Download PDF
Semin Respir Crit Care Med 2003; 24(1): 089-098
DOI: 10.1055/s-2003-37920
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Stenotrophomonas Maltophilia Infections

M. Cecilia Dignani1 , Monica Grazziutti2 , Elias Anaissie3
  • 1FUNDALEU, Buenos Aires, Argentina
  • 2FUNCEI, Buenos Aires, Argentina
  • 3Myeloma Institute for Research and Treatment, The Arkansas Cancer Research Center, The University of Arkansas for Medical Sciences, Little Rock, Arkansas
Further Information

Publication History

Publication Date:
14 March 2003 (online)

    Permissions and Reprints

ABSTRACT

Stenotrophomonas maltophilia is a ubiquitous, gram-negative organism that causes hospital-acquired infections. Persons often come in contact with S. maltophilia through environmental water sources, including hospital tap water or faucets, and it has been associated with nosocomial outbreaks of infection. S. maltophilia often infects debilitated persons and those with underlying medical conditions, including immunosuppression. Manifestations of infection include pneumonia, often in mechanically ventilated patients, bacteremia, skin and soft tissue infection, urinary tract infection, and endocarditis. Treatment of S. maltophilia infection is difficult because the organism is resistant to a number of agents typically used for hospital-acquired infections. In vitro and clinical data indicate that trimethoprim-sulfamethoxazole is the agent of choice. Beta-lactamase inhibitors such as clavulanate are also active, and combination therapy may be indicated for certain serious infections due to S. maltophilia.

KEYWORDS

Stenotrophomonas maltophilia, nosocomial infections - immunocompromised host

REFERENCES

  • 1 Denton M, Kerr K G. Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia .  Clin Microbiol Rev . 1998;  11 57-80
    CrossrefPubMedGoogle Scholar
  • 2 Gales A C, Jones R N, Forward K R, Linares J, Sader H S, 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) 104-113
    CrossrefPubMedGoogle Scholar
  • 3 Gopalakrishnan R, Hawley H B, Czachor J S, Markert R J, Bernstein J M. Stenotrophomonas maltophilia infection and colonization in the intensive care units of two community hospitals: a study of 143 patients.  Heart Lung . 1999;  28 134-141
    CrossrefPubMedGoogle Scholar
  • 4 Micozzi A, Venditti M, Monaco M. Bacteremia due to Stenotrophomonas maltophilia in patients with hematologic malignancies.  Clin Infect Dis . 2000;  31 705-711
    CrossrefPubMedGoogle Scholar
  • 5 Labarca J A, Leber A L, Kern V L. Outbreak of Stenotrophomonas maltophilia bacteremia in allogenic bone marrow transplant patients: role of severe neutropenia and mucositis.  Clin Infect Dis . 2000;  30 195-197
    CrossrefPubMedGoogle Scholar
  • 6 Khardori N, Elting L, Wong E, Schable B, Bodey G P. Nosocomial infections due to Xanthomonas maltophilia (Pseudomonas maltophilia) in patients with cancer.  Rev Infect Dis . 1990;  12 997-1003
    PubMedGoogle Scholar
  • 7 Muder R R, Harris A P, Muller S. Bacteremia due to Stenotrophomona (Xanthomonas) maltophilia: a prospective, multicenter study of 91 episodes.  Clin Infect Dis . 1996;  22 508-512
    PubMedGoogle Scholar
  • 8 Victor M A, Arpi M, Bruun B, Jonsson V, Hansen M M. Xanthomonas maltophilia bacteremia in immunocompromised hematological patients.  Scand J Infect Dis . 1994;  26 163-170
