Clinical Challenges Treating Infections: an Update

Overview

Journal JAC Antimicrob Resist

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2022 May 9

PMID 35529051

Authors

Maria F Mojica

Romney Humphries

John J LiPuma

Amy J Mathers

Gauri G Rao

Samuel A Shelburne

Derrick E Fouts

David van Duin

Robert A Bonomo

Affiliations

Soon will be listed here.

Abstract

is a non-fermenting, Gram-negative bacillus that has emerged as an opportunistic nosocomial pathogen. Its intrinsic multidrug resistance makes treating infections caused by a great clinical challenge. Clinical management is further complicated by its molecular heterogeneity that is reflected in the uneven distribution of antibiotic resistance and virulence determinants among different strains, the shortcomings of available antimicrobial susceptibility tests and the lack of standardized breakpoints for the handful of antibiotics with activity against this microorganism. Herein, we provide an update on the most recent literature concerning these issues, emphasizing the impact they have on clinical management of infections.

Citing Articles

Cefiderocol for the Treatment of Nosocomial Bloodstream Infections Caused by Stenotrophomonas maltophilia: A Case Series and Literature Review.

Vena A, Mezzogori L, Castaldo N, Corcione S, Pascale R, Giannella M Infect Dis Ther. 2025; .

PMID: 40032812 DOI: 10.1007/s40121-025-01117-2.

Roles of the operon in superoxide tolerance and β-lactam susceptibility of .

Ku R, Lu H, Li L, Yeh T, Lin Y, Yang T Front Cell Infect Microbiol. 2025; 15:1492008.

PMID: 39967789 PMC: 11832516. DOI: 10.3389/fcimb.2025.1492008.

Evidence of dissemination of a -type integrative and conjugative element to , mediating acquisition of and other resistance determinants.

Boncompagni S, Riccobono E, Cusi M, Di Pilato V, Rossolini G Antimicrob Agents Chemother. 2025; 69(2):e0155424.

PMID: 39817763 PMC: 11823659. DOI: 10.1128/aac.01554-24.

Prevalence, Distribution and Antimicrobial Susceptibility of Enterobacteriaceae and Non-Fermenting Gram-Negative Bacilli Isolated From Environmental Samples in a Veterinary Clinical Hospital in Madrid, Spain.

Perez Jimenez J, Penelo Hidalgo S, Baquero Artigao M, Ortiz-Diez G, Ayllon Santiago T Environ Microbiol Rep. 2024; 16(6):e70055.

PMID: 39714783 PMC: 11665279. DOI: 10.1111/1758-2229.70055.

Cytotoxic Effect of Stenotrophomonas maltophilia Isolated from Prostate and Bladder Cancer Patients in Iraq.

Ammar E, Al-Mudallal N, Abbas S Asian Pac J Cancer Prev. 2024; 25(10):3701-3705.

PMID: 39471038 PMC: 11711334. DOI: 10.31557/APJCP.2024.25.10.3701.

References

Adegoke A, Stenstrom T, Okoh A . as an Emerging Ubiquitous Pathogen: Looking Beyond Contemporary Antibiotic Therapy. Front Microbiol. 2017; 8:2276. PMC: 5714879. DOI: 10.3389/fmicb.2017.02276. View

Wang G, Xu N, Yang L, Zheng F, Sai L, Zhou J . Community acquired Stenotrophomonas maltophilia discitis: Diagnosis aided by shotgun metagenomic sequencing. Int J Infect Dis. 2019; 81:1-3. DOI: 10.1016/j.ijid.2019.01.032. View

Avison M, von Heldreich C, Higgins C, Bennett P, Walsh T . A TEM-2beta-lactamase encoded on an active Tn1-like transposon in the genome of a clinical isolate of Stenotrophomonas maltophilia. J Antimicrob Chemother. 2000; 46(6):879-84. DOI: 10.1093/jac/46.6.879. View

Chatterjee S, Sarathi Chakraborty D, Choudhury S, Lahiry S . Cefiderocol: A new Antimicrobial for Complicated Urinary Tract Infection (CUTI) Caused by Carbapenem-resistant Enterobacteriaceae (CRE). Curr Drug Res Rev. 2021; 14(1):20-23. DOI: 10.2174/2589977513666211206100749. View

Masgala A, Galani I, Souli M, Giamarellou H . Discrepancies between various methods in susceptibility testing and epidemiological analysis of Stenotrophomonas maltophilia clinical isolates. Cent Eur J Public Health. 2010; 18(2):119-23. DOI: 10.21101/cejph.a3571. View

Kim E, Kim Y, Ahn J, Jeong S, Ku N, Choi J . Risk factors for mortality in patients with Stenotrophomonas maltophilia bacteremia and clinical impact of quinolone-resistant strains. BMC Infect Dis. 2019; 19(1):754. PMC: 6714101. DOI: 10.1186/s12879-019-4394-4. View

