Infection Trends, Susceptibility Pattern, and Treatment Options for Stenotrophomonas maltophilia Infections in Trauma Patients: A Retrospective Study

Smriti Srivastava; Parul Singh; Neha Sharad; Vandana Vijayeta Kiro; Rajesh Malhotra; Purva Mathur

doi:10.1055/s-0042-1757413

Infection Trends, Susceptibility Pattern, and Treatment Options for Stenotrophomonas maltophilia Infections in Trauma Patients: A Retrospective Study

J Lab Physicians. 2022 Oct 20;15(1):106-109. doi: 10.1055/s-0042-1757413. eCollection 2023 Mar.

Authors

Smriti Srivastava¹, Parul Singh¹, Neha Sharad¹, Vandana Vijayeta Kiro¹, Rajesh Malhotra², Purva Mathur³

Affiliations

¹ Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
² Department of Orthopaedic, All India Institute of Medical Sciences, New Delhi, India.
³ Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre (JPNATC), All India Institute of Medical Sciences, New Delhi, India.

Abstract

Introduction Stenotrophomonas maltophilia is an emerging environmental, gram-negative, multidrug-resistant organism, associated with risk factors such as prolonged hospitalization, invasive procedures, admission to the intensive care unit, mechanical ventilation, use of indwelling catheters, administration of immunosuppressants or corticosteroids, human immunodeficiency virus infection, underlying malignancy, and organ transplantation. The organism, despite being of low invasiveness in immune-competent individuals, is difficult to treat because of intrinsic resistance to several antimicrobial agents. Materials and Methods This study focuses on commonly encountered resistance from among the isolates over a duration of 7 years from 2012 to 2018, analyzed retrospectively. Identification and susceptibility testing were performed using Vitek 2 (BioMérieux, Marcy-l'Etoile, France). Results Bloodstream infections were found to be most common (52.02%), followed by respiratory infections (35.83%). The median age of the patients was 36 years, and male to female ratio was 143:27. The median duration of hospital stay was 18 days, and mortality was seen in 18.82% of patients. Susceptibility to cotrimoxazole and levofloxacin was seen in 97.1% of isolates (168 out of 173) and 90.1% of isolates (156 out of 173), respectively. Conclusion Despite being effective in a majority of S . maltophilia isolates, both cotrimoxazole and levofloxacin have their shortcomings. Cotrimoxazole is bacteriostatic and can cause bone marrow suppression and resistance to levofloxacin sometimes develops during therapy. Thus, the therapy should be decided considering the characteristics of both of these drugs.

Keywords: Stenotrophomonas maltophilia; bloodstream infections; trauma.

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