Stenotrophomonas maltophilia infection

What causes _Stenotrophomonas maltophilia_ infection?

Stenotrophomonas maltophilia (S. maltophilia ) infections are caused by the S. maltophilia bacteria. These bacteria live in wet environments. In a hospital setting, they are able to survive and multiply in fluids such as mucus of the respiratory system, urine, intravenous (IV) fluids, and irrigation fluids used to clean wounds or body cavities such as the ear canal or bladder. S. maltophilia can also grow in medical devices exposed to these fluids including urinary catheters, IV lines, and breathing machines (ventilators).

Most healthy people do not get S. maltophilia infections even when exposed to the bacteria. However, people who are hospitalized and receiving treatment for other serious medical conditions may be more susceptible to an infection, especially if their immune system is weakened. Factors that increase the risk for S. maltophilia infection include admission to an intensive care unit (ICU), prolonged hospitalization, HIV infection, cancer, cystic fibrosis, neutropenia, recent surgery, serious trauma or injury, being on a breathing machine (ventilator), and previous treatment with broad-spectrum antibiotics (medications that target a wide range of bacteria).

Last updated on 05-01-20

How is _Stenotrophomonas maltophilia_ infection diagnosed?

Stenotrophomonas maltophilia ( S. maltophilia ) infection is usually suspected when there are symptoms of a bacterial infection along with certain risk factors. A small sample of body fluid such as blood, mucus, urine, or abdominal fluid will be cultured to confirm which bacteria is causing the infection. When an infection is suspected, other possible sites of infection including wounds, intravenous (IV) catheters, urinary catheters, and breathing machines should also be tested for the presence of the __ bacteria.

Because S. maltophilia may sometimes grow in parts of the respiratory system or other parts of the body without causing infection (colonization), an infectious disease specialist should be consulted to determine if there is a true infection.

Last updated on 05-01-20

What is the long-term outlook for people with _Stenotrophomonas maltophilia_ infection?

The course of a Stenotrophomonas maltophilia ( S. maltophilia ) infection will depend on many factors including the site of the infection, severity of the infection, response to antibiotics, and presence and severity of other health problems. S. maltophilia infections may be life-threatening, especially for people with severely weakened immune systems.

Last updated on 05-01-20

How might _Stenotrophomonas maltophilia_ infection be treated?

Stenotrophomonas maltophilia ( S. maltophilia ) bacteria are resistant to many antibiotics, so treatment options may be limited. As of 2018, treatment usually begins with trimethoprim- sulfamethoxazole (also called co-trimoxazole, or TMP-SMX), but this may vary due to the antibiotic resistance of the particular strain causing the infection and/or new antibiotics being developed. Potential alternatives for people unable to tolerate TMP-SMX include a class of antibiotics called fluoroquinolones, in particular, levofloxacin. Minocycline and tigecycline have also been shown to be effective in small retrospective studies. Combination therapy (using more than one antibiotic) may be necessary in life- threatening cases. However, data regarding the benefit of combination therapy are currently limited, so its role remains uncertain.

The duration of therapy often depends on the site of infection. A longer duration of therapy may be necessary for people with a weakened immune system. Consultation with an infectious disease specialist is important to develop an individualized treatment plan.

More detailed information about medications used to treat S. maltophilia infection is available from Medscape Reference.

Last updated on 05-01-20

Selected Full-Text Journal Articles

Stenotrophomonas maltophilia infection - articles

Brooke JS. Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen. Clin Microbiol Rev. January, 2012; 25(1):2-41.

Last updated on 04-27-20

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