Optimizing Therapy for Stenotrophomonas maltophilia

Robert R. Muder

doi:10.1055/s-2007-996414

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2007; 28(6): 672-677
DOI: 10.1055/s-2007-996414

Published by Thieme Medical Publishers

Optimizing Therapy for Stenotrophomonas maltophilia

Robert R. Muder¹ ^, ²

¹Infectious Disease Section, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
²Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

Abstract

ABSTRACT

Stenotrophomonas (Xanthomonas) maltophilia is a nonfermentative, gram-negative bacillus that is widely distributed in natural and humanmade environments. In the nonhospital setting it is an uncommon pathogen, typically causing soft tissue infection of contaminated wounds. In the hospital setting, particularly among critical care and oncology patients, S. maltophilia may cause catheter-related bacteremia, pneumonia, soft tissue infection, meningitis, prosthetic valve endocarditis, and ocular infections. S. maltophilia is usually resistant to multiple antimicrobials, including expanded-spectrum penicillins, third-generation cephalosporins, carbapenems, aminoglycosides, and quinolones. Trimethoprim-sulfamethoxazole is the antimicrobial agent of choice for this pathogen but is bacteriostatic. Further, resistance to this agent is increasing. Certain combinations of antibiotics are synergistic and may be appropriate for patients harboring resistant organisms or with life-threatening infections.

KEYWORDS

Stenotrophomonas (Xanthomonas) maltophilia - nosocomial infections - antimicrobial resistance

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Referenzen

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Robert R MuderM.D.

Infectious Disease Section 111E-U, VA Pittsburgh Healthcare System

University Drive C, Pittsburgh, PA 15240

eMail: Robert.muder@va.gov