Stenotrophomonas maltophilia: Complicating treatment of ESBL UTI

Authors
Simit Kumar
Maitreyi Bandyopadhyay
Mitali Chatterjee
Parthajit Banerjee
Sumon Poddar
Debarati Banerjee
Department of Microbiology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India
Abstract
Stenotrophomonas maltophilia (S. maltophilia) is a gram-negative bacillus emerging as an opportunistic, nosocomial pathogen associated with a high mortality rate. The organism has been shown to survive several biocides used in the hospital setting. Hospital water sources can serve as a reservoir for S. maltophilia. The transmission of S. maltophilia to susceptible individuals may occur through direct contact with the source or through the hands of health care personnel. S. maltophilia is usually resistant to third-generation cephalosporins, aminoglycosides and antipseudomonal penicillins. These microorganisms are intrinsically resistant to carbapenems, and exposure to these agents has been linked to selection of S. maltophilia. There have also been reports of the organism developing resistance to trimethoprim-sulfamethoxazole (TMP-SMX), which was initially considered as the drug of choice for S. maltophillia infections. We describe a case of nosocomial urinary tract infection (UTI) due to S. maltophilia in a diabetic patient, which the patient developed during treatment with meropenem for UTI due to Klebsiella pneumonia that was resistant to TMP-SMX.

Keywords

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Advanced Biomedical Research
Volume 2015, February
February 2015
Pages 1-4