Clinical associations with carriage of pulmonary Stenotrophomonas maltophilia

J R Coll Physicians Edinb. 2022 Mar;52(1):14-19. doi: 10.1177/14782715221088909.

Abstract

Background: Stenotrophomonas maltophilia causes opportunistic respiratory infections and is associated with declining lung function in patients with cystic fibrosis (CF). Risk factors for carrying S. maltophilia remain unclear.

Methods: We conducted a retrospective study of patients yielding ⩾1 respiratory S. maltophilia isolate at the Oxford University Hospitals Trust between 2014 and 2019 and a cohort study of S. maltophilia carriage in CF patients attending annual review in 2018.

Results: Seven hundred and forty isolates were identified from 238 patients (median 1.0 isolate/patient). Predisposing conditions included invasive ventilation (29.8%), CF (25.6%) and non-CF bronchiectasis (24.4%). The rates of Stenotrophomonas isolates and co-trimoxazole resistance were stable over time. About 10.8% of isolates were co-trimoxazole-resistant, with resistance more common in CF than in other diagnoses (29.5% vs 5.8%, p < 0.001). No clinical features were significantly associated with S. maltophilia carriage in the CF population.

Discussion: We present new insight into the epidemiology of Stenotrophomonas colonisation/infection and identify increased co-trimoxazole resistance in CF isolates.

Keywords: Stenotrophomonas maltophilia; antimicrobial resistance; cystic fibrosis; lung infection.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cohort Studies
  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / drug therapy
  • Gram-Negative Bacterial Infections* / complications
  • Gram-Negative Bacterial Infections* / diagnosis
  • Gram-Negative Bacterial Infections* / epidemiology
  • Humans
  • Lung
  • Retrospective Studies
  • Stenotrophomonas maltophilia*
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination