Stenotrophomonas maltophilia: Difference between revisions

Revision as of 15:14, 15 August 2020

Aerobic, non-fermentive, catalase-positive, oxidase-negative, Gram-negative bacillus
Multiple mechanisms of resistance
- RND, MfsA, and Sme-related efflux pumps
- Sul or dfrA genes (TMP-SMX resistance)
- β-lactamases
- Aminoglycoside-modifying enzymes

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-== Microbiology ==
+== Background ==
+===Microbiology===
-* Aerobic, non-fermentive, Gram negative, catalase positive, oxidase negative
+*Aerobic, non-fermentive, [[Catalase test::catalase-positive]], [[Oxidase test::oxidase-negative]], [[Stain::Gram-negative]] [[Cellular shape::bacillus]]
-== Clinical Manifestations ==
+*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
+*Nosocomial infections with high mortality and high antibiotic resistance
-== Management ==
+==Management==
-* Limited antibiotic options:
-** [[Levofloxacin]] (and other FQs)
+*Limited antibiotic options
-** [[TMP-SMX]] (Septra)
+*Therapy should be guided by antimicrobial susceptibility testing
-** [[Doxycycline]]
+*Antistenotrophomonal antibiotics:
-** Maybe also ticarcillin-clavulanate and [[ceftazidime]]
+**[[TMP-SMX]] (preferred agent, if susceptible)
+**[[Fluoroquinolones]], including [[moxifloxacin]], [[levofloxacin]], and [[ciprofloxacin]] (though develops resistance quickly on monotherapy)
+**[[Minocycline]], [[doxycycline]], and [[tigecycline]]
+**[[Ticarcillin-clavulanate]] and [[ampicillin-sulbactam]]
+**[[ceftazidime]] and [[ceftazidime-avibactam]]
+**Possibly [[ceftriaxone]]
 {{DISPLAYTITLE:''Stenotrophomonas maltophilia''}}