<i><scp>S</scp>tenotrophomonas maltophilia:</i> Rare cause of meningitis

Correia, Cátia; Ferreira, Sara Tavares; Nunes, Paula Santos

doi:10.1111/ped.12352

Cited by 14 publications

(8 citation statements)

References 10 publications

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“…In more recent studies, combinations of TMP/SMX or β-lactam/β-lactam inhibitors with new or old antibiotics such as tigecycline, fluoroquinolones, televancin (Hornsey et al, 2012 ), rifampin (Betts et al, 2014 ), and aerosolized colistin have been investigated; they demonstrated various extents of synergism and the ability to maintain effectivity in biofilm. TMP/SMX plus ceftazidime plus levofloxacin has been shown to be effective in treatment of meningitis (Correia et al, 2014 ) and intrabiliary infusion of colistin plus parenteral fosfomycin with tigecycline was reported to be effective at treating complicated biliary tract infection (Perez et al, 2014 ). Several combinations of novel agents are currently under investigation, including a β-lactam and dual β-lactamase inhibitor combination (Page et al, 2011 ) and MD3 (a novel synthetic inhibitor of peptidases) plus colistin (Personne et al, 2014 ).…”

Section: Antimicrobial Treatment Studiesmentioning

confidence: 99%

Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options

et al. 2015

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Stenotrophomonas maltophilia is a Gram-negative, biofilm-forming bacterium. Although generally regarded as an organism of low virulence, S. maltophilia is an emerging multi-drug resistant opportunistic pathogen in hospital and community settings, especially among immunocompromised hosts. Risk factors associated with S. maltophilia infection include underlying malignancy, cystic fibrosis, corticosteroid or immunosuppressant therapy, the presence of an indwelling central venous catheter and exposure to broad spectrum antibiotics. In this review, we provide a synthesis of information on current global trends in S. maltophilia pathogenicity as well as updated information on the molecular mechanisms contributing to its resistance to an array of antimicrobial agents. The prevalence of S. maltophilia infection in the general population increased from 0.8–1.4% during 1997–2003 to 1.3–1.68% during 2007–2012. The most important molecular mechanisms contributing to its resistance to antibiotics include β-lactamase production, the expression of Qnr genes, and the presence of class 1 integrons and efflux pumps. Trimethoprim/sulfamethoxazole (TMP/SMX) is the antimicrobial drug of choice. Although a few studies have reported increased resistance to TMP/SMX, the majority of studies worldwide show that S. maltophilia continues to be highly susceptible. Drugs with historically good susceptibility results include ceftazidime, ticarcillin-clavulanate, and fluoroquinolones; however, a number of studies show an alarming trend in resistance to those agents. Tetracyclines such as tigecycline, minocycline, and doxycycline are also effective agents and consistently display good activity against S. maltophilia in various geographic regions and across different time periods. Combination therapies, novel agents, and aerosolized forms of antimicrobial drugs are currently being tested for their ability to treat infections caused by this multi-drug resistant organism.

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Section: Antimicrobial Treatment Studiesmentioning

confidence: 99%

Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options

et al. 2015

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“…Yersinia seeligeri) (Barron et al 2003;Berg et al 2005;Correia et al 2014;Mendes et al 2013;Kozak et al 1996;Strydom and Witthuhn 2015), were only found on the agriculturally improved fields, and specifically, one of the rapeseed fields fertilized with digestate from a local anaerobic digester Although we did not specifically set out to identify soil pathogens in our analysis and we did not test for pathogenicity (e.g. by immunofluorescence assay, etc.…”

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confidence: 98%

Conversion of grassland to arable decreases microbial diversity and alters community composition

French

Tkacz

Turnbull

2017

Applied Soil Ecology

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The rapid global conversion of biodiverse landscapes to intensively managed arable fields may decrease microbial diversity and threaten the long-term fertility of native soils. Previous laboratory and experimental studies provide conflicting results: some have recorded declines in overall microbial diversity and certain beneficial microorganisms under intensified cultivation while others report no change (or even increased) diversity. However, few studies have been carried out in actual agricultural fields. We analysed the soil metagenomic communities of 36 current and former grasslands in Oxfordshire, England using Illumina sequencing of the bacterial 16S and fungal ITS1 regions to examine how agricultural intensification alters native microbial communities and whether arable reversion can reverse these processes. We demonstrate that land-use change did not affect bacterial diversity or specific beneficial taxa (nitrogen-fixing bacteria and mycorrhizas). However, fungal diversity declined and certain microbiota known to be plant pathogens (e.g. Olpidium) were significantly more abundant on agriculturally improved fields. On sites where arable reversion took place, microbial communities were similar to those from unimproved grasslands although overall vegetation diversity and fungal richness was lower. The conservation of species-rich grasslands and their associated microbial diversity could therefore be a key resource for sustainable agriculture in the future.

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“…The antibiotic of choice for S. maltophilia is TMP-SMX, which is based on good clinical outcomes and susceptibility profiles reported from previous studies [ 2 , 4 ]. Furthermore, TMP-SMX is the most frequently used antibiotic, both alone or in combination, in previously reported cases of S. maltophilia meningitis [ 1 , 2 , 4 , 9 , 11 - 15 , 18 - 20 ]. Both of our patients were treated with TMP-SMX (in combination with ceftazidime in one patient, and colistin in the other) based on susceptibility data.…”

Section: Discussionmentioning

confidence: 99%

Stenotrophomonas maltophilia Meningitis - A Case Series and Review of the Literature

Khanum¹,

Ilyas²,

Ali³

2020

Cureus

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Stenotrophomonas maltophilia is an infrequent cause of acute bacterial meningitis and only a few cases have been reported in the literature. Infection is associated with morbidity and mortality, and its optimal management remains ill-defined. The aim of the current study is to review the management of S. maltophilia meningitis. We described two cases of S. maltophilia meningitis following neurosurgical procedures. The first patient was a 60-year-old female. She was admitted to the hospital with a left basal ganglia bleed and underwent placement of an external ventricular drain for the treatment of hydrocephalus. She developed S. maltophilia meningitis 20 days after surgery. She was successfully treated with a combination of trimethoprimsulfamethoxazole and intravenous colistin and the removal of the drain. She successfully underwent a ventriculoperitoneal (VP) shunt placement at the therapeutic midway point. The second patient was a 35year-old male with a history of intracranial aneurysm bleeding. He had undergone a craniotomy and placement of a ventriculoperitoneal shunt two years previously. His shunt was replaced twice due to blockage. The last replacement had occurred 15 days prior to the development of meningitis. He was treated with a combination of trimethoprim-sulfamethoxazole and ceftazidime (as well as undergoing another shunt replacement) and experienced an excellent recovery. S. maltophilia is a rare but important cause of nosocomial meningitis. It is strongly associated with prior hospitalization and neurosurgical intervention, which is also found in our case series. The management of S. maltophilia meningitis is a therapeutic challenge due to its high resistance to multiple antibiotics. Optimal therapy is based on antimicrobial sensitivity, and the trimethoprim-sulfamethoxazole-based combination has been shown to be successful. The duration of therapy is debatable, but like most gram-negative meningitis infections, therapy lasting up to three weeks appears to be adequate.

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Stenotrophomonas maltophilia: Rare cause of meningitis

Cited by 14 publications

References 10 publications

Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options

Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options

Conversion of grassland to arable decreases microbial diversity and alters community composition

Stenotrophomonas maltophilia Meningitis - A Case Series and Review of the Literature

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