Clinical and Microbiologic Outcomes in Patients with Monomicrobial Stenotrophomonas maltophilia Infections

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Antimicrobial Resistance

Background:

• Stenotrophomonas maltophilia is a resilient opportunistic pathogen frequently implicated in hospital-acquired infections.
• Its capacity for biofilm formation and broad antimicrobial resistance poses significant challenges for effective treatment and patient recovery.

Purpose of the Study:

• To evaluate the clinical outcomes of monomicrobial Stenotrophomonas maltophilia infections.
• To compare the efficacy of trimethoprim-sulfamethoxazole versus levofloxacin in treating these infections.

Main Methods:

• A retrospective study involving 76 patients with monomicrobial S. maltophilia infections.
• Patients were treated with either trimethoprim-sulfamethoxazole (45 patients) or levofloxacin (31 patients).
• Outcomes assessed included clinical cure, microbiological eradication, and 28-day mortality.

Main Results:

• High rates of clinical cure (79%) and microbiological eradication (82%) were observed across both treatment groups.
• The 28-day mortality rate was 14%.
• While both antibiotics demonstrated efficacy, a trend towards increased resistance selection was noted with levofloxacin use.

Conclusions:

• Trimethoprim-sulfamethoxazole and levofloxacin are effective in achieving high cure rates for S. maltophilia infections.
• The observed trend of resistance selection with levofloxacin warrants further investigation and careful consideration in treatment strategies.
• Optimizing antimicrobial therapy is crucial for managing S. maltophilia infections and preventing further resistance development.