    PubMedGoogle Scholar
  • 9 Senol E, DesJardin J, Stark P C, Barefoot L, Snydman D R. Attributable mortality of Stenotrophomonas maltophilia bacteremia.  Clin Infect Dis . 2002;  34 1653-1656
    CrossrefPubMedGoogle Scholar
  • 10 Hugh R, Ryschenkow E. Pseudomonas maltophilia, an alcaligenes-like species.  J Gen Microbiol . 1961;  26 123-132
    PubMedGoogle Scholar
  • 11 Swings J, De Vos P, Van den Mooter M, De Ley J. Transfer of Pseudomonas maltophilia Hugh 1981 to the genus Xanthomonas maltophilia (Hugh 1981) comb, nov.  Int J Syst Bacteriol . 1983;  33 409-413
    PubMedGoogle Scholar
  • 12 Palleroni N J, Bradbury J F. Stenotrophomona, a new bacterial genus for Xanthomonas maltophilia (Hugh 1980) Swings et al 1983.  Int J Syst Bacteriol . 1993;  43 606-609
    PubMedGoogle Scholar
  • 13 Gilligan P H, Whittier S. Burkholderia, Stenotrophomona, Ralstonia, Brevundimonas, Comamonas, and Acidovorax In: Murray PR, ed. Manual of Clinical Microbiology.  7th ed. Washington, DC: ASM Press 1999: 526-538
    Google Scholar
  • 14 Burdge D R, Noble M A, Campbell M E, Krell V L, Speert D P. Xanthomonas maltophilia misidentified as Pseudomonas cepacia in cultures of sputum from patients with cystic fibrosis: a diagnostic pitfall with major clinical implications.  Clin Infect Dis . 1995;  20 445-448
    PubMedGoogle Scholar
  • 15 Kerr K G, Corps C M, Hawkey P M. Infections due to Xanthomonas maltophilia in patients with hematologic malignancy [letter; comment].  Rev Infect Dis . 1991;  13 762
    PubMedGoogle Scholar
  • 16 Von Graevenitz A, Bucher C. Isolation of Pseudomonas maltophilia from human stools with thienamycin.  Zentralblatt für Bakteriologie, Mikrobiologie und Hygiene-1-Abt- Originale A, Medizinische Mikrobiologie, Infektionskrankheiten und Parasitologie . 1983;  254 403-404
    PubMedGoogle Scholar
  • 17 Rosenthal S L. Sources of Pseudomonas and Acinetobacter species found in human culture materials.  Am J Clin Pathol . 1974;  62 807-811
    PubMedGoogle Scholar
  • 18 Denton M, Todd N J, Kerr K G, Hawkey P M, Littlewood J M. Molecular epidemiology of Stenotrophomonas maltophilia isolated from clinical specimens from patients with cystic fibrosis and associated environmental samples.  J Clin Microbiol . 1998;  36 1953-1958
    PubMedGoogle Scholar
  • 19 Villarino M E, Stevens L E, Schable B. Risk factors for epidemic Xanthomonas maltophilia infection/colonization in intensive care unit patients.  Infect Control Hosp Epidemiol . 1992;  13 201-206
    PubMedGoogle Scholar
  • 20 VanCouwenbergh C, Cohen S. Analysis of epidemic and endemic isolates of Xanthomonas maltophilia by contour-clamped homogeneous electric field gel electrophoresis.  Infect Control Hosp Epidemiol . 1994;  15 691-696
    PubMedGoogle Scholar
  • 21 Khardori N, Reuben A, Rosenbaum B, Rolston K, Bodey G P. In vitro susceptibility of Xanthomonas (Pseudomonas) maltophilia to newer antimicrobial agents.  Antimicrob Agents Chemother . 1990;  34 1609-1610
    PubMedGoogle Scholar
  • 22 del Toro D M, Rodriguez-Bano J, Herrero M. Clinical epidemiology of Stenotrophomonas maltophilia colonization and infection: a multicenter study.  Medicine . 2002;  81 228-239