Sumida K, Chong Y, Miyake N, Akahoshi T, Yasuda M, Shimono N . Risk Factors Associated with Stenotrophomonas maltophilia Bacteremia: A Matched Case-Control Study. PLoS One. 2015; 10(7):e0133731. PMC: 4514668. DOI: 10.1371/journal.pone.0133731. View

Huang Y, Hu R, Lin C, Chung T, Yang T . NagZ-dependent and NagZ-independent mechanisms for β-lactamase expression in Stenotrophomonas maltophilia. Antimicrob Agents Chemother. 2012; 56(4):1936-41. PMC: 3318340. DOI: 10.1128/AAC.05645-11. View

Marchac V, Equi A, Le Bihan-Benjamin C, Hodson M, Bush A . Case-control study of Stenotrophomonas maltophilia acquisition in cystic fibrosis patients. Eur Respir J. 2004; 23(1):98-102. DOI: 10.1183/09031936.03.00007203. View

10.

Kalidasan V, Joseph N, Kumar S, Hamat R, Neela V . Iron and Virulence in : All We Know So Far. Front Cell Infect Microbiol. 2018; 8:401. PMC: 6240677. DOI: 10.3389/fcimb.2018.00401. View

11.

Khan A, Arias C, Abbott A, Bard J, Bhatti M, Humphries R . Evaluation of the Vitek 2, Phoenix, and MicroScan for Antimicrobial Susceptibility Testing of Stenotrophomonas maltophilia. J Clin Microbiol. 2021; 59(9):e0065421. PMC: 8373028. DOI: 10.1128/JCM.00654-21. View

12.

Golden A, Adam H, Baxter M, Walkty A, Lagace-Wiens P, Karlowsky J . In Vitro Activity of Cefiderocol, a Novel Siderophore Cephalosporin, against Gram-Negative Bacilli Isolated from Patients in Canadian Intensive Care Units. Diagn Microbiol Infect Dis. 2020; 97(1):115012. DOI: 10.1016/j.diagmicrobio.2020.115012. View

13.

Al Naiemi N, Duim B, Bart A . A CTX-M extended-spectrum beta-lactamase in Pseudomonas aeruginosa and Stenotrophomonas maltophilia. J Med Microbiol. 2006; 55(Pt 11):1607-1608. DOI: 10.1099/jmm.0.46704-0. View

14.

Pathmanathan A, Waterer G . Significance of positive Stenotrophomonas maltophilia culture in acute respiratory tract infection. Eur Respir J. 2005; 25(5):911-4. DOI: 10.1183/09031936.05.00096704. View

15.

Toro M, Rodriguez-Bano J, Herrero M, Rivero A, Corzo J . Clinical epidemiology of Stenotrophomonas maltophilia colonization and infection: a multicenter study. Medicine (Baltimore). 2002; 81(3):228-39. DOI: 10.1097/00005792-200205000-00006. View

16.

Chang L, Chen H, Chang C, Lee T, Wu W . Contribution of integrons, and SmeABC and SmeDEF efflux pumps to multidrug resistance in clinical isolates of Stenotrophomonas maltophilia. J Antimicrob Chemother. 2004; 53(3):518-21. DOI: 10.1093/jac/dkh094. View

17.

Mojica M, Ouellette C, Leber A, Becknell M, Ardura M, Perez F . Successful Treatment of Bloodstream Infection Due to Metallo-β-Lactamase-Producing Stenotrophomonas maltophilia in a Renal Transplant Patient. Antimicrob Agents Chemother. 2016; 60(9):5130-4. PMC: 4997835. DOI: 10.1128/AAC.00264-16. View

18.

Lambert T, Ploy M, Denis F, Courvalin P . Characterization of the chromosomal aac(6')-Iz gene of Stenotrophomonas maltophilia. Antimicrob Agents Chemother. 1999; 43(10):2366-71. PMC: 89484. DOI: 10.1128/AAC.43.10.2366. View

19.

Ko J, Kang C, Cornejo-Juarez P, Yeh K, Wang C, Cho S . Fluoroquinolones versus trimethoprim-sulfamethoxazole for the treatment of Stenotrophomonas maltophilia infections: a systematic review and meta-analysis. Clin Microbiol Infect. 2018; 25(5):546-554. DOI: 10.1016/j.cmi.2018.11.008. View

20.

Baidya A, Kodan P, Fazal F, Tsering S, Menon P, Jorwal P . More than Just a Colonizer!. Indian J Crit Care Med. 2019; 23(9):434-436. PMC: 6775712. DOI: 10.5005/jp-journals-10071-23241. View