Investigation of in vitro activity of colistin and tygecyclin against Stenotrophomonas maltophilia isolates

Year 2021, Volume: 38 Issue: 4, 529 - 532, 09.10.2021

Yeliz Tanrıverdi Çaycı İlknur Bıyık Gonca Yılmaz Kemal Bilgin Asuman Bırıncı

Abstract

Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen, causing infections whose management is often problematic due to its inherent resistance to many antibiotics. In this study, we aimed to investigate the antimicrobial susceptiblity of colistin and tygecyclin as an alternative treatment options for S. maltophilia infections. A total of 122 S. maltophilia isolates were tested. Minimum inhibitory concentration (MIC) values of colistin and tygecycline were determined by broth microdilution method. Susceptibility of TMP/SMX and levofloxacin (LVX) were determined by disc diffusion method and MIC value of ceftazidime (CAZ) was determined by using E-test. Out of 122 S. maltophilia isolates, 5 (4%) of them were resistant to TMP-SXM. MIC range was 0.125- >512 μg/ml and MIC50 64 μg/ml, MIC90 512 μg/ml for colistin. MIC range for tygecyclin was detected as 0.5- >8, MIC50 2 μg/ml and MIC90 8 μg/ml. Tygecyclin resistance was detected as 66.4% according to the EUCAST guideline and 13.1% according to the USA-FDA breakpoints. And colistin resistance was determined as 86.9% according to both guidelines.

Keywords

Stenotrophomonas maltophilia, colistin, tygecycline

References

• 1- Denton M, Kerr KG. Microbiological and Clinical Aspects of Infection Associated with Stenotrophomonas maltophilia. Clın Mıcrob Rev. 1998;11(1): 57–80.
• 2- Zhang L, Li XZ, Poole K. Multiple antibiotic resistance in Stenotrophomonas maltophilia: involvement of a multidrug efflux system. Antimicrob Agents Chemother. 2000; 44:287–93.
• 3-Valdezate S, Vindel A, Loza E, Baquero F, Canto´n R. Antimicrobial susceptibilities of unique Stenotrophomonas maltophilia clinical strains. Antimicrob Agents Chemother. 2001;45: 1581–4.
• 4-Falagas ME, Kastoris AC, Vouloumanou EK, Rafailidis PI, Kapaskelis AM, Dimopoulos G. Attributable mortality of Stenotrophomonas maltophilia infections: a systematic review of the literature. Future Microbiology. 2009; 4:1103-9.
• 5-Alonso A, Martı´nez JL. Multiple antibiotic resistance in Stenotrophomonas maltophilia. Antimicrob Agents Chemother. 1997; 41:1140–2.
• 6-Yamazaki E, Ishii J, Sato K, Nakae T. The barrier function of the outer membrane of Pseudomonas maltophilia in the diffusion of saccharides and beta-lactam antibiotics. FEMS Microbiol Lett. 1989; 51:85–8.
• 7- Nicodemo AC, Paez JI. Antimicrobial therapy for Stenotrophomonas maltophilia infections. Eur J Clin Microbiol Infect Dis. 2007; 26: 229- 37.
• 8- Gales AC, Jones RN, Forward KR, Linares J, Sader HS, Verhoef J. Emerging importance of multidrug-resistant Acinetobacter species and Stenotrophomonas maltophilia as pathogens in seriously ill patients: geographic patterns, epidemiological features, and trends in the SENTRY Antimicrobial Surveillance Program (1997-1999). Clin Infect Dis. 2001; 32 Suppl 2:S104-S113.
• 9- Petersen PJ, Jacobus NV, Weiss WJ, Sum PE, Testa RT. In vitro and in vivo antibacterial activities of a novel glycylcycline, the 9-t10 butylglycylamido derivative of minocycline (GAR-936). 174 Antimicrob Agents Chemother. 1999; 43:738-44.
• 10- Li J, Nationa RL, Milneb RW, Turnidgec JD, Coulthard K. Evaluation of colistin as an agent against multi-resistant Gram-negative bacteria. International Journal of Antimicrobial Agents. 2005; 25: 11–25.
• 11- Gales AC, Reis AO, Jones RN. Contemporary assessment of antimicrobial susceptibility testing methods for polymyxin B and colistin: review of available interpretative criteria and quality control guidelines. J Clin Microbiol. 2001; 39: 183–90.
• 12- Hogardt M, Schmoldt S, Gotzfried M, Adler K, Heesemann J. Pitfalls of polymyxin antimicrobial susceptibility testing of Pseudomonas aeruginosa isolated from cystic fibrosis patients. J Antimicrob Chemother. 2004; 54:1057–61.
• 13- Clinical and Laboratory Standarts Institute. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically; Approved Standard—Ninth Edition, M07-A9. 2012; 32(2).
• 14- Clinical and Laboratory Standards Institute: Performance Standards for Antimicrobial Susceptibility Testing, Twentieth Informational Supplement, M100-S24, CLSI, 2014, Wayne, PA.
• 15-EUCAST. http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_6.0_Breakpoint_table.pdf (Accessed 31.03.2021).
• 16- Tygacil. Wyeth Pharmaceuticals, Philadelphia, PA. 2009.
• 17-Dizbay M, Tunçcan ÖG, Maral I, Aktaş F, Şenol E. Five year surveillance of nosocomial Stenotrophomonas maltophi¬lia infections in Gazi University Hospital. Türkiye Klinikleri J Med Sci. 2009; 29: 1406-11.
• 18-Jones RN, Sader HS, Beach ML. Contemporary in vitro spectrum of activity summary for antimicrobial agents tested against 18569 strains non-fermentative gram negative bacilli isolated in the SENTRY Antimicrobial Surveillance Program (1997-2001). Int J Antimicrob Agents. 2003; 22: 551-6.
• 19- Samonis G, Karageorgopoulos DE, Maraki S, Levis P, Dimopoulou D, Spernovasilis NA et al. Stenotrophomonas maltophilia Infections in a General Hospital: Patient Characteristics, Antimicrobial Susceptibility, and Treatment Outcome. PLoS ONE. 2012 ;7(5):e37375.
• 20-Öngüt G, Özcan A, Kandişer A, Öğünç D, Çolak D, Gültekin M. Çeşitli klinik örneklerden izole edilen Stenotrophomonas maltophilia suşlarının antimikrobiyal duyarlılıklarının E Test ile araştırılması (in Turkish). İnfeks Derg. 2005; 19: 425-8.
