From the Guidelines
Stenotrophomonas (S. maltophilia) is a type of gram-negative bacterium that is often associated with multidrug resistance and can cause infections in hospitalized patients, particularly those with compromised immune systems or underlying medical conditions.
Key Characteristics of S. maltophilia
- Gram-negative bacterium: S. maltophilia is a type of gram-negative bacterium that can cause infections in humans 1.
- Multidrug resistance: S. maltophilia is often resistant to multiple antibiotics, making treatment challenging 1.
- Opportunistic pathogen: S. maltophilia is an opportunistic pathogen that can cause infections in people with compromised immune systems or underlying medical conditions 1.
Infection Control Measures
- Hand hygiene: Hand hygiene is essential in preventing the transmission of S. maltophilia, and healthcare workers should perform hand hygiene with an alcohol-based hand rub before and after patient contact 1.
- Contact precautions: Contact precautions, such as wearing gloves and gowns, should be implemented for patients colonized or infected with S. maltophilia to reduce the risk of transmission 1.
- Environmental cleaning: Environmental cleaning and disinfection are crucial in reducing the transmission of S. maltophilia, and protocols should be implemented to ensure consistent cleaning and disinfection of surfaces and equipment 1.
Treatment
- Antimicrobial therapy: Antimicrobial therapy, such as trimethoprim/sulfamethoxazole (TMP/SMX), may be effective in treating S. maltophilia infections, but treatment should be guided by susceptibility testing and clinical judgment 1.
From the Research
Characteristics of Stenotrophomonas maltophilia
- Stenotrophomonas maltophilia is a Gram-negative, biofilm-forming bacterium 2
- It is a cosmopolitan and ubiquitous bacterium found in a range of environmental habitats, including extreme ones 3
- S. maltophilia is an emerging multi-drug resistant opportunistic pathogen in hospital and community settings, especially among immunocompromised hosts 2, 4
Pathogenicity and Infections
- S. maltophilia is associated with high morbidity and mortality in severely immunocompromised and debilitated individuals 3
- It can cause a wide range of nosocomial infections, including respiratory and urinary tract infections 4
- S. maltophilia is also implicated in necrotizing otitis, cutaneous infections, endocarditis, meningitis, and septic arthritis 5
Virulence Factors and Antibiotic Resistance
- S. maltophilia has numerous virulence factors, including extracellular enzymes, bacterial motility, and biofilm formation 6
- The bacterium has intrinsic antimicrobial resistance and can acquire resistance to multiple antimicrobial agents 6
- The low outer membrane permeability and the presence of multidrug-resistance efflux systems make it challenging to control 4
Treatment and Therapeutic Options
- Trimethoprim/sulfamethoxazole (TMP/SMX) is the antimicrobial drug of choice for treating S. maltophilia infections 2
- Tetracycline derivatives, fluoroquinolones, and combination therapies are also considered effective against S. maltophilia 5, 4
- However, the emergence of antibiotic-resistant strains and the limitations of current therapeutic options highlight the need for new strategies to control S. maltophilia infections 6