Oral Infection Caused by<i>Stenotrophomonas maltophilia</i>: A Rare Presentation of an Emerging Opportunistic Pathogen

Prates, Marcelo; Fernandes, Fernando; Proença, Francisco; Mussá, Y; Tavares, Ana; Pereira, André Prates

doi:10.1155/2020/6346120

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…The limited number of patients with microbial testing from respiratory sites prevented us from drawing clear conclusions on the links between periodontal microbes and secondary lung infections in COVID-19 patients. Nevertheless, the bacteria species identified (Stenotrophomonas maltophilia, and Staphylococcus hominis, Staphylococcus epidermidis, Pseudomonas putida and Klebsiella pneumoniae) are all known to be present in the oral cavity [48][49][50][51][52][53][54]. In this study, Stenotrophomonas maltophilia, an antibiotic resistant opportunistic bacteria found in the oral cavity of immunocompromised patients [53,54], was only identified in patients without periodontitis.…”

Section: Discussionmentioning

confidence: 64%

“…Nevertheless, the bacteria species identified (Stenotrophomonas maltophilia, and Staphylococcus hominis, Staphylococcus epidermidis, Pseudomonas putida and Klebsiella pneumoniae) are all known to be present in the oral cavity [48][49][50][51][52][53][54]. In this study, Stenotrophomonas maltophilia, an antibiotic resistant opportunistic bacteria found in the oral cavity of immunocompromised patients [53,54], was only identified in patients without periodontitis. Similarly, Staphylococcus hominis was only found in patients without periodontitis, although this bacterium could be found in periodontitis and periapical lesions [51,52].…”

Section: Discussionmentioning

confidence: 64%

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Association of periodontal therapy, with inflammatory biomarkers and complications in COVID-19 patients: a case control study

et al. 2022

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Background In previous studies, COVID-19 complications were reported to be associated with periodontitis. Accordingly, this study was designed to test the hypothesis that a history of periodontal therapy could be associated with lower risk of COVID-19 complications. Methods A case–control study was performed using the medical health records of COVID-19 patients in the State of Qatar between March 2020 and February 2021 and dental records between January 2017 and December 2021. Cases were defined as COVID-19 patients who suffered complications (death, ICU admissions and/or mechanical ventilation); controls were COVID-19 patients who recovered without major complications. Associations between a history of periodontal therapy and COVID-19 complications were analysed using logistic regression models adjusted for demographic and medical factors. Blood parameters were compared using Kruskal–Wallis test. Results In total, 1,325 patients were included. Adjusted odds ratio (AOR) analysis revealed that non-treated periodontitis was associated with significant risk of need for mechanical ventilation (AOR = 3.91, 95% CI 1.21–12.57, p = 0.022) compared to periodontally healthy patients, while treated periodontitis was not (AOR = 1.28, 95% CI 0.25–6.58, p = 0.768). Blood analyses revealed that periodontitis patients with a history of periodontal therapy had significantly lower levels of D-dimer and Ferritin than non-treated periodontitis patients. Conclusion Among COVID-19 patients with periodontal bone loss, only those that have not received periodontal therapy had higher risk of need for assisted ventilation. COVID-19 patients with a history of periodontal therapy were associated with significantly lower D-dimer levels than those without recent records of periodontal therapy. Clinical relevance The fact that patients with treated periodontitis were less likely to suffer COVID-19 complications than non-treated ones further strengthen the hypothesis linking periodontitis to COVID-19 complications and suggests that managing periodontitis could help reduce the risk for COVID-19 complications, although future research is needed to verify this.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 64%

Association of periodontal therapy, with inflammatory biomarkers and complications in COVID-19 patients: a case control study

et al. 2022

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“…Prates et al, 2020 reported that S. maltophilia belongs to the genus Stenotrophomonas, an emerging multidrug-resistant opportunistic pathogen that leads to oral infections, malignancy, and respiratory tract infections [90]. Serratia marcescens is associated with urinary and respiratory infections, endocarditis, osteomyelitis, septicemia, wound infections, eye infections, meningitis, dental caries, and plaque [91].…”

