Cited by 419Infections and bacterial resistanceBacterial biofilms and quorum sensingMycobacterium research and diagnosis

Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options

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Chang, Ya-Ting, Lin, Chun-Yu, Chen, Yen-Hsu, Hsueh, Po-Ren·2015·Frontiers in Microbiology

Abstract

Stenotrophomonas maltophilia is a Gram-negative, biofilm-forming bacterium. Although generally regarded as an organism of low virulence, S. maltophilia is an emerging multi-drug resistant opportunistic pathogen in hospital and community settings, especially among immunocompromised hosts. Risk factors associated with S. maltophilia infection include underlying malignancy, cystic fibrosis, corticosteroid or immunosuppressant therapy, the presence of an indwelling central venous catheter and exposure to broad spectrum antibiotics. In this review, we provide a synthesis of information on current global trends in S. maltophilia pathogenicity as well as updated information on the molecular mechanisms contributing to its resistance to an array of antimicrobial agents. The prevalence of S. maltophilia infection in the general population increased from 0.8-1.4% during 1997-2003 to 1.3-1.68% during 2007-2012. The most important molecular mechanisms contributing to its resistance to antibiotics include β-lactamase production, the expression of Qnr genes, and the presence of class 1 integrons and efflux pumps. Trimethoprim/sulfamethoxazole (TMP/SMX) is the antimicrobial drug of choice. Although a few studies have reported increased resistance to TMP/SMX, the majority of studies worldwide show that S. maltophilia continues to be highly susceptible. Drugs with historically good susceptibility results include ceftazidime, ticarcillin-clavulanate, and fluoroquinolones; however, a number of studies show an alarming trend in resistance to those agents. Tetracyclines such as tigecycline, minocycline, and doxycycline are also effective agents and consistently display good activity against S. maltophilia in various geographic regions and across different time periods. Combination therapies, novel agents, and aerosolized forms of antimicrobial drugs are currently being tested for their ability to treat infections caused by this multi-drug resistant organism.

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Authors
Chang, Y.-T., Lin, C.-Y., Chen, Y.-H., & Hsueh, P.-R.
Affiliations
  • Kaohsiung Medical University (TW)
  • National Yang Ming Chiao Tung University (TW)
  • National Taiwan University (TW)
Corresponding author
  • Chen, Yen-Hsu
  • Hsueh, Po-Ren
Venue
Frontiers in Microbiology
Published
2015-09-02
Volume
6
Pages
893-893
ISSN
1664-302X (ISSN-L)
OpenAlex
W1921056904
Cited by
419
References
191
Citations by year
2026: 29 · 2025: 32 · 2024: 52 · 2023: 50 · 2022: 38 · 2021: 57 · 2020: 51 · 2019: 40 · 2018: 26 · 2017: 29 · 2016: 13
FWCI
2.51
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Frontiers in Microbiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Infections and bacterial resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bacterial biofilms and quorum sensing
  • Health Sciences › Medicine › Epidemiology › Mycobacterium research and diagnosis
Keywords
Stenotrophomonas maltophilia, antimicrobial resistance, multidrug resistance, opportunistic infections, biofilm formation, beta-lactamase, qnr genes, class 1 integron, efflux pumps, trimethoprim-sulfamethoxazole, fluoroquinolone resistance, tetracycline, tigecycline, doxycycline, minocycline, ceftazidime, ticarcillin-clavulanic acid, combination therapy, immunocompromised patients, cystic fibrosis, central venous catheters, emerging pathogens

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