    CrossrefPubMedGoogle Scholar
  • 23 Ballestero S, Virseda I, Escobar H, Suarez L, Baquero F. Stenotrophomonas maltophilia in cystic fibrosis patients [letter].  Eur J Clin Microbiol Infecti Dis . 1995;  14 728-729
    PubMedGoogle Scholar
  • 24 Weber D J, Rutala W A, Blanchet C N, Jordan M, Gergen M F. Faucet aerators: a source of patient colonization with Stenotrophomonas maltophilia Am J Infect Control .  1999;  27 59-63
    PubMedGoogle Scholar
  • 25 Sakhnini E, Weissmann A, Oren I. Fulminant Stenotrophomonas maltophilia soft tissue infection in immunocompromised patients: an outbreak transmitted via tap water.  Am J Med Sci . 2002;  323 269-272
    PubMedGoogle Scholar
  • 26 Alfieri N, Ramotar K, Armstrong P. Two consecutive outbreaks of Stenotrophomonas maltophilia (Xanthomonas maltophilia) in an intensive-care unit defined by restriction fragment-length polymorphism typing.  Infect Control Hosp Epidemiol . 1999;  20 553-556
    PubMedGoogle Scholar
  • 27 Cameron J L, Reese W A, Tayal V S. Bacterial contamination of ambulance oxygen humidifier water reservoirs: a potential source of pulmonary infection.  Ann Emerg Med . 1986;  15 1300-1302
    PubMedGoogle Scholar
  • 28 Rogues A M, Maugein J, Allery A. Electronic ventilator temperature sensors as a potential source of respiratory tract colonization with Stenotrophomonas maltophilia J Hosp Infect .  2001;  49 289-292
    PubMedGoogle Scholar
  • 29 Fisher M C, Long S S, Roberts E M, Dunn J M, Balsara R K. Pseudomonas maltophilia bacteremia in children undergoing open heart surgery.  JAMA . 1981;  246 1571-1574
    CrossrefPubMedGoogle Scholar
  • 30 Wishart M M, Riley T V. Infection with Pseudomonas maltophilia hospital outbreak due to contaminated disinfectant.  Med J Aust . 1976;  2 710-712
    PubMedGoogle Scholar
  • 31 Oie S, Kamiya A. Microbial contamination of brushes used for preoperative shaving.  J Hosp Infect . 1992;  21 103-110
    CrossrefPubMedGoogle Scholar
  • 32 Loukhmas L, Houmane N, Mskine M, Mdaghri N, Benbachir M, Benchemsi N. [Prevalence of bacterial contamination of standard platelet units: prospective study].  Transfus Clin Biol . 2000;  7 171-176
    CrossrefPubMedGoogle Scholar
  • 33 Orr K, Gould F K, Sisson P R, Lightfoot N F, Freeman R, Burdess D. Rapid inter-strain comparison by pyrolysis mass spectrometry in nosocomial infection with Xanthomonas maltophilia J Hosp Infect .  1991;  17 187-195
    PubMedGoogle Scholar
  • 34 Flaherty J P, Garcia-Houchins S, Chudy R, Arnow P M. An outbreak of gram-negative bacteremia traced to contaminated O-rings in reprocessed dialyzers.  Ann Intern Med . 1993;  119 1072-1078
    PubMedGoogle Scholar
  • 35 Anonymous. Ice as a source of infection acquired in hospital. Communicable Disease Report.  CDR Weekly . 1993;  3 241
    PubMedGoogle Scholar
  • 36 Klausner J D, Zukerman C, Limaye A P, Corey L. Outbreak of Stenotrophomonas maltophilia bacteremia among patients undergoing bone marrow transplantation: association with faulty replacement of handwashing soap.  Infect Control Hosp Epidemiol . 1999;  20 756-758
    PubMedGoogle Scholar
  • 37 Verweij P E, Meis J F, Christmann V. Nosocomial outbreak of colonization and infection with Stenotrophomonas maltophilia in preterm infants associated with contaminated tap water.  Epidemiol Infect . 1998;  120 251-256
