Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis. 2023

Yu-Lin Lee, and Po-Ren Hsueh
Department of Internal Medicine.

This systematic review aimed to explore the recent trends in the epidemiology, risk factors, and antimicrobial susceptibility of two emerging opportunistic pathogens, Stenotrophomonas maltophilia and Elizabethkingia anophelis . Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia . Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis , there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis . The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported. Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis , but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens.

UI MeSH Term Description Entries
D008826 Microbial Sensitivity Tests Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses). Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D008911 Minocycline A TETRACYCLINE analog, having a 7-dimethylamino and lacking the 5 methyl and hydroxyl groups, which is effective against tetracycline-resistant STAPHYLOCOCCUS infections. Akamin,Akne-Puren,Aknemin,Aknin-Mino,Aknosan,Apo-Minocycline,Arestin,Blemix,Cyclomin,Cyclops,Dentomycin,Dynacin,Icht-Oral,Klinomycin,Lederderm,Mestacine,Minakne,Mino-Wolff,Minocin,Minocin MR,Minoclir,Minocycline Hydrochloride,Minocycline Monohydrochloride,Minocycline, (4R-(4 alpha,4a beta,5a beta,12a beta))-Isomer,Minolis,Minomycin,Minoplus,Minotab,Minox 50,Mynocine,Akne Puren,Aknin Mino,Apo Minocycline,Hydrochloride, Minocycline,Icht Oral,Mino Wolff,Monohydrochloride, Minocycline
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000097602 Cefiderocol A siderophore cephalosporin with enhanced activity against GRAM-NEGATIVE AEROBIC BACTERIA. Cefiderocol Sulfate Tosylate,Fetroja,S-649266,S 649266,S649266
D000890 Anti-Infective Agents Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. Anti-Infective Agent,Anti-Microbial Agent,Antimicrobial Agent,Microbicide,Microbicides,Anti-Microbial Agents,Antiinfective Agents,Antimicrobial Agents,Agent, Anti-Infective,Agent, Anti-Microbial,Agent, Antimicrobial,Agents, Anti-Infective,Agents, Anti-Microbial,Agents, Antiinfective,Agents, Antimicrobial,Anti Infective Agent,Anti Infective Agents,Anti Microbial Agent,Anti Microbial Agents
D000900 Anti-Bacterial Agents Substances that inhibit the growth or reproduction of BACTERIA. Anti-Bacterial Agent,Anti-Bacterial Compound,Anti-Mycobacterial Agent,Antibacterial Agent,Antibiotics,Antimycobacterial Agent,Bacteriocidal Agent,Bacteriocide,Anti-Bacterial Compounds,Anti-Mycobacterial Agents,Antibacterial Agents,Antibiotic,Antimycobacterial Agents,Bacteriocidal Agents,Bacteriocides,Agent, Anti-Bacterial,Agent, Anti-Mycobacterial,Agent, Antibacterial,Agent, Antimycobacterial,Agent, Bacteriocidal,Agents, Anti-Bacterial,Agents, Anti-Mycobacterial,Agents, Antibacterial,Agents, Antimycobacterial,Agents, Bacteriocidal,Anti Bacterial Agent,Anti Bacterial Agents,Anti Bacterial Compound,Anti Bacterial Compounds,Anti Mycobacterial Agent,Anti Mycobacterial Agents,Compound, Anti-Bacterial,Compounds, Anti-Bacterial
D014640 Vancomycin Antibacterial obtained from Streptomyces orientalis. It is a glycopeptide related to RISTOCETIN that inhibits bacterial cell wall assembly and is toxic to kidneys and the inner ear. AB-Vancomycin,Diatracin,VANCO-cell,Vanco Azupharma,Vanco-saar,Vancocin,Vancocin HCl,Vancocine,Vancomicina Abbott,Vancomicina Chiesi,Vancomicina Combino Phar,Vancomicina Norman,Vancomycin Hexal,Vancomycin Hydrochloride,Vancomycin Lilly,Vancomycin Phosphate (1:2),Vancomycin Phosphate (1:2), Decahydrate,Vancomycin Sulfate,Vancomycin-ratiopharm,Vancomycine Dakota,Hydrochloride, Vancomycin,Sulfate, Vancomycin
D015662 Trimethoprim, Sulfamethoxazole Drug Combination A drug combination with broad-spectrum antibacterial activity against both gram-positive and gram-negative organisms. It is effective in the treatment of many infections, including PNEUMOCYSTIS PNEUMONIA in AIDS. Trimethoprim-Sulfamethoxazole Combination,Abactrim,Bactifor,Bactrim,Biseptol,Biseptol-480,Centran,Centrin,Co-Trimoxazole,Cotrimoxazole,Drylin,Eslectin,Eusaprim,Insozalin,Kepinol,Kepinol Forte,Lescot,Metomide,Oriprim,Septra,Septrin,Sulfamethoxazole-Trimethoprim Combination,Sulprim,Sumetrolim,TMP SMX,TMP-SMX,Trimedin,Trimethoprim-Sulfamethoxazole,Trimethoprimsulfa,Trimezole,Trimosulfa,Biseptol 480,Biseptol480,Co Trimoxazole,Sulfamethoxazole Trimethoprim Combination,Trimethoprim Sulfamethoxazole,Trimethoprim Sulfamethoxazole Combination
D016905 Gram-Negative Bacterial Infections Infections caused by bacteria that show up as pink (negative) when treated by the gram-staining method. Bacterial Infections, Gram-Negative,Infections, Gram-Negative Bacterial,Bacterial Infection, Gram-Negative,Gram Negative Bacterial Infections,Gram-Negative Bacterial Infection,Infection, Gram-Negative Bacterial
D020615 Stenotrophomonas maltophilia A species of STENOTROPHOMONAS, formerly called Xanthomonas maltophilia, which reduces nitrate. It is a cause of hospital-acquired ocular and lung infections, especially in those patients with cystic fibrosis and those who are immunosuppressed. Xanthomonas maltophilia,Pseudomonas maltophilia

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