YL, Scipione MR, Dubrovskaya Y, Papadopoulos J. Monotherapy with fluoroquinolone or trimethoprim-sulfamethoxazole for treatment of Stenotrophomonas maltophilia infections. Antimicrob Agents Chemother. 2014;5 8(1):176-82. doi: 10.1128/AAC.01324-13. Epub 2013 Oct 21.
Jeon YD, Jeong WY, Kim MH, Jung IY, Ahn MY, Ann HW et al. Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia. Medicine. 2016; 95(31):e4375. doi: 10.1097/MD.0000000000004375.
Agência Nacional de Vigilância Sanitária(BR). Manual de microbiologia clínica para o controle de infecção em serviços de saúde. Salvador: Edição Comemorativa para o IX Congresso Brasileiro de Controle de Infecção e Epidemiologia Hospitalar; 2004.
Performance Standards for Antimicrobial Susceptibility Testing. Seventeenth informational supplement, M100-S17. Wayne: Clinical and Laboratory Standards Institute; 2007.
Performance Standards for Antimicrobial Susceptibility Testing. Eighteenth informational supplement, M100-S18. Wayne: Clinical and Laboratory Standards Institute; 2008.
Performance Standards for Antimicrobial Susceptibility Testing. Nineteenth informational supplement, M100-S19. Wayne: Clinical and Laboratory Standards Institute; 2009.
Performance Standards for Antimicrobial Susceptibility Testing. Twenty informational supplement, M100-S20. Wayne: Clinical and Laboratory Standards Institute; 2010.
Performance Standards for Antimicrobial Susceptibility Testing. Twenty-first informational supplement, M100-S21. Wayne: Clinical and Laboratory Standards Institute; 2011.
Performance Standards for Antimicrobial Susceptibility Testing. Twenty-second informational supplement, M100-S22. Wayne: Clinical and Laboratory Standards Institute; 2012.
Performance Standards for Antimicrobial Susceptibility Testing. Twenty-third informational supplement, M100-S23. Wayne: Clinical and Laboratory Standards Institute; 2013.
Performance Standards for Antimicrobial Susceptibility Testing. Twenty-fourth informational supplement, M100-S24. Wayne: Clinical and Laboratory Standards Institute; 2014.
Performance Standards for Antimicrobial Susceptibility Testing. Twenty-fiveth informational supplement, M100-S25. Wayne: Clinical and Laboratory Standards Institute; 2015.
Performance Standards for Antimicrobial Susceptibility Testing. Twenty-sixth informational supplement, M100-S26. Wayne: Clinical and Laboratory Standards Institute; 2016.
Biočanin M, Madi H, Vasiljević Z, Kojić M, Jovčić B, Lozo J. Temperature, pH and Trimethoprim-Sulfamethoxazole are potent inhibitors of biofilm formation by Stenotrophomonas maltophilia clinical isolates. Pol J Microbiol. 2017;66(4):433-8. doi: 10.5604/01.3001.0010.6996.
Cikman A, Parlak M, Bayram Y, Güdücüoğlu H, Berktaş M. Antibiotics resistance of Stenotrophomonas maltophilia strains isolated from various clinical specimens. Afr Health Sci. 2016; 16(1):149-52. doi: 10.4314/ahs.v16i1.20.
Dias VC, Diniz CG, Peter AC, Bastos AN, Bastos VQ, Bastos LQ et al. Epidemiological characteristics and antimicrobial susceptibility among carbapenem-resistant non-fermenting bacteria in Brazil. J Infect Dev Ctries. 2016; 10(6):544-53. doi: 10.3855/jidc.6640.
Juhász E, Krizsán G, Lengyel G, Grósz G, Pongrácz J, Kristóf K. Infection and colonization by Stenotrophomonas maltophilia: antimicrobial susceptibility and clinical background of strains isolated at a tertiary care centre in Hungary. Ann Clin Microbiol Antimicrob. 2014; 13:333. doi: 10.1186/s12941-014-0058-9.
Jia W, Wang J, Xu H, Li G. Resistance of Stenotrophomonas maltophilia to fluoroquinolones: prevalence in a university hospital and possible mechanisms. Int J Environ Res Public Health. 2015; 12(5):5177-95. doi: 10.3390/ijerph120505177.
Hankiewicz-Ziołkowska K, Mikucka A, Gospodarek E. Clinical strains isolation and antibiotic susceptibility of Stenotrophomonas maltophilia. Med Dosw Mikrobiol.2010;62(2):127-34.
Díez-Aguilar M, Ekkelenkamp M, Morosini MI, Merino I, de Dios Caballero J, Jones M et al. Antimicrobial susceptibility of non-fermenting Gram-negative pathogens isolated from cystic fibrosis patients. Int J Antimicrob Agents. 2019; 53(1):84-8. doi: 10.1016/j.ijantimicag.2018.09.001. Epub 2018 Sep 19.
Türk DH, Arslan U, Tuncer İ. Kan kültürlerinden izole edilen Stenotrophomonas maltophilia suşlarının antibiyotik direnci. ANKEM Derg 2011; 25(1):27-30 doi:10.5222/ankem.2011.27
Hu LF, Chen GS, Kong QX, Gao LP, Chen X, Ye Y et al. Increase in the prevalence of resistance determinants to trimetroprim/sulfamethoxazole in clinical Stenotrophomonas maltophilia isolates in China. PLoS One.2016; 11(6):e0157693. doi: 10.1371/journal.pone.0157693. eCollection 2016.
Sanchez MB. Antibiotic resistance in the opportunistic pathogen Stenotrophomonas maltophilia. Front Microbiol.2015; 6:658. doi: 10.3389/fmicb.2015.00658. eCollection 2015.
Nicodemo AC, Paez JI. Antimicrobial therapy for Stenotrophomonas maltophilia infections. Eur J Clin Microbiol Infect Dis. 2007;26(4):229-37.
Falagas ME, Kastoris AC, Vouloumanou EK, Rafailidis PI, Kapaskelis AM, Dimopoulos G.Attributable mortality of Stenotrophomonas maltophilia infections: a systematic review of the literature. Future Microbiol.2009; 4(9):1103-9. doi: 10.2217/fmb.09.84.
Downloads
Published
How to Cite
Issue
Section
License
Cessão de Primeira Publicação à HU Revista
Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.
