Stenotrophomonas maltophilia treatment

Treatment of Stenotrophomonas maltophilia infections can be difficult, as S. maltophilia is inherently resistant to many classes of antibiotics ¹⁾.

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 ²⁾

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 ³⁾.

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 ⁴⁾.

Antibiotics with in vitro activity against S. maltophilia include trimethoprim-sulfamethoxazole (SXT), fluoroquinolones (FQs), tetracyclines, ticarcillin-clavulanate, and ceftazidime; however, there are limited clinical data on the use of these agents ^{5) 6) 7) 8) 9) 10)}