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#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.
01:12:10
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Quick takeaways
- Stenotrophomonas maltophilia is an opportunistic pathogen increasingly recognized in nosocomial infections, posing significant treatment challenges due to intrinsic antibiotic resistance.
- The primary treatment for S. maltophilia infections is trimethoprim-sulfamethoxazole, but its clinical efficacy is variable due to emerging resistance patterns.
Deep dives
Overview of Stenotrophomonas maltophilia
Stenotrophomonas maltophilia is an aerobic, catalase-positive, oxidase-negative, gram-negative bacterium recognized for its environmental ubiquity, commonly found in soil, water, plants, and contaminated medical devices. Initially identified as Bacterium bucchere in 1943, it underwent several reclassifications before settling on its current nomenclature in 1993. Despite its presence in various settings, this organism is generally of low virulence, often colonizing non-sterile sites like the human respiratory tract or chronic wounds rather than causing true infections. Notably, S. maltophilia is an opportunistic pathogen mostly affecting patients with compromised immune systems or underlying health conditions, showcasing a significant resilience due to its extensive intrinsic antibiotic resistance mechanisms.
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