Abstract
Background
Stenotrophomonas maltophilia (SM) has emerged as a common hospital-associated opportunistic pathogen found in immunocompromised and immunocompetent patients. SM is intrinsically resistant to many common drug classes, including carbapenems, cephalosporins, and aminoglycosides. Only 4 antibiotics have CLSI breakpoints for SM: minocycline (MIN), ceftazidime (CAZ), levofloxacin (LVX) and trimethoprim-sulfamethoxazole (TMP-SMX). Minocycline is frequently used to treat SM infections. In this study, we analyzed susceptibilities of SM isolates collected as part of the SENTRY Program. We also examined the frequency of SM isolation from pneumonia in hospitalized patients (PIHP) among all Gram-negative (GN) species.
Methods
From 2014 to 2018, 990 SM isolates were collected from hospitalized patients in 32 US hospitals. Hospitals submitted 1 isolate per patient per infection episode that met local criteria for being the likely causative pathogen and submitted consecutive isolates from pneumonia. Isolates were tested for MIN susceptibility (S) using the CLSI broth microdilution method at JMI Laboratories. Other antimicrobials tested were CAZ, LVX, and TMP-SMX. TMP-SMX was tested 3 of 5 years. All infection types were included in the susceptibility analysis. The prevalence of SM isolates in PIHP during this period was also analyzed.
Results
There were 9,120 GN pathogens isolated from PIHP. The most commonly isolated species was P. aeruginosa (34.7%), followed by Klebsiella pneumoniae (12.6%), Escherichia coli (10.1%), and SM (7.9%). Among the 990 infections caused by SM, PIHP was the most common at 72.4%, followed by bloodstream infections (14.4%) and skin/skin structure infections (6.9%). The %S and MIC50/90 values of the 4 antimicrobials tested in this study are shown in the table.
Conclusion
SM was the fourth most frequent cause of GN PIHP in US medical centers. MIN was the most active drug tested against SM with 99.5%S, followed by TMP-SMX (94.7%), and CAZ was the least active with 28.5%S. This study suggests that MIN may be a consideration as a treatment for infections caused by SM, with a very low resistance rate based on CLSI breakpoints.
Disclosures
All authors: No reported disclosures.