Epidemiological Trends and Resistance Associated with Stenotrophomonas maltophilia Bacteremia: A 10-Year Retrospective Cohort Study in a Tertiary-Care Hospital in Hungary.

Márió Gajdács,Edit Urbán

doi:10.3390/diseases7020041

Abstract

Stenotrophomonas maltophilia has been recognized as an emerging nosocomial pathogen in invasive infections of immunocompromised, severely debilitated patients with significant underlying illnesses. The first-choice drug in these infections is sulfamethoxazole-trimethoprim (SMX/TMP), and resistance to this antimicrobial is a daunting challenge for clinicians. The aim of this study was to assess the prevalence of S. maltophilia bacteremia and SMX/TMP-resistance levels at a tertiary-care university hospital. A total of 175 episodes of S. maltophilia bacteremia were identified (2008–2012: n = 82, 2013–2017: n = 93; p = 0.061), 52% of affected patients were 60 years of age, and had recent surgery, severe injuries or underlying conditions (malignant hematologic diseases and solid tumors) in their history. Sixteen percent of isolates were resistant to SMX/TMP (2008–2012: n = 13.8%, 2013–2017: n = 17.2%; p = 0.076), and out of the resistant strains, 32.7% were also resistant to levofloxacin and colistin. Our findings on the SMX/TMP-resistance were similar to global literature data.

Highlights

Stenotrophomonas maltophilia is a non-fermenting, oxidase-negative and catalase-positive aerobicGram-negative bacillus [1,2]
The aim of this study was to assess and describe the prevalence of bacteremia caused by S. maltophilia at a tertiary-care hospital in Hungary retrospectively, during a 10-year study period (2008–2017), to assess the resistance trends associated with this pathogen and to compare our findings with results of other studies in Hungary and from the international literature
Isolates were considered separate if they occurred more than 14 days apart or S. maltophilia isolates with different antibiotic susceptibilities were detected

Summary

Introduction

Stenotrophomonas maltophilia is a non-fermenting, oxidase-negative and catalase-positive aerobicGram-negative bacillus [1,2]. Owing to the advancements in medical interventions and pharmacological therapies (complex surgeries, cancer chemotherapy, immunosuppression for organ transplantation), in addition to the developments in more sensitive and precise identification methods in clinical microbiology, there have been more reports on S. maltophilia infections. This pathogen has been recognized as an emerging nosocomial pathogen in invasive infections of Diseases 2019, 7, 41; doi:10.3390/diseases7020041 www.mdpi.com/journal/diseases

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