Stenotrophomonas maltophilia: Difference between revisions
From IDWiki
Stenotrophomonas maltophilia
m (→) |
(→) |
||
| Line 19: | Line 19: | ||
*Therapy should be guided by antimicrobial susceptibility testing |
*Therapy should be guided by antimicrobial susceptibility testing |
||
*Antistenotrophomonal antibiotics: |
*Antistenotrophomonal antibiotics: |
||
**[[TMP-SMX]] (preferred agent, if susceptible) |
**[[Is treated by::TMP-SMX]] (preferred agent, if susceptible) |
||
**[[Fluoroquinolones]], including [[moxifloxacin]], [[levofloxacin]], and [[ciprofloxacin]] (though develops resistance quickly on monotherapy) |
**[[Is treated by::Fluoroquinolones]], including [[Is treated by::moxifloxacin]], [[Is treated by::levofloxacin]], and [[Is treated by::ciprofloxacin]] (though develops resistance quickly on monotherapy) |
||
**[[Minocycline]], [[doxycycline]], and [[tigecycline]] |
**[[Is treated by::Minocycline]], [[Is treated by::doxycycline]], and [[Is treated by::tigecycline]] |
||
**[[Ticarcillin-clavulanate]] and [[ampicillin-sulbactam]] |
**[[Is treated by::Ticarcillin-clavulanate]] and [[Is treated by::ampicillin-sulbactam]] |
||
**[[ |
**[[Is treated by::Ceftazidime]] and [[Is treated by::ceftazidime-avibactam]] |
||
**Possibly [[ceftriaxone]] |
**Possibly [[Is treated by::ceftriaxone]] |
||
{{DISPLAYTITLE:''Stenotrophomonas maltophilia''}} |
{{DISPLAYTITLE:''Stenotrophomonas maltophilia''}} |
||
Revision as of 01:36, 17 August 2020
Background
Microbiology
- 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
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:
- 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