Section: Discussionmentioning

confidence: 99%

Effect of Dextranase and Dextranase-and-Nisin-Containing Mouthwashes on Oral Microbial Community of Healthy Adults—A Pilot Study

et al. 2022

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This study analyzed the alteration of oral microbial composition in healthy subjects after using dextranase-containing mouthwash (DMW; Mouthwash formulation I) and dextranase-and-nisin-containing mouthwash (DNMW; Mouthwash formulation II). Eighteen participants were recruited and were randomly allocated to two groups: G1 (DMW user; n = 8) and G2 (DNMW user; n = 10). The subjects were instructed to use the provided mouthwash regularly twice a day for 30 days. The bleeding on probing (BOP), plaque index (PI), probing depth (PBD), and gingival index (GI) were analyzed, and saliva samples were collected before (day 0) and after (day 30) the use of mouthwashes. The saliva metagenomic DNA was extracted and sequenced (next-generation sequencing, Miseq paired-end Illumina 2 × 250 bp platform). The oral microbial community in the pre-and post-treated samples were annotated using QIIME 2™. The results showed the PI and PBD values were significantly reduced in G2 samples. The BOP and GI values of both groups were not significantly altered. The post-treated samples of both groups yielded a reduced amount of microbial DNA. The computed phylogenetic diversity, species richness, and evenness were reduced significantly in the post-treated samples of G2 compared to the post-treated G1 samples. The mouthwash formulations also supported some pathogens’ growth, which indicated that formulations required further improvement. The study needs further experiments to conclude the results. The study suggested that the improved DNMW could be an adjuvant product to improve oral hygiene.

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“…It mainly induces respiratory tract infection but can also cause multisite infections, such as bloodstream infections, urinary tract infections, skin and soft tissue infections, bone and joint infections, biliary tract infections, ocular, endocarditis, meningitis and oral infections. 4,5 S. maltophilia mainly causes infections in vulnerable groups, including patients in the intensive care unit (ICU), neonates, lung transplant recipients, patients with organ failure, patients with cystic fibrosis (CF), and patients with chronic obstructive pulmonary disease (COPD) or bronchiectasis. [6][7][8][9][10][11][12] In addition, due to its complex resistance mechanisms, including the production of β-lactamase, biofilm and drug efflux pumps, reduction of the outer membrane permeability, and integron-mediated resistance genes, S. maltophilia shows inherent resistance to multi-antimicrobial agents, and the empiric treatment to S. maltophilia should be highlighted accordingly.…”

Section: Introductionmentioning

confidence: 99%

The Prognosis of Patients Tested Positive for Stenotrophomonas maltophilia from Different Sources

Ma¹,

Chen²,

Huang³

et al. 2023

IDR

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The purpose of this study was to analyze the prognosis of patients tested positive for Stenotrophomonas maltophilia (SMA) from different sources. Methods: A retrospective study was conducted among 651 patients tested positive for SMA from January 2020 to October 2022 in the First Affiliated Hospital of Anhui Medical University. The patients were divided into seven groups by the source of SMA. Univariate and multivariate analyses were used to identify risk factors for mortality in patients tested positive for SMA from different sources. Results: A total of 651 SMA isolates were collected from various sources, including sputum (348 isolates, 53%), bronchoalveolar lavage fluid (52, 8%), abdominal drainage fluid (76, 12%), wound secretion (66, 10%), blood (62, 10%), urine (41, 6%) and cerebrospinal fluid (6, 1%). Compared with other groups, the mortality of the patients in the bronchoalveolar lavage fluid culture group, blood culture group, and abdominal drainage fluid culture group was higher, at 40.38%, 32.26%, and 26.32%, respectively. Multivariate analysis showed that continuous renal replacement therapy was an independent risk factor for mortality in patients with SMA bloodstream infection (P=0.020, OR=6.86), and effective antimicrobial therapy after being positive for S. maltophilia isolates (P=0.002, OR=0.10) was negatively correlated with the death of patients with SMA bloodstream infection. Age ≥65 years (P= 0.043, OR=4.96), kidney disease (P=0.045, OR=4.62) and antifungal agent exposure (P=0.036, OR=5.13) were independent risk factors for mortality in patients with SMA intra-abdominal infection. Antifungal agent exposure (P=0.024, OR=0.51) and glycopeptide exposure (P=0.045, OR=0.53) were independent risk factors for mortality in patients in the sputum culture group. Conclusion: SMA has a high rate of antimicrobial resistance and can cause multisite infection. Pulmonary infections, bloodstream infections and abdominal infections caused by SMA have high mortality, and timely standardized treatment can reduce mortality.

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Oral Infection Caused byStenotrophomonas maltophilia: A Rare Presentation of an Emerging Opportunistic Pathogen

Cited by 8 publications

References 30 publications

Association of periodontal therapy, with inflammatory biomarkers and complications in COVID-19 patients: a case control study

Association of periodontal therapy, with inflammatory biomarkers and complications in COVID-19 patients: a case control study

Effect of Dextranase and Dextranase-and-Nisin-Containing Mouthwashes on Oral Microbial Community of Healthy Adults—A Pilot Study

The Prognosis of Patients Tested Positive for Stenotrophomonas maltophilia from Different Sources

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