Stenotrophomonas maltophilia treatment [Neurosurgery Wiki]

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====== Stenotrophomonas maltophilia treatment ======

[[Treatment]] of [[Stenotrophomonas maltophilia]] [[infection]]s can be difficult, as S. maltophilia is inherently resistant to many classes of [[antibiotic]]s
((Varshini MK, Ganesan V, Sundaramurthy R, Rajendran T. Risk Factors and Clinical Outcomes of Stenotrophomonas maltophilia Infections: Scenario in a Tertiary Care Center from South India. Indian J Crit Care Med. 2022 Aug;26(8):935-937. doi: 10.5005/jp-journals-10071-24288. PMID: 36042762; PMCID: PMC9363814.)).
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A bacterial strain of the Gram-negative opportunistic pathogen Stenotrophomonas maltophilia capable of degrading [[colistin]] and exhibiting a high-level colistin resistance was isolated from the soil environment. A colistin-degrading protease (Cdp) was identified in this strain, and its contribution to colistin resistance was demonstrated by growth inhibition experiments using knock-out (Δcdp) and complemented (Δcdp::cdp) mutants
((Lee DH, Cha JH, Kim DW, Lee K, Kim YS, Oh HY, Cho YH, Cha CJ. Colistin-degrading proteases confer collective resistance to microbial communities during polymicrobial infections. Microbiome. 2022 Aug 19;10(1):129. doi: 10.1186/s40168-022-01315-x. PMID: 35982474; PMCID: PMC9389796.))
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Stenotrophomonas maltophilia is an urgent global threat due to its increasing incidence and intrinsic antibiotic resistance. Antibiotic development has focused on carbapenem-resistant Enterobacteriaceae, Pseudomonas, and Acinetobacter, with approved antibiotics in recent years having limited activity for Stenotrophomonas. Accordingly, novel treatment strategies for Stenotrophomonas are desperately needed
((Gibb J, Wong DW. Antimicrobial Treatment Strategies for Stenotrophomonas maltophilia: A Focus on Novel Therapies. Antibiotics (Basel). 2021 Oct 9;10(10):1226. doi: 10.3390/antibiotics10101226. PMID: 34680807; PMCID: PMC8532924.)).

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[[Fluoroquinolone]] and  trimethoprim-sulfamethoxazole (SXT) monotherapies may be equally effective for the treatment of S. maltophilia infections. Resistance was documented in subsequent isolates of S. maltophilia in both groups
((Wang YL, Scipione MR, Dubrovskaya Y, Papadopoulos J. Monotherapy with fluoroquinolone or trimethoprim-sulfamethoxazole for treatment of Stenotrophomonas maltophilia infections. Antimicrob Agents Chemother. 2014;58(1):176-82. doi: 10.1128/AAC.01324-13. Epub 2013 Oct 21. PMID: 24145530; PMCID: PMC3910778.)).
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Antibiotics with in vitro activity against S. maltophilia include [[trimethoprim]]-[[sulfamethoxazole]] (SXT), [[fluoroquinolone]]s (FQs), [[tetracycline]]s, ticarcillin-clavulanate, and [[ceftazidime]]; however, there are limited clinical data on the use of these agents
((Falagas ME, Valkimadi PE, Huang YT, Matthaiou DK, Hsueh PR. 2008. Therapeutic options for Stenotrophomonas maltophilia infections beyond co-trimoxazole: a systematic review. J. Antimicrob. Chemother. 62:889–894. 10.1093/jac/dkn301))
((Czosnowski QA, Wood GC, Magnotti LJ, Croce MA, Swanson JM, Boucher BA, Fabian TC. 2011. Clinical and microbiologic outcomes in trauma patients treated for Stenotrophomonas maltophilia ventilator-associated pneumonia. Pharmacotherapy 31:338–345. 10.1592/phco.31.4.338))
((Samonis G, Karageorgopoulos DE, Maraki S, Levis P, Dimopoulou D, Spernovasilis NA, Kofteridis DP, Falagas ME. 2012. Stenotrophomonas maltophilia infections in a general hospital: patient characteristics, antimicrobial susceptibility, and treatment outcome. PLoS One 7:e37375. 10.1371/journal.pone.0037375))
((Wang WS, Liu CP, Lee CM, Huang FY. 2004. Stenotrophomonas maltophilia bacteremia in adults: four years' experience in a medical center in northern Taiwan. J. Microbiol. Immunol. Infect. 37:359–365))
((Muder RR, Harris AP, Muller S, Edmond M, Chow JW, Papadakis K, Wagerner MW, Bodey GP, Steckelberg JM. 1996. Bacteremia due to Stenotrophomonas (Xanthomonas) maltophilia: a prospective, multicenter study of 91 episodes. Clin. Infect. Dis. 22:508–512. 10.1093/clinids/22.3.508 ))
((Belvisi V, Fabietti P, Del Borgo C, Marocco R, Di Vincenzo E, Soscia F, Mastroianni CM. 2009. Successful treatment of Stenotrophomonas maltophilia soft tissue infection with tigecycline: a case report. J. Chemother. 21:367–368))