Breakpoints #112 – Say It Ain't Steno: Stenotrophomonas maltophilia Review
Feb 28, 2025
Dr. Amy Mathers, a microbiology expert and IDSA guidance author, joins Dr. Julie Ann Justo, a clinical pharmacist specializing in infectious diseases, for an insightful discussion. They explore the challenges of treating Stenotrophomonas maltophilia, a tricky pathogen known for its resistance. The conversation delves into effective combination therapies and the significance of updated treatment guidelines. They also examine pharmacokinetics, particularly the efficacy of tetracyclines and fluoroquinolones, while emphasizing the importance of tailored approaches for vulnerable patient populations.
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Steno's Environmental and Resistance Profile
- Stenotrophomonas maltophilia is a water-loving, ubiquitous organism with low virulence but massive intrinsic antibiotic resistance.
- It colonizes many wet hospital surfaces and can rarely cause serious infection mostly in immunocompromised hosts.
Increasing Steno Prevalence Globally
- Steno is increasingly prevalent worldwide, especially in respiratory and bloodstream infections.
- It ranks third among non-lactose fermenting gram-negative bacteria and causes significant carbapenem-resistant bacteremia in the U.S.
Complex Resistance Mechanisms Explained
- Steno's multiple beta-lactamases and efflux pumps make it difficult to treat with common antibiotics.
- These complex resistance mechanisms explain its intrinsic multidrug resistance and treatment challenges.