Role of anti-pseudomonal antibiotics in the emergence ofStenotrophomonas maltophilia in cystic fibrosis patients

Denton, M.; Todd, N J; Littlewood, J M

doi:10.1007/bf01690098

Cited by 75 publications

(52 citation statements)

References 11 publications

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“…Tobramycin was the first antibiotic used for inhalational therapy for CF patients (175). The delivery of antipseudomonal aminoglycoside therapy by nebulizer has been associated with an increased risk for colonization by S. maltophilia (82). The intermittent delivery of aerosolized tobramycin by a nebulizer (cycles of 300 mg tobramycin or taste-masked placebo twice daily for 28 days followed by 28 days without treatment) did not increase the selection of tobramycin-resistant S. maltophilia and resulted in persistent treatment-emergent S. maltophilia in a very low number of patients (43,276).…”

Section: New Treatment Strategiesmentioning

confidence: 99%

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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Section: New Treatment Strategiesmentioning

confidence: 99%

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

2012

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“…This suggests that the organism resides in the lungs under continuous antibiotic pressure, which raises concerns on the emergence of antibiotic resistance 38 . Several factors contribute to the resistance of P. aeruginosa, including its genetic capacity to express a wide repertoire of resistance mechanisms and its ability to become resistant through mutations in chromosomal genes which regulate resistance genes 39 . Additionally, P. aeruginosa can acquire resistance genes from other organisms via plasmids, transposons and bacteriophages.…”

Section: Antibiotic Resistancementioning

confidence: 99%

“…In a retrospective case-control study, Denton et al found that in the years preceding the first isolation of S. maltophilia, colonized patients had received more oral ciprofloxacin and intravenous anti-pseudomonal antibiotics 39 . Similarly, upon evaluating the effect of intermittent inhalation of tobramycin on the microbiology of respiratory secretions 40 , Burns et al found that the use of oral quinolones was the only factor that significantly increased the risk of S. maltophilia isolation 34 .…”

Section: Clinical Impactmentioning

confidence: 99%

Challenging and emerging pathogens in cystic fibrosis

Vrankrijker

Wolfs

Ent

2010

Paediatric Respiratory Reviews

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“…It should be noted that the low susceptibility showed by S. maltophilia strains can be considered an important virulence factor in patients under antibiotic treatment. In fact, prior exposure of the patient to antibiotics has been identified as an important risk factor associated with S. maltophilia infection or colonization (9,10).…”

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confidence: 99%

Cloning and Characterization of SmeDEF, a Novel Multidrug Efflux Pump from Stenotrophomonas maltophilia

Alonso

Martínez

2000

Antimicrob Agents Chemother

186

155

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Stenotrophomonas maltophilia is a nosocomial bacterial pathogen intrinsically resistant to several antibiotics. The mechanisms involved in this intrinsic multiresistance phenotype are poorly understood. A library of chromosomal DNA from a spontaneous multidrug-resistant S. maltophilia D457R mutant (A. Alonso and J. L. Martinez, Antimicrob. Agents Chemother. 41:1140-1142, 1997) was screened for complementation of erythromycin susceptibility on an antibiotic-hypersusceptible Escherichia coli ⌬acrAB strain. Cloning and further analysis revealed that a 6-kbp region constituting a transcriptional unit was capable of complementing the antibiotic-susceptible phenotype of an E. coli ⌬acrAB strain. We identified three open reading frames, smeD, smeE and smeF, which code for members of the membrane fusion protein, resistance nodulation division, and outer membrane factor families, respectively. Drug susceptibility assays indicated that the SmeDEF system cloned in E. coli mediates resistance to a wide range of antibiotics. Ethidium bromide and norfloxacin accumulation experiments in the presence and in the absence of carbonyl cyanide m-chlorophenylhydrazone showed that this system constitutes a drug efflux pump dependent on the membrane proton motive force. The presence of high levels of smeDEF mRNA in the multiresistant D457R mutant was consistent with the high levels of SmeF (formerly Omp54) observed in the same strain. In contrast, transcription levels of smeDEF in the D457 strain were tiny, which correlates with the low levels of SmeF observed for this strain. Also, for both the D457 and D457R strains, we observed growth phase-dependent regulation in which the highest level of transcription corresponded to early exponential phase, with transcription decreasing throughout the growth curve to undetectable levels at 24 h.

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Role of anti-pseudomonal antibiotics in the emergence ofStenotrophomonas maltophilia in cystic fibrosis patients

Cited by 75 publications

References 11 publications

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

Challenging and emerging pathogens in cystic fibrosis

Cloning and Characterization of SmeDEF, a Novel Multidrug Efflux Pump from Stenotrophomonas maltophilia

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