Abstract
Amaç: S.maltophilia düşük patojenite özelliklerine rağmen, immün düşkün ve yoğun bakım ünitelerinde uzun süre yatan hastalarda kolonize olabilen, solunum ve gastrointestinal sistemden seçilerek sıklıkla pnömoni ve bakteriyemi gibi enfeksiyonlara neden olabilen bir mikroorganizmadır. Özellikle kistik fibrozisli hastaların risk altında olduğu bilinmektedir. Çalışmamızın amacı, S. maltophilia izolatlarını ve trimetoprim-sülfometaksazol(TMP-SXT) duyarlılık durumunu inceleyerek lokal epidemiyolojik veri elde etmektir.
Gereç ve Yöntem: 1 Ocak 2018-31 Mayıs 2019 tarihleri arasında Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Hastanesi’ne gelen hastaların kültür örneklerinden izole edilmiş 96 S. maltophilia izolatı retrospektif olarak incelenmiştir.
Bulgular: S.maltophilia’nın önemli bir kısmı (%50) solunum yolu örneklerinden izole edilmiş, TMP-SXT’ye direnç %1,04’si (n=1) olarak bulunmuştur.
Sonuç: Stenotrophomonas maltophilia ‘nın birçok antibiyotiğe dirençli olması tedavide güçlüklere neden olmaktadır. TMP-SXT Stenotrophomonas maltophilia enfeksiyonlarında hala kullanılabilecek en etkili antibiyotiktir. Özellikle kültür örneklerinden S. maltophilia izole edildiğinde etken –kolonizasyon ayırımı yapılmalı ve gereksiz antibiyotik kullanımından kaçınılarak direnç gelişimi önlenmelidir.
References
- Dülger D, Berktaş M. Stenotrophomonas maltophilia suşlarının klinik önemi Van Tıp Dergisi 2007; 14 (3):90-95.
- Durupınar B, Darka Ö. In Ayşe Wilke Topçu, Güner Söyletir, Mehmet Doğanay (Eds). Enfeksiyon Hastalıkları ve Klinik Mikrobiyolojisi etkenlere Göre Enfeksiyonlar 2. İstanbul: Nobel Kitabevleri, 2017:1910-1916.
- Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogen.Clin Microbiol Rev 2012; 25(1): 2-41.
- Denton M,Kerr KG. Microbiological and clinical aspects of infectionassociated with S. Maltophilia.Clin Microbiol Rev.1998;11: 57.
- Agger WA, Cogbill TH, Bush H, Landercasper JJ, Callister SM. Wounds caused by corn-harvesting machines:an unusual source of infection due to Gram negative bacilli.Rev Infect Dis 1986; 8:927-931.
- Tanrıverdİ Çaycı Y, Karadağ A, Yılmaz H, Yanık K, Günaydın M. Stenotrophomonas maltophilia Klinik Suşlarında Antimikrobiyal Direnç. Türk Mikrobiyol Cem Derg 2013; 43(1):22-25.
- Valdezate S,Vindel A, Loza E,Baquero F, Canton R.Antimikrobial susceptibilities of unique Stenotrophomonas maltophilia clinical strains.Antimicrob Agents Chemother 2001;45:15-81.
- Versolovic J,Carrol KC,Funke G, et al. Manual of Clinical Microbiology. Canada: ASM Press,2011:702-705.
- Dizbay M, Tunçcan ÖG, Maral I, Aktaş F, Şenol E. Five year surveillance of nosocomial Stenotrophomonas maltophilia infections in Gazi University Hospital. Türkiye Klinikleri J Med Sci 2009; 29:1406-11.
- Tsiodras S, Pittet D, Carmeli Y, et al. Clinical implications of Stenotrophomonas maltophilia resistant to trimethoprim-sulfamethoxazole: A study of 69 patients at 2 university hospitals. Scand J Infect Dis 2000; 32: 651-656.
- Hejnar P, Kolář M, Sauer P. Antibiotic resistance of Stenotrophomonas maltophilia strains isolated from captive snakes. Folia Microbiol 2010; 55: 83–87.
- Krcmery V Jr, Sykora P, Trupl J, et al. Antibiotic use and development of resistance in blood culture isolates: 8 years of experience from a cancer referral center. J Chemother 2001; 13: 133-142.
- Hejnar P, Kolar M, Hajek V, Koukalova D, Hamal P. Occurence of variants with temperature dependent susceptibility (TDS) to antibiotics among Stenotrophomonas maltophilia clinical strains. Folia Microbiol 2001; 46: 151-155.
- Mooney L, Kerr KG, Denton M. Survival of Stenotrophomonas maltophilia following exposure to concentrations of tobramycin used in aerosolized therapy for cystic fibrosis patients, Int J Antimicrob Agents 2001; 17: 63-66.
- Falagas ME, Valkimadi PE, Huang YT, Matthaiou DK, Hsueh PR. Therapeutic options for Stenotrophomonas maltophilia infections beyond co-trimoxazole: a systematic review. J Antimicrob Chemother 2008; 62: 889-894.
- Chung HS, Hong SG, Kim YR, et al. Antimicrobial susceptibility of Stenotrophomonas maltophilia isolates from Korea, and the activity of antimicrobial combinations against the isolates. J. Korean Med Sci 2013; 28: 62–66.
- Farrell DJ, Sader HS, Flamm RK, Jones RN.Ceftolozane/tazobactam activity tested against Gram-negative bacterial isolates from hospitalised patients with pneumonia in US and European medical centres (2012). Int J Antimicrob. Agents 2014; 43: 533–539.
