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      Infective endocarditis caused by Stenotrophomonas maltophilia: A report of two cases and review of literature

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          Abstract

          Stenotrophomonas maltophilia is known for nosocomial habitat. Infective endocarditis due to this organism is rare and challenging because of resistance to multiple broad-spectrum antibiotic regimens. Early detection and appropriate antibiotic based on culture sensitivity reports are the key to its management. We report the diagnosis, treatment, and outcome of two cases of infective endocarditis caused by S. maltophilia.

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          Stenotrophomonas maltophilia: an emerging opportunist human pathogen.

          W John Looney, Masashi Narita, Kathrin Mühlemann (2009)
          Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen in the debilitated host. S maltophilia is not an inherently virulent pathogen, but its ability to colonise respiratory-tract epithelial cells and surfaces of medical devices makes it a ready coloniser of hospitalised patients. S maltophilia can cause blood-stream infections and pneumonia with considerable morbidity in immunosuppressed patients. Management of infection is hampered by high-level intrinsic resistance to many antibiotic classes and the increasing occurrence of acquired resistance to the first-line drug co-trimoxazole. Prevention of acquisition and infection depends upon the application of modern infection-control practices, with emphasis on the control of antibiotic use and environmental reservoirs.
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            Guidelines for the management of intravascular catheter-related infections.

            , , Robert Sherertz … (2001)
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              Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia.

              K Kerr, M Denton (1997)
              The gram-negative bacterium Stenotrophomonas maltophilia is increasingly recognized as an important cause of nosocomial infection. Infection occurs principally, but not exclusively, in debilitated and immunosuppressed individuals. Management of S. maltophilia-associated infection is problematic because many strains of the bacterium manifest resistance to multiple antibiotics. These difficulties are compounded by methodological problems in in vitro susceptibility testing for which there are, as yet, no formal guidelines. Despite its acknowledged importance as a nosocomial pathogen, little is known of the epidemiology of S. maltophilia, and although it is considered an environmental bacterium, its sources and reservoirs are often not readily apparent. Molecular typing systems may contribute to our knowledge of the epidemiology of S. maltophilia infection, thus allowing the development of strategies to interrupt the transmission of the bacterium in the hospital setting. Even less is known of pathogenic mechanisms and putative virulence factors involved in the natural history of S. maltophilia infection and this, coupled with difficulties in distinguishing colonization from true infection, has fostered the view that the bacterium is essentially nonpathogenic. This article aims to review the current taxonomic status of S. maltophilia, and it discusses the laboratory identification of the bacterium. The epidemiology of the organism is considered with particular reference to nosocomial outbreaks, several of which have been investigated by molecular typing techniques. Risk factors for acquisition of the bacterium are also reviewed, and the ever-expanding spectrum of clinical syndromes associated with S. maltophilia is surveyed. Antimicrobial resistance mechanisms, pitfalls in in vitro susceptibility testing, and therapy of S. maltophilia infections are also discussed.
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                Author and article information

                Contributors
                Shaik Subhani
                Journal
                Journal ID (nlm-ta): Indian Heart J
                Journal ID (iso-abbrev): Indian Heart J
                Title: Indian Heart Journal
                Publisher: Elsevier
                ISSN (Print): 0019-4832
                Publication date (Print): September 2016
                Publication date (Electronic): 14 January 2016
                Volume: 68
                Issue: Suppl 2
                Pages: S267-S270
                Affiliations
                [a ]Senior Resident, Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad 500082, India
                [b ]Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad 500082, India
                Author notes
                [* ] Corresponding author. drsubhani03@ 123456gmail.com
                Article
                Publisher ID: S0019-4832(15)00336-3
                DOI: 10.1016/j.ihj.2015.07.048
                PMC ID: 5067447
                PubMed ID: 27751311
                SO-VID: 4b8e34a6-52bf-4142-9cf7-d432380ecbc8
                Copyright © © 2015 Cardiological Society of India. Published by Elsevier B.V.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 28 December 2013
                Date accepted : 30 July 2015
                Categories
                Subject: Case Reports

                Keywords: s. maltophilia,infective endocarditis,nosocomial,in-hospital habitat
                Data availability:
                Keywords: s. maltophilia, infective endocarditis, nosocomial, in-hospital habitat

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