Abstract
Stenotrophomonas maltophilia is an environmental bacterium found in the soil, associated with plants and animals, and in aquatic environments. It is also an opportunistic pathogen now causing an increasing number of nosocomial infections. The treatment of S. maltophilia is quite difficult given its intrinsic resistance to a number of antibiotics, and because it is able to acquire new resistances via horizontal gene transfer and mutations. Certainly, strains resistant to quinolones, cotrimoxale and/or cephalosporins—antibiotics commonly used to treat S. maltophilia infections—have emerged. The increasing number of available S. maltophilia genomes has allowed the identification and annotation of a large number of antimicrobial resistance genes. Most encode inactivating enzymes and efflux pumps, but information on their role in intrinsic and acquired resistance is limited. Non-typical antibiotic resistance mechanisms that also form part of the intrinsic resistome have been identified via mutant library screening. These include non-typical antibiotic resistance genes, such as bacterial metabolism genes, and non-inheritable resistant phenotypes, such as biofilm formation and persistence. Their relationships with resistance are complex and require further study.
Highlights
Reviewed by: Paras Jain, Albert Einstein College of Medicine, New York, USA Li Xu, Cornell University, USA
The treatment of S. maltophilia is quite difficult given its intrinsic resistance to a number of antibiotics, and because it is able to acquire new resistances via horizontal gene transfer and mutations
Non-typical antibiotic resistance mechanisms that form part of the intrinsic resistome have been identified via mutant library screening
Summary
Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas, Madrid, Spain. Most studies have focused on classical antibiotic resistance genes, such as those coding for efflux pumps or modifying enzymes (intrinsic resistance), and on the appearance during clinical treatment of mutants showing low susceptibility to antibiotics (acquired resistance). Overexpression is associated with low antibiotic susceptibility, and is sometimes related to mutations in regulator genes Such mutations have been identified both in vitro and in vivo (Alonso and Martinez, 2001; Cho et al, 2012; Gould et al, 2013; García-León et al, 2015), supporting the idea that in vitro evolution studies may be able predict mutations appearing in vivo during the treatment of patients. The overexpression of the SmeDEF and SmeVWX efflux pumps is related to mutations
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