Antibiotic Susceptibility and Minimum Inhibitory Concentration for Stenotrophomonas maltophilia Ocular Infections
Margaret Ming-Chih Ho1, Ming-Hui Sun1,2, Wei-Chi Wu1,2
1Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
Abstract:
Stenotrophomonas maltophilia (S. maltophilia) is a Gram-negative, opportunistic pathogen that can lead to ocular infections, such as keratitis and endophthalmitis. The purpose of this study was to determine the antibiotic susceptibility and minimum inhibitory concentrations (MICs) of S. maltophilia isolates from ocular infections and to evaluate the differences in antibiotic MICs between keratitis and endophthalmitis isolates. The disc diffusion method revealed that S. maltophilia isolates exhibited 91% susceptibility to levofloxacin and moxifloxacin and 61% susceptibility to trimethoprim−sulfamethoxazole (TMP−SMX). The E-test indicated that S. maltophilia isolates exhibited 40%, 100%, 72%, 91%, 91%, and 93% susceptibility to ceftazidime, tigecycline, TMP−SMX, levofloxacin, gatifloxacin, and moxifloxacin, respectively. The MIC90 values of amikacin, ceftazidime, cefuroxime, tigecycline, TMP−SMX, levofloxacin, gatifloxacin, and moxifloxacin were >256, >256, >256, 3, >32, 1, 2, and 0.75 µg/mL, respectively. The geometric mean MICs of ceftazidime, TMP−SMX, levofloxacin, gatifloxacin, and moxifloxacin were significantly lower for the keratitis isolates than for the endophthalmitis isolates (p = 0.0047, 0.003, 0.0029, 0.0003, and 0.0004, respectively). Fluoroquinolones showed higher susceptibility and lower MICs for the S. maltophilia isolates when compared with other antibiotics. Fluoroquinolones can be recommended for treating S. maltophilia ocular infections. Tigecycline and TMP−SMX could be alternative antibiotics for S. maltophilia ocular infections.
Insights
Stenotrophomonas maltophilia ocular infections are best treated with fluoroquinolones, showing high susceptibility and low MICs. Tigecycline and trimethoprim-sulfamethoxazole are viable alternatives for these serious eye infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Stenotrophomonas maltophilia is an opportunistic pathogen causing severe ocular infections like keratitis and endophthalmitis.
- Understanding antibiotic susceptibility is crucial for effective treatment of S. maltophilia eye infections.
Purpose of the Study:
- To determine antibiotic susceptibility and MICs of S. maltophilia from ocular infections.
- To compare antibiotic MICs between keratitis and endophthalmitis isolates.
Main Methods:
- Disc diffusion and E-test methods were employed to assess antibiotic susceptibility.
- Minimum Inhibitory Concentrations (MICs) were determined for various antibiotics against S. maltophilia isolates.
Main Results:
- High susceptibility (91-93%) was observed for fluoroquinolones (levofloxacin, moxifloxacin, gatifloxacin) and tigecycline (100%).
- Trimethoprim-sulfamethoxazole (TMP-SMX) showed 61-72% susceptibility.
- MIC90 values were lowest for fluoroquinolones (0.75-2 µg/mL) and tigecycline (3 µg/mL).
- Significantly lower geometric mean MICs for ceftazidime, TMP-SMX, levofloxacin, gatifloxacin, and moxifloxacin were found in keratitis isolates compared to endophthalmitis isolates.
Conclusions:
- Fluoroquinolones are recommended for treating S. maltophilia ocular infections due to superior susceptibility and lower MICs.
- Tigecycline and TMP-SMX can serve as alternative antibiotic options for S. maltophilia ocular infections.
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