    CrossrefPubMedGoogle Scholar
  • 38 Talon D, Bailly P, Leprat R. Typing of hospital strains of Xanthomonas maltophilia by pulsed-field gel electrophoresis.  J Hosp Infect . 1994;  27 209-217
    CrossrefPubMedGoogle Scholar
  • 39 Krzewinski J W, Nguyen C D, Foster J M, Burns J L. Use of random amplified polymorphic DNA PCR to examine epidemiology of Stenotrophomonas maltophilia and Achromobacter (Alcaligenes) xylosoxidans from patients with cystic fibrosis.  J Clin Microbiol . 2001;  39 3597-3602
    CrossrefPubMedGoogle Scholar
  • 40 Gerner-Smidt P, Bruun B, Arpi M, Schmidt J. Diversity of nosocomial Xanthomonas maltophilia (Stenotrophomonas maltophilia) as determined by ribotyping.  Eur J Clin Microbiol Infect Dis . 1995;  14 137-140
    PubMedGoogle Scholar
  • 41 Davin-Regli A, Bollet C, Auffray J P, Saux P, De Micco P. Use of random amplified polymorphic DNA for epidemiological typing of Stenotrophomonas maltophilia J Hosp Infect .  1996;  32 39-50
    CrossrefPubMedGoogle Scholar
  • 42 Laing F P, Ramotar K, Read R R. Molecular epidemiology of Xanthomonas maltophilia colonization and infection in the hospital environment.  J Clin Microbiol . 1995;  33 513-518
    PubMedGoogle Scholar
  • 43 de Viedma G D, Marin M, Cercenado E, Alonso R, Rodriguez-Creixems M, Bouza E. Evidence of nosocomial Stenotrophomonas maltophilia cross-infection in a neonatology unit analyzed by three molecular typing methods.  Infect Control Hosp Epidemiol . 1999;  20 816-820
    PubMedGoogle Scholar
  • 44 VanCouwenbergh C, Cohen S. Analysis of epidemic and endemic isolates of Xanthomonas maltophilia by contour-clamped homogeneous electric field gel electrophoresis.  Infect Control Hosp Epidemiol . 1994;  15 691-696
    PubMedGoogle Scholar
  • 45 Elting L S, Khardori N, Bodey G P, Fainstein V. Nosocomial infection caused by Xanthomonas maltophilia: a case-control study of predisposing factors.  Infect Control Hosp Epidemiol . 1990;  11 134-138
    PubMedGoogle Scholar
  • 46 VanCouwenberghe C J, Farver T B, Cohen S H. Risk factors associated with isolation of Stenotrophomona (Xanthomonas) maltophilia in clinical specimens.  Infect Control Hosp Epidemiol . 1997;  18 316-321
    PubMedGoogle Scholar
  • 47 Talmaciu I, Varlotta L, Mortensen J, Schidlow D V. Risk factors for emergence of Stenotrophomonas maltophilia in cystic fibrosis.  Pediatr Pulmonol . 2000;  30 10-15
    CrossrefPubMedGoogle Scholar
  • 48 Hanes S D, Demirkan K, Tolley E. Risk factors for late-onset nosocomial pneumonia caused by Stenotrophomonas maltophilia in critically ill trauma patients.  Clin Infect Dis . 2002;  35 228-235
    CrossrefPubMedGoogle Scholar
  • 49 Marshall W F, Keating M R, Anhalt J P, Steckelberg J M. Xanthomonas maltophilia: an emerging nosocomial pathogen.  Mayo Clin Proc . 1989;  64 1097-1104
    PubMedGoogle Scholar
  • 50 Elting L S, Bodey G P. Septicemia due to Xanthomonas species and non-aeruginosa Pseudomonas species: increasing incidence of catheter-related infections.  Medicine . 1990;  69 296-306
    PubMedGoogle Scholar
  • 51 Penland R L, Wilhelmus K R. Stenotrophomonas maltophilia ocular infections.  Arch of Ophthalmol . 1996;  114 433-436
    PubMedGoogle Scholar
