Antibiotic combinations significantly more active than monotherapy in an in vitro infection model of Stenotrophomonas maltophilia

Zelenitsky, Sheryl; Iacovides, Harris; Ariano, Robert E.; Harding, G. K. M.

doi:10.1016/j.diagmicrobio.2004.09.002

Cited by 74 publications

(34 citation statements)

References 20 publications

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“…Four of our patients received ceftazidime alone and three received a combination therapy. In a study by Ze lenitsky et al, antibiotic combinations were significant ly more active than monotherapy in an in vitro pharma codynamic model of S. maltophilia infection, as deter mined by bacterial load reductions at 24 and 48 hours [16]. Interestingly, one of our patients had persistent bacteremia after monotherapy but was effectively cured with a combination of ceftazidime and levofloxacin.…”

Section: Discussionmentioning

confidence: 78%

“…Ceftazidime is a betalactam shown to have reasonable efficacy in some studies, but usually not more than 50% of isolates are susceptible to this agent [11]. Nevertheless, in iso lates that are susceptible to TMP/SMX and show inter mediate susceptibility to ceftazidime, the combination of the two drugs produced a net bacterial killing [16]. The early fluoroquinolones such as ciprofloxacin have shown markedly variable efficacy ranging from 15% to 55%.…”

Section: Discussionmentioning

confidence: 98%

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Cluster of Stenotrophomonas maltophilia endocarditis after prosthetic valve replacement

Müller-Premru¹,

Gabrijelčič

Geršak

et al. 2008

Wien Klin Wochenschr

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Early postoperative prosthetic valve endocarditis due to Stenotrophomonas maltophilia was diagnosed in seven patients (two men) aged from 68 to 84 years (mean age 78.1 years) over a three-year period. All patients had undergone aortic valve replacement. S. maltophilia was isolated from at least two blood cultures per patient. Four patients experienced CNS embolic complications. Three patients died. All patients were treated with ceftazidime, one in combination with amikacin, one with ciprofloxacin and one with levofloxacin. Because a common source of infection in the operating theater was suspected, 24 environmental samples were taken, of which two contained S. maltophilia. Six of the seven clinical isolates from the patients and two isolates from the environment were analyzed using molecular typing by pulsed-field gel electrophoresis (PFGE). The patients' isolates were resistant to gentamicin, ciprofloxacin, trimethoprim/sulfamethoxazole and, except in one case, to amikacin and piperacillin/tazobactam and susceptible to ceftazidime and levofloxacin. In contrast, the environmental isolates were resistant to ceftazidime, showed intermediate susceptibility to ciprofloxacin, and were susceptible to trimethoprim/sulfamethoxazole. PFGE demonstrated indistinguishable or closely related (1-3 band difference) PFGE patterns in isolates from the patients, but a different pattern in the environmental isolates. No common source of infection was found despite intensive investigation. Extensive cleaning and other measures of infection control were carried out and no new cases were recorded in the two year follow-up period.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 98%

Cluster of Stenotrophomonas maltophilia endocarditis after prosthetic valve replacement

Müller-Premru¹,

Gabrijelčič

Geršak

et al. 2008

Wien Klin Wochenschr

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“…Using the checkerboard method, some synergism has been observed between tigecycline and TMP-SMX, and between tigecycline and amikacin, against S. maltophilia (100,349). In vitro pharmacodynamic model results revealed that TMP-SMX in combination with either ciprofloxacin, ceftazidime, or tobramycin demonstrated higher bactericidal efficacy (P Ͻ 0.0001) against S. maltophilia clinical isolates than TMP-SMX alone (379). Synergy testing by Etest revealed that TMP-SMX plus ceftazidime and TMP-SMX plus ticarcillin-clavulanate demonstrated the highest level of synergistic activity against S. maltophilia isolates (133).…”

Section: New Treatment Strategiesmentioning

confidence: 96%

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

2012

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SUMMARY Stenotrophomonas maltophilia is an emerging multidrug-resistant global opportunistic pathogen. The increasing incidence of nosocomial and community-acquired S. maltophilia infections is of particular concern for immunocompromised individuals, as this bacterial pathogen is associated with a significant fatality/case ratio. S. maltophilia is an environmental bacterium found in aqueous habitats, including plant rhizospheres, animals, foods, and water sources. Infections of S. maltophilia can occur in a range of organs and tissues; the organism is commonly found in respiratory tract infections. This review summarizes the current literature and presents S. maltophilia as an organism with various molecular mechanisms used for colonization and infection. S. maltophilia can be recovered from polymicrobial infections, most notably from the respiratory tract of cystic fibrosis patients, as a cocolonizer with Pseudomonas aeruginosa . Recent evidence of cell-cell communication between these pathogens has implications for the development of novel pharmacological therapies. Animal models of S. maltophilia infection have provided useful information about the type of host immune response induced by this opportunistic pathogen. Current and emerging treatments for patients infected with S. maltophilia are discussed.

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“…Apart from this, sensitivity pattern of ceftazidime levofloxacin, and ticarcillin/k-clavulanate also changed from I→R. Above antimicrobials are the newer combination strategy against treatment of S. maltophilia infection [24,25]. These results suggest that biofield treatment possibly made some alterations either in some enzymatic pathways of microorganism or a change at genetic level, which leads to alter the phenotypic features of S. maltophilia like sensitivity pattern and MIC values in biofield treated group.…”

Section: Discussionmentioning

confidence: 68%

An Evaluation of Biofield Treatment on Susceptibility Pattern of Multidrug Resistant Stenotrophomonas maltophilia: An Emerging Global Opportunistic Pathogen

Trivedi¹,

Patil²,

Shettigar³

et al. 2015

Clin Microbiol

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Stenotrophomonas maltophilia (S. maltophilia) is a Gram-negative bacillus, an opportunistic pathogen, particularly among nosocomial infections. Multi-drug resistant strains are associated with very high rate of morbidity and mortality in severely immunocompromised patients. Present study was designed to evaluate the effect of biofield treatment against multidrug resistant S. maltophilia. Clinical sample of S. maltophilia was collected and divided into two groups i.e. control and biofield treated which were analyzed after 10 days with respect to control. The following parameters viz. susceptibility pattern, minimum inhibitory concentration (MIC), biochemical studies and biotype number of both control and treated samples were measured by MicroScan Walk-Away ® system. The results showed an overall change of 37.5% in susceptibility pattern and 39.4% in biochemical study while 33.3% changes in MIC values of tested antimicrobials after biofield treatment. Further, the treated group of S. maltophilia has also shown a significant change in biochemical reactions followed by its biotype number as compared to control group. Biochemical reactions of treated group showed negative reaction to acetamide and positive reactions to colistin, glucose, adonitol, melibiose, arabinose, nitrate, oxidation-fermentation, raffinose, rhaminose, sorbitol, sucrose, and Voges-Proskauer as compared with control. The biofield treatment showed an alteration in MIC values of amikacin, amoxicillin/K-clavulanate, chloramphenicol, gatifloxacin, levofloxacin, moxifloxacin, ceftazidime, cefotetan, ticarcillin/K-clavulanate, trimethoprim/sulfamethoxazole. Altogether, data suggest that biofield treatment has significant effect to alter the sensitivity pattern of antimicrobials and biotype number against multidrug resistant strain of S. maltophilia.

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Antibiotic combinations significantly more active than monotherapy in an in vitro infection model of Stenotrophomonas maltophilia

Cited by 74 publications

References 20 publications

Cluster of Stenotrophomonas maltophilia endocarditis after prosthetic valve replacement

Cluster of Stenotrophomonas maltophilia endocarditis after prosthetic valve replacement

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

An Evaluation of Biofield Treatment on Susceptibility Pattern of Multidrug Resistant Stenotrophomonas maltophilia: An Emerging Global Opportunistic Pathogen

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