Limited therapeutic options are available for the treatment of S. maltophilia can be associated with high mortality rates (∼70%), particularly in patients who are critically ill, are receiving broad-spectrum antimicrobial therapy, have hematological malignancies, or have prolonged neutropenia ( 2, 3). Stenotrophomonas maltophilia is a Gram-negative, opportunistic, multidrug-resistant bacterium that can cause severe nosocomial infections in immunocompromised hosts ( 1). maltophilia, with the exception of tests for LEV and CAZ, for which high error rates were observed. Manual commercial tests perform well for S. CIP and TGC, two clinically valuable alternatives to SXT, did not demonstrate promising disk-to-MIC correlates using CLSI document M100-ED30 (Clinical and Laboratory Standards Institute, Performance Standards for Antimicrobial Susceptibility Testing, M100-ED30, 2020) P. Categorical agreement values for SXT, LEV, MIN, and CAZ gradient strips were 98%, 85%, 93%, and 71%, respectively, by Etest (bioMerieux) and 98%, 83%, 99%, and 73% by the MIC test strip (MTS Liofilchem). Categorical agreement values for SXT, LEV, and MIN disk diffusion were 93%, 89%, and 95%, respectively. We assessed performance of disk and gradient diffusion tests relative to BMD for 109 contemporary isolates of S. maltophilia, although generic pharmacokinetic/pharmacodynamic (PK/PD) MIC breakpoints are available for these drugs. Furthermore, interpretive criteria are not available for CIP or TIG for S.
maltophilia is broth microdilution (BMD), but very few clinical laboratories perform reference BMD. The reference standard method for testing S. In this population, levofloxacin (LEV), minocycline (MIN), ceftazidime (CAZ), ciprofloxacin (CIP), and tigecycline (TIG) are used as alternative therapies, all of which require testing to inform susceptibilities. Side effects of SXT include bone marrow suppression, which precludes its use for many neutropenic patients. Despite this, >90% of isolates are susceptible to trimethoprim-sulfamethoxazole (SXT), which is the front-line therapy for this organism. maltophilia infections is complicated by intrinsic resistance to many antimicrobials, including carbapenems, aminoglycosides, and some cephalosporins.
Stenotrophomonas maltophilia is an emerging cause of serious infections with high associated mortality in immunocompromised patients.
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