Clinical challenges treating Stenotrophomonas maltophilia infections: an update

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

doi:10.1093/jacamr/dlac040

Clinical challenges treating Stenotrophomonas maltophilia infections: an update

JAC Antimicrob Resist. 2022 May 5;4(3):dlac040. doi: 10.1093/jacamr/dlac040. eCollection 2022 Jun.

Authors

Maria F Mojica^{1

2

3

4}, Romney Humphries⁵, John J Lipuma⁶, Amy J Mathers^{7

8}, Gauri G Rao⁹, Samuel A Shelburne^{10

11

12}, Derrick E Fouts¹³, David Van Duin¹⁴, Robert A Bonomo^{2

3

15

16

17}

Affiliations

¹ Department of Molecular Biology and Microbiology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
² Case Western Reserve University-Cleveland VA Medical Center for Antimicrobial Resistance and Epidemiology (Case VA CARES), Cleveland, OH, USA.
³ Research Service, VA Northeast Ohio Healthcare System, Cleveland, OH, USA.
⁴ Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque, Bogotá, Colombia.
⁵ Department of Pathology, Immunology and Microbiology, Vanderbilt University Medical Center, Nashville, TN, USA.
⁶ University of Michigan Medical School, Pediatric Infectious Disease, Ann Arbor, MI, USA.
⁷ Division of Infectious Disease and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA.
⁸ Clinical Microbiology Laboratory, Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA.
⁹ Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹⁰ Department of Infectious Diseases Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
¹¹ Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
¹² Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health Science Center McGovern Medical School, Houston, TX, USA.
¹³ Genomic Medicine, The J. Craig Venter Institute, Rockville, MD, USA.
¹⁴ Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
¹⁵ Senior Clinician Scientist Investigator, Veterans Affairs Northeast Ohio Healthcare System, Cleveland, OH, USA.
¹⁶ Medical Service and Geriatric Research, Education, and Clinical Center (GRECC), Veterans Affairs Northeast Ohio Healthcare System, Cleveland, OH, USA.
¹⁷ Departments of Medicine, Biochemistry, Pharmacology, Molecular Biology and Microbiology, and Proteomics and Bioinformatics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.

Abstract

Stenotrophomonas maltophilia is a non-fermenting, Gram-negative bacillus that has emerged as an opportunistic nosocomial pathogen. Its intrinsic multidrug resistance makes treating infections caused by S. maltophilia 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 in vitro 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 S. maltophilia infections.

Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy 2022.

Publication types

Review