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European Journal of Clinical Microbiology & Infectious Diseases
Published in: European Journal of Clinical Microbiology & Infectious Diseases 4/2007

01-04-2007 | Review

Antimicrobial therapy for Stenotrophomonas maltophilia infections

Authors: A. C. Nicodemo, J. I. Garcia Paez

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 4/2007

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Abstract

Stenotrophomonas maltophilia has emerged as an important nosocomial pathogen capable of causing respiratory, bloodstream, and urinary infections. The treatment of nosocomial infections by S. maltophilia is difficult, as this pathogen shows high levels of intrinsic or acquired resistance to different antimicrobial agents, drastically reducing the antibiotic options available for treatment. Intrinsic resistance may be due to reduced outer membrane permeability or to the multidrug efflux pumps. However, specific mechanisms of resistance such as aminoglycoside-modifying enzymes or the heterogeneous production of metallo-β-lactamase have contributed to the multidrug-resistant phenotype displayed by this pathogen. Moreover, the lack of standardized susceptibility tests and their interpretative criteria hinder the choice of an adequate antibiotic treatment. Recommendations for the treatment of infections by S. maltophilia are based on in vitro studies, certain nonrandomized clinical trials, and anecdotal experience. Trimethoprim-sulfamethoxazole remains the drug of choice, although in vitro studies indicate that ticarcillin-clavulanic acid, minocycline, some of the new fluoroquinolones, and tigecycline may be useful agents. This review describes the main resistance mechanisms, the in vitro susceptibility profile, and treatment options for S. maltophilia infections.
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Metadata
Title
Antimicrobial therapy for Stenotrophomonas maltophilia infections
Authors
A. C. Nicodemo
J. I. Garcia Paez
Publication date
01-04-2007
Publisher
Springer-Verlag
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 4/2007
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-007-0279-3

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