  • 52 Taylor G, McKenzie M, Buchanan-Chell M, Perry D, Chui L, Dasgupta M. Peritonitis due to Stenotrophomonas maltophilia in patients undergoing chronic peritoneal dialysis.  Perit Dial Int . 1999;  19 259-262
    PubMedGoogle Scholar
  • 53 Sattler C A, Mason Jr O E, Kaplan S L. Nonrespiratory Stenotrophomonas maltophilia infection at a children's hospital.  Clin Infect Dis . 2000;  31 1321-1330
    CrossrefPubMedGoogle Scholar
  • 54 Zuravleff J J, Yu V L. Infections caused by Pseudomonas maltophilia with emphasis on bacteremia: case reports and a review of the literature.  Rev Infect Dis . 1982;  4 1236-1246
    PubMedGoogle Scholar
  • 55 Vartivarian S. Therapy of Stenotrophomona (Xanthomonas) maltophilia infections: problems and pitfalls. In: Programs and Abstracts of the 36th Interscience Conference of Antimicrobial Agents and Chemotherapy, September 15-18, 1996, New Orleans, Louisiana
    Google Scholar
  • 56 Vartivarian S, Papadakis A, Kiwan E, Anaissie E J. The clinical spectrum of Stenotrophomona (Xanthomonas) maltophilia respiratory infection.  Semin Respir Crit Care Med . 2000;  21 349-353
    PubMedGoogle Scholar
  • 57 Ibrahim E H, Ward S, Sherman G, Kollef M H. A comparative analysis of patients with early-onset vs late-onset nosocomial pneumonia in the ICU setting.  Chest . 2000;  117 1434-1442
    CrossrefPubMedGoogle Scholar
  • 58 Koontz C S, Chang M C, Meredith J W. Effects of empiric antibiotic administration for suspected pneumonia on subsequent opportunisitc pulmonary infections.  Am Surg . 2000;  66 1110-1114
    PubMedGoogle Scholar
  • 59 Trouillet J L, Chastre J, Vuagnat A. Ventilator-associated pneumonia caused by potentially drug-resistant bacteria.  Amer J Respir Crit Care Med . 1998;  157 531-539
    CrossrefPubMedGoogle Scholar
  • 60 Liu Z, Zhao Z, Xiong J. Analysis of clinical characteristics and drug sensitivity tests of lower respiratory tract infection by Xanthomonas maltophilia Zhonghua Jie He He Hu Xi Za Zhi .  1999;  22 211-213
    PubMedGoogle Scholar
  • 61 Raffenberg M, Szymanski T, Lubasch A. Infections caused by Stenotrophomonas maltophilia (SMA) in intensive care patients: a prospective case-control study.  Dtsch Med Wochenschr . 2001;  126 514-518
    Article in Thieme ConnectPubMedGoogle Scholar
  • 62 Maningo E, Watanakunakorn C. Xanthomonas maltophilia and Pseudomonas cepacia in lower respiratory tracts of patients in critical care units.  J Infect . 1995;  31 89-92
    CrossrefPubMedGoogle Scholar
  • 63 Wu C L, Yang D, Wang N Y, Kuo H T, Chen P Z. Quantitative culture of endotracheal aspirates in the diagnosis of ventilator-associated pneumonia in patients with treatment failure.  Chest . 2002;  122 662-668
    CrossrefPubMedGoogle Scholar
  • 64 Kollef M H, Silver P, Murphy D M, Trovillion E. The effect of late-onset ventilator-associated pneumonia in determining patient mortality.  Chest . 1995;  108 1655-1662
    CrossrefPubMedGoogle Scholar
  • 65 Soler N, Torres A, Ewing S. Bronchial microbial patterns in severe exacerbations of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation.  Am J Respir Crit Care Med . 1998;  157 1498-1505
    CrossrefPubMedGoogle Scholar
  • 66 Elsner H A, Duhrsen U, Hollwitz B, Kaulfers P M, Hossfeld D K. Fatal pulmonary hemorrhage in patients with acute leukemia and fulminant pneumonia caused by Stenotrophomonas maltophilia Ann Hematol .  1997;  74 155-161
