Stenotrophomonas maltophilia: Difference between revisions
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Stenotrophomonas maltophilia
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*Therapy should be guided by antimicrobial susceptibility testing |
*Therapy should be guided by antimicrobial susceptibility testing |
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*Antistenotrophomonal antibiotics: |
*Antistenotrophomonal antibiotics: |
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| − | **[[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''}} |
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Revision as of 21:36, 16 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