• 21- Dülger D, Berktaş M, Bozkurt H, Güdücüoğlu H, Mısırlıgil A. Nozokomiyal Stenotrophomonas maltophilia suşlarının izolasyonu ve antibiyotiklere duyarlılığı (in Turkish). Van Tıp Derg. 2006; 13:49-52.
• 22- Zer Y, Karaoğlan İ, Çevik S, Erdem M. Stenotrophomonas maltophilia suşlarının antibiyotik duyarlılıklarının irdelenme¬si (in Turkish). Klimik Derg. 2009; 22: 21-4.
• 23-Penzak SR, Abate BJ. Stenotrophomonas (Xanthomonas) maltophilia: a multidrug-resistant nosocomial pathogen. Pharmacotherapy. 1997; 17: 293–301.
• 24-Crossman LC, Gould VC, Dow JM, Vernikos GS, Okazaki A, Sebaihia M et al. The complete genome, comparative and functional analysis of Stenotrophomonas maltophilia reveals an organism heavily shielded by drug resistance determinants. Genome Biol. 2008; 9: R74.
• 25- Toleman MA, Bennett PM, Bennett DM, Jones RN, Walsh TR. Global emergence of trimethoprim/sulfamethoxazole resistance in Stenotrophomonas maltophilia mediated by acquisition of sul genes. Emerg Infect Dis. 2007; 13: 559–65.
• 26-Hu LF, Chang X, Ye Y, Wang ZX, Shao YB, et al. Stenotrophomonas maltophilia resistance to trimethoprim/sulfamethoxazole mediated by acquisition of sul and dfrA genes in a plasmid-mediated class 1 integron. Int J Antimicrob Agents. 2011; 37: 230–4.
• 27-Looney WJ, Narita M, Muhlemann K. Stenotrophomonas maltophilia: an emerging opportunist human pathogen. Lancet Infect Dis. 2009; 9: 312–23.
• 28-Falagas ME, Valkimadi PE, Huang YT, Matthaiou DK, Hsueh PR. Therapeutic options for Stenotrophomonas maltophilia infections beyond cotrimoxazole: a systematic review. J Antimicrob Chemother. 2008; 62: 889–94.
• 29- Vartivarian S, Anaissie E, Bodey G, Sprigg H, Rolston K. A changing pattern of susceptibility of Xanthomonas maltophilia to antimicrobial agents: implications for therapy. Antimicrob Agents Chemother. 1994; 38: 624–7.
• 30-Garrison MW, Anderson DE, Campbell DM, Carroll KC, Malone CL, Anderson JD et al. Stenotrophomonas maltophilia: emergence of multidrug-resistant strains during therapy and in an in vitro pharmacodynamic chamber model. Antimicrob Agents Chemother. 1996; 40: 2859–64.
• 31-Valdezate S, Vindel A, Saez-Nieto JA, Baquero F, Canton R. Preservation of topoisomerase genetic sequences during in vivo and in vitro development of high-level resistance to ciprofloxacin in isogenic Stenotrophomonas maltophilia strains. J Antimicrob Chemother. 2005; 56: 220–3.
• 32-Lecso-Bornet M, Pierre J, Sarkis-Karam D, Lubera S, Bergogne-Berezin E. Susceptibility of Xanthomonas maltophilia to six quinolones and study of outer membrane proteins in resistant mutants selected in vitro. Antimicrob Agents Chemother. 1992; 36: 669–71.
• 33-Farrell DJ, Sader HS, Jones RN. Antimicrobial susceptibilities of a worldwide collection of Stenotrophomonas maltophilia isolates tested against tigecycline and agents commonly used for S. maltophilia infections. Antimicrob Agents Chemother. 2010; 54: 2735–7.
• 34- Rodrı´guez CH, Nastro M, Lopez Calvo J, Farin ME, Dabos L, Famiglietti A. In vitro activity of colistin against Stenotrophomonas maltophilia. J Glob Antimicrob Resist. 2014: 316–7.
• 35- Moskowitz SM, Garber E, Chen Y, Clock SA, Tabibi S, Miller AK et al. Colistin susceptibility testing: evaluation of reliability for cystic fibrosis isolates of Pseudomonas aeruginosa and Stenotrophomonas maltophilia. J Antimicrob Chemother. 2010; 65: 1416–23.
• 36-Nicodemo AC, Araujo MR, Ruiz AS Gales AC. In vitro susceptibility of Stenotrophomonas maltophilia isolates: comparison of disc diffusion, Etest and agar dilution methods. J Antimicrob Chemother. 2004; 53: 604–8.
• 37-Tan TY, Ng SY. Comparison of Etest, Vitek and agar dilution for susceptibility testing of colistin. Clin Microbiol Infect. 2007; 13: 541–4.
• 38-San Gabriel P, Zhou J, Tabibi S, Chen Y, Trauzzi M, Saiman L. Antimicrobial susceptibility and synergy studies of Stenotrophomonas maltophilia isolates from patients with cystic fibrosis. Antimicrob Agents Chemother. 2004; 48: 168–171.
• 39- Insa R, E. Cercenado E, Goyanes MJ, Morente A, Bouza E. In vitro activity of tigecycline against clinical isolates of Acinetobacter baumannii and Stenotrophomonas maltophilia. J Antimicrob Chemother. 2007;59 (3): 583-5.