    PubMedGoogle Scholar
  • 67 Ozkan H, Pasaoglu G, Olgac N, Gunel R, Yuce A, Gulay Z. Stenotrophomonas maltophilia pneumonia in a premature infant.  Turk J Pediatr . 1999;  41 283-286
    PubMedGoogle Scholar
  • 68 Sales P, Garcia R, Saballs P, Drobnic L, Gimeno J L. [Community-acquired bacteremia and pneumonia caused by Stenotrophomonas maltophilia in a patient with AIDS (letter)].  Enfermedades Infecciosas y Microbiologia Clinica . 1998;  16 437
    PubMedGoogle Scholar
  • 69 Sarkar T K, Gilardi G, Aguam A S, Josephson J, Leventhal G L. Primary Pseudomonas maltophilia infection of the lung.  Postgrad Med . 1979;  65 253-260
    PubMedGoogle Scholar
  • 70 Guannarsson G, Steinsson K. Sinusitis due to Stenotrophomonas maltophilia Scan J Infect Dis .  2002;  34 136-137
    PubMedGoogle Scholar
  • 71 Harlowe H D. Acute mastoiditis following Pseudomonas maltophilia infection: case report.  Laryngoscope . 1972;  82 882-883
    PubMedGoogle Scholar
  • 72 Lyczak J B, Cannon C L, Pier G B. Lung infections associated with cystic fibrosis.  Clin Microbiol Rev . 2002;  15 194-222
    CrossrefPubMedGoogle Scholar
  • 73 Burns J L, Emerson J, Stapp J R. Microbiology of sputum from patients at cystic fibrosis centers in the United States.  Clin Infect Dis . 1998;  27 158-163
    CrossrefPubMedGoogle Scholar
  • 74 Burns J L, Van Dalfsen M J, Shawar R M. Effect of chronic intermittent administration of inhaled tobramycin on respiratory microbial flora in patients with cystic fibrosis.  J Infect Dis . 1999;  179 1190-1196
    CrossrefPubMedGoogle Scholar
  • 75 Graff G R, Burns J L. Factors affecting the incidence of Stenotrophomonas maltophilia isolation in cystic fibrosis.  Chest . 2002;  121 1754-1760
    CrossrefPubMedGoogle Scholar
  • 76 Goss C H, Otto K, Aitken M L, Rubenfeld G D. Detecting Stenotrophomonas maltophilia does not reduce survival of patients with cystic fibrosis.  Am J Respir Crit Care Med . 2002;  166 356-361
    CrossrefPubMedGoogle Scholar
  • 77 Valdezate S, Vindel A, Maiz L, Baquero F, Escobar H, Canton R. Persistence and variability of Stenotrophomonas maltophilia in cystic fibrosis patients, Madrid, 1991-1998.  Emerg Infect Dis . 2001;  7 113-122
    PubMedGoogle Scholar
  • 78 Penzak S R, Gubbins P O, Stratton S L, Anaissie E J. Investigation of an outbreak of gram-negative bacteremia among hematology-oncology outpatients.  Infect Control Hosp Epidemiol . 2000;  21 597-599
    PubMedGoogle Scholar
  • 79 Krcmery V J, Sykora P, Trupl J. Antimicrobial use and development of resistance in blood culture isolates: 8 years of experience from a cancer referral center.  J Chemother . 2001;  13 133-142
    PubMedGoogle Scholar
  • 80 Carmeli Y, Samore M H. Comparison of treatment with imipenem versus ceftazidime as a predisposing factor for nosocomial acquisition of Stenotrophomonas maltophilia: a historical cohort study.  Clin Infect Dis . 1997;  24 1131-1134
    PubMedGoogle Scholar
  • 81 Friedman N, Korman T, Fairley C, Franklin J, Spelman D. Bacteremia due to Stenotrophomonas maltophilia: an analysis of 45 episodes.  J Infect . 2002;  45 47
    CrossrefPubMedGoogle Scholar
