Stenotrophomonas maltophilia: Difference between revisions
From IDWiki
Stenotrophomonas maltophilia
(→) |
(→) |
||
| Line 24: | Line 24: | ||
**[[Is treated by::Ticarcillin-clavulanate]] and [[Is treated by::ampicillin-sulbactam]] |
**[[Is treated by::Ticarcillin-clavulanate]] and [[Is treated by::ampicillin-sulbactam]] |
||
**[[Is treated by::Ceftazidime]] and [[Is treated by::ceftazidime-avibactam]] |
**[[Is treated by::Ceftazidime]] and [[Is treated by::ceftazidime-avibactam]] |
||
| + | **[[Is treated by::Colistin]] |
||
**Possibly [[Is treated by::ceftriaxone]] |
**Possibly [[Is treated by::ceftriaxone]] |
||
Revision as of 21:38, 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
- Colistin
- Possibly ceftriaxone