- Outcomes of Stenotrophomonas maltophilia hospital-acquired pneumonia in intensive care unit: a nationwide retrospective study. Crit Care 2019; 23: 371.
Abstract
Objectives: S.maltophilia despite its low pathogenicity, can cause colonization in immunocompetent and long-term inpatients in the intensive care unit, and can cause pneumonia and bacteremia, often selected from the respiratory and gastrointestinal tract. It is known that especially cystic fibrosis patients are at risk.
The aim of this study was to obtain local epidemiological data by examining S. maltophilia isolates and trimetoprim-sulfometaxazole (TMP-SXT) susceptibility.
Methods: Ninetysix S. maltophilia isolates, isolated from culture samples sent to Kahramanmaraş Sütçü İmam University Medical Faculty Hospital Microbiology Laboratory between January 1, 2018 and May 31, 2019 were analyzed retrospectively.
Results: A significant portion (50%) of S.maltophilia was isolated from respiratory tract samples and resistance to TMP-SXT was found to be 1.04% (n = 1).
Conclusion: Stenotrophomonas maltophilia is resistant to many antibiotics, causing treatment difficulties. TMP-SXT is the most effective antibiotic that can still be used in Stenotrophomonas maltophilia infections.Especially when S. maltophilia is isolated from cultural examples, pathogen/ colonization should be differentiated and resistance should be prevented by avoiding unnecessary antibiotic use.
References
- Dülger D, Berktaş M. Stenotrophomonas maltophilia suşlarının klinik önemi Van Tıp Dergisi 2007; 14 (3):90-95.
- Durupınar B, Darka Ö. In Ayşe Wilke Topçu, Güner Söyletir, Mehmet Doğanay (Eds). Enfeksiyon Hastalıkları ve Klinik Mikrobiyolojisi etkenlere Göre Enfeksiyonlar 2. İstanbul: Nobel Kitabevleri, 2017:1910-1916.
- Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogen.Clin Microbiol Rev 2012; 25(1): 2-41.
- Denton M,Kerr KG. Microbiological and clinical aspects of infectionassociated with S. Maltophilia.Clin Microbiol Rev.1998;11: 57.
- Agger WA, Cogbill TH, Bush H, Landercasper JJ, Callister SM. Wounds caused by corn-harvesting machines:an unusual source of infection due to Gram negative bacilli.Rev Infect Dis 1986; 8:927-931.
- Tanrıverdİ Çaycı Y, Karadağ A, Yılmaz H, Yanık K, Günaydın M. Stenotrophomonas maltophilia Klinik Suşlarında Antimikrobiyal Direnç. Türk Mikrobiyol Cem Derg 2013; 43(1):22-25.
- Valdezate S,Vindel A, Loza E,Baquero F, Canton R.Antimikrobial susceptibilities of unique Stenotrophomonas maltophilia clinical strains.Antimicrob Agents Chemother 2001;45:15-81.
- Versolovic J,Carrol KC,Funke G, et al. Manual of Clinical Microbiology. Canada: ASM Press,2011:702-705.
- Dizbay M, Tunçcan ÖG, Maral I, Aktaş F, Şenol E. Five year surveillance of nosocomial Stenotrophomonas maltophilia infections in Gazi University Hospital. Türkiye Klinikleri J Med Sci 2009; 29:1406-11.
- Tsiodras S, Pittet D, Carmeli Y, et al. Clinical implications of Stenotrophomonas maltophilia resistant to trimethoprim-sulfamethoxazole: A study of 69 patients at 2 university hospitals. Scand J Infect Dis 2000; 32: 651-656.
- Hejnar P, Kolář M, Sauer P. Antibiotic resistance of Stenotrophomonas maltophilia strains isolated from captive snakes. Folia Microbiol 2010; 55: 83–87.
- Krcmery V Jr, Sykora P, Trupl J, et al. Antibiotic use and development of resistance in blood culture isolates: 8 years of experience from a cancer referral center. J Chemother 2001; 13: 133-142.
- Hejnar P, Kolar M, Hajek V, Koukalova D, Hamal P. Occurence of variants with temperature dependent susceptibility (TDS) to antibiotics among Stenotrophomonas maltophilia clinical strains. Folia Microbiol 2001; 46: 151-155.
- Mooney L, Kerr KG, Denton M. Survival of Stenotrophomonas maltophilia following exposure to concentrations of tobramycin used in aerosolized therapy for cystic fibrosis patients, Int J Antimicrob Agents 2001; 17: 63-66.
- Falagas ME, Valkimadi PE, Huang YT, Matthaiou DK, Hsueh PR. Therapeutic options for Stenotrophomonas maltophilia infections beyond co-trimoxazole: a systematic review. J Antimicrob Chemother 2008; 62: 889-894.
- Chung HS, Hong SG, Kim YR, et al. Antimicrobial susceptibility of Stenotrophomonas maltophilia isolates from Korea, and the activity of antimicrobial combinations against the isolates. J. Korean Med Sci 2013; 28: 62–66.
- Farrell DJ, Sader HS, Flamm RK, Jones RN.Ceftolozane/tazobactam activity tested against Gram-negative bacterial isolates from hospitalised patients with pneumonia in US and European medical centres (2012). Int J Antimicrob. Agents 2014; 43: 533–539.
- Outcomes of Stenotrophomonas maltophilia hospital-acquired pneumonia in intensive care unit: a nationwide retrospective study. Crit Care 2019; 23: 371.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original Article |
| Authors | |
| Publication Date | June 30, 2021 |
| Submission Date | March 17, 2020 |
| Published in Issue | Year 2021 Volume: 31 Issue: 2 |
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