  • 82 Krupova Y, Novotny J, Sabo A, Mateicka F, Krcmery Jr V. Aetiology, cost of antimicrobial therapy and outcome in neutropenic patients who developed bacteraemia during antimicrobial prophylaxis: a case-control study.  Int J Antimicrob Agents . 1998;  10 313-316
    PubMedGoogle Scholar
  • 83 Muder R R, Yu V L, Dummer J S, Vinson C, Lumish R M. Infections caused by Pseudomonas maltophilia: expanding clinical spectrum.  Arch Intern Med . 1987;  147 1672-1674
    CrossrefPubMedGoogle Scholar
  • 84 Sefcick A, Tait R C, Wood B. Stenotrophomonas maltophilia: an increasing problem in patients with acute leukemia.  Leuk Lymph . 1999;  35 207-211
    PubMedGoogle Scholar
  • 85 Al-Hilali N, Nampoory M R, Johny K V, Chugh T D. Xanthomonas maltophilia infection in chronic peritoneal dialysis patients.  Scand J Urol Nephrol . 2000;  34 67-69
    PubMedGoogle Scholar
  • 86 Vartivarian S E, Papadakis K A, Palacios J A, Manning Jr T J, Anaissie E J. Mucocutaneous and soft tissue infections caused by Xanthomonas maltophilia: a new spectrum.  Ann Intern Med . 1994;  121 969-973
    PubMedGoogle Scholar
  • 87 Downhour N P, Petersen E A, Krueger T S, Tangella K V, Nix D E. Severe cellulitis/myositis caused by Stenotrophomonas maltophilia Ann Pharmacother .  2002;  36 63-66
    PubMedGoogle Scholar
  • 88 Moser C, Jonsson V, Thomsen K, Albrectsen J, Hansen M M, Prag J. Subcutaneous lesions and bacteraemia due to Stenotrophomonas maltophilia in three leukaemic patients with neutropenia.  Br J Dermatol . 1997;  136 949-952
    CrossrefPubMedGoogle Scholar
  • 89 Burns R L, Lowe L. Xanthomonas maltophilia infection presenting as erythematous nodules.  J Am Acad Dermatol . 1997;  37(5 Pt 2) 836-838
    PubMedGoogle Scholar
  • 90 Pereira O, Velho G C, Lopes V, Mota F, Santos C, Massa A. Acral necrosis by Stenotrophomonas maltophilia J Eur Dermatol Venereol .  2001;  15 334-336
    PubMedGoogle Scholar
  • 91 Meier S, Zellweger G, Elsner P, Wuthrich D, Krause M. [Fulminant purpura in Still's disease and bacteremia with Xanthomonas maltophilia and coagulase-negative staphylococci]. Schweizerische Medizinische Wochenschrift.  Journal Suisse de Medecine . 1994;  124(21) 900-905
    PubMedGoogle Scholar
  • 92 Vartivarian S E, Papadakis K A, Anaissie E J. Stenotrophomona (Xanthomonas) maltophilia urinary tract infection: a disease that is usually severe and complicated. Arch Intern Med .  1996;  156 433-435
    CrossrefPubMedGoogle Scholar
  • 93 Fischer J J. Pseudomonas maltophilia endocarditis after replacement of the mitral valve: a case study.  J Infect Dis . 1973;  128(suppl) S771-S773
    PubMedGoogle Scholar
  • 94 Gutierrez Rodero F, Masia M M, Cortes J, Ortiz de la Tabla V, Mainar V, Vilar A. Endocarditis caused by Stenotrophomonas maltophilia: case report and review.  Clin Infect Dis . 1996;  23 1261-1265
    PubMedGoogle Scholar
  • 95 Munter R G, Yinnon A M, Schlesinger Y, Hershko C. Infective endocarditis due to Stenotrophomona (Xanthomonas) maltophilia Eur J Clin Microbiol Infect Dis .  1998;  17 353-356
    PubMedGoogle Scholar
  • 96 Onate J, Aguirrebengoa K, Ibanez de Maeztu C J, Hernandez J L, Montejo M. [Xanthomonas maltophilia aortic endocarditis in an intravenous drug addict and review of the literature (letter)].  Enferm Infecc Microbiol Clin . 1995;  13 188-