View source for Stenotrophomonas maltophilia

==Background==

===Microbiology===

*Aerobic, non-fermentive, catalase [[Catalase::positive]], oxidase [[Oxidase::negative]], [[Stain::Gram-negative]] [[Shape::bacillus]]
*Multiple mechanisms of resistance
**RND, MfsA, and Sme-related efflux pumps
**''Sul'' or ''dfrA'' genes (TMP-SMX resistance)
**β-lactamases
**Aminoglycoside-modifying enzymes

==Clinical Manifestations==

*Nosocomial infections with high mortality and high antibiotic resistance

==Management==

*Limited antibiotic options
*Therapy should be guided by antimicrobial susceptibility testing
*Antistenotrophomonal antibiotics:
**[[Is treated by::TMP-SMX]] 15 mg/kg split q8h (preferred agent, if susceptible)
**[[Is treated by::Fluoroquinolones]], including [[Is treated by::moxifloxacin]], [[Is treated by::levofloxacin]], and [[Is treated by::ciprofloxacin]] (though develops resistance quickly on monotherapy)
**[[Is treated by::Minocycline]], [[Is treated by::doxycycline]], and [[Is treated by::tigecycline]]
**[[Is treated by::Ticarcillin-clavulanate]] and [[Is treated by::ampicillin-sulbactam]]
**[[Is treated by::Ceftazidime]] and [[Is treated by::ceftazidime-avibactam]]
**[[Is treated by::Colistin]], though high rates of resistance
**Possibly [[Is treated by::ceftriaxone]]

{{DISPLAYTITLE:''Stenotrophomonas maltophilia''}}
[[Category:Gram-negative bacilli]]