Clinical challenges treating<i>Stenotrophomonas maltophilia</i>infections: an update

Mojica, María F; Humphries, Romney M.; LiPuma, John J.; Mathers, Amy J; Rao, Gauri G.; Shelburne, Samuel A.; Fouts, Derrick E.; Duin, David van; Bonomo, Robert A.

doi:10.1093/jacamr/dlac040

Cited by 72 publications

(84 citation statements)

References 265 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…S. maltophilia is characterized by high resistance to antibiotics, including broad-spectrum β-lactam, aminoglycosides and carbapenem, which is associated with high morbidity and mortality in immunocompromised patients ( 2 , 3 ). Important to mention here that previous therapy with broad-range antibiotics, especially carbapenem has been deemed as a risk factor for S. maltophilia infection ( 4 , 5 ). The attributed mortality rates of S. maltophilia infections in pneumonia range between 25 and 75%, 26 and 28% in case of nosocomial bloodstream infections, and crude mortality rates of S. maltophilia bacteremia range from 21 to 69% ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

Risk factors of lower respiratory tract infection caused by Stenotrophomonas maltophilia: Systematic review and meta-analysis

Wang

Rong

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

ObjectiveTo systematically evaluate the risk factors of lower respiratory tract infection caused by Stenotrophomonas maltophilia for better clinical treatment.MethodsPubMed, Embase, the Cochrane Library, Web of Science, China Journal full-text Database (CNKI), Wanfang Database (WanFang Data), VIP (VIP), and China Biomedical Literature Database (CBM) were selected and published by June 2022 about the risk factors of lower respiratory tract infection of S. maltophilia. Two researchers independently screened the literature, extracted data, and quality evaluation according to the inclusion and exclusion criteria. RevMan 5.4 software was used for meta-analysis.ResultsA total of 18 articles were included, including 10 in English and 8 in Chinese. Meta analysis showed that the risk factors of lower respiratory tract infection caused by S. maltophilia included disease severity, hospitalization days, use of glucocorticoids, invasive procedures, use of broad-spectrum antibiotics and use of more than 3 Antibiotics. The OR values of patients with hospitalization, mechanical ventilation, use of more than 3 Antibiotics, endotracheal intubation and tracheotomy were the highest. Specific hospitalization days (OR = 14.56, 95% CI: 6.12~23.01), mechanical ventilation (OR = 14.16, 95% CI: 5.85~34.3), use of more than 3 Antibiotics (OR = 6.21, 95% CI: 1.24~31.14), tracheal intubation (OR = 6.07, 95% CI: 1.97~3.64), tracheotomy (OR = 3.77, 95% CI: 1.09~13.04).ConclusionThere are many risk factors for lower respiratory tract infection of S. maltophilia, which can occur in patients with severe illness, high APACHE-II score, invasive procedures, and the need for broad-spectrum antibiotics. In terms of the host, these patients are characterized by impaired immune function, severe illness and long-term hospitalization, which objectively leads to the infection of S. maltophilia. Therefore, strengthening the monitoring, prevention and control of patients with risk factors of S. maltophilia infection is conducive to reducing the risk of infection and death.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk factors of lower respiratory tract infection caused by Stenotrophomonas maltophilia: Systematic review and meta-analysis

Wang

Rong

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

show abstract

“… S. maltophilia is an extremely challenging pathogen with very limited treatment options due to its prolific intrinsic resistome ( 26 , 27 ). Although SMX-TMP has traditionally been considered the drug of choice, there are no rigorous clinical data to support its use, and the optimal therapy remains unknown ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Activity of Delafloxacin and Levofloxacin against Stenotrophomonas maltophilia at Simulated Plasma and Intrapulmonary pH Values

et al. 2022

View full text Add to dashboard Cite

Stenotrophomonas maltophilia most often infects the lungs, where the physiologic environment is naturally slightly acidic (pH ~6.6), compared to most parts of the body (such as the bloodstream), which have neutral pH values (~7.4). Pneumonia due to S. maltophilia is often treated with the antibiotic levofloxacin, despite the activity of levofloxacin being known to be impaired at acidic pH.

show abstract

“…In the ubiquitous Gram-negative bacterium Stenotrophomonas maltophilia the main QS system described so far is mediated by the fatty acid signal cis -11-methyl-2-dodecenoic acid, also called DSF (for D iffusible S ignal F actor). S. maltophilia has emerged over the last decades as an opportunistic pathogen, causing nosocomial infections in the immunocompromised population and it is commonly isolated from the lungs of cystic fibrosis patients (6, 7). One of the main concerns about the members of this species is that they tend to be intrinsically resistant to multiple antibiotics, with specific isolates showing evidence of adaptive resistance (8, 9).…”

Section: Introductionmentioning

confidence: 99%

A TetR-like transcriptional regulator in Stenotrophomonas maltophilia involved in fatty acid metabolism is controlled by quorum sensing signals

Coves

Huedo

Bravo

et al. 2022

Preprint

View full text Add to dashboard Cite

Stenotrophomonas maltophilia is an environmental bacterium and it is also an emerging opportunistic multidrug-resistant pathogen. It uses the endogenous DSF quorum sensing (QS) system to coordinate population behaviors and to regulate virulence processes but can also respond to exogenous AHL signals produced by neighboring bacteria. Whole-transcriptome sequencing analyses were performed for S. maltophilia K279a in the exponential and stationary phases as well as in exponential cultures after treatment with exogenous DSF or AHLs. The results revealed that at the beginning of the stationary phase 1673 genes are differentially expressed. COG analysis showed that most of these genes were enriched for energetic metabolism processes and regulation of gene expression. After adding DSF or AHLs, 28 or 82 genes were found deregulated, respectively, 22 of which upregulated by both autoinducers. Interestingly, among these later genes, 14 were also upregulated in the stationary phase. Gene functions regulated by all conditions include lipid and amino acid metabolism, stress response and signal transduction, nitrogen and iron metabolism, and adaptation to microoxic conditions. Among the common top upregulated QS core genes, a putative TetR-like regulator (Smlt2053) was selected for functional characterization. This regulator has been shown to control a narrow regulon, including its own operon. It was found to sense long-chain fatty acids, including the QS signal DSF, and regulate a β-oxidation catabolic pathway. Overall, our findings provide clues on the role that the QS could have in S. maltophilia in the transition from the exponential to the stationary phase and bacterial fitness under high-density growth.

show abstract

Clinical challenges treatingStenotrophomonas maltophiliainfections: an update

Cited by 72 publications

References 265 publications

Risk factors of lower respiratory tract infection caused by Stenotrophomonas maltophilia: Systematic review and meta-analysis

Risk factors of lower respiratory tract infection caused by Stenotrophomonas maltophilia: Systematic review and meta-analysis

Activity of Delafloxacin and Levofloxacin against Stenotrophomonas maltophilia at Simulated Plasma and Intrapulmonary pH Values

A TetR-like transcriptional regulator in Stenotrophomonas maltophilia involved in fatty acid metabolism is controlled by quorum sensing signals

Contact Info

Product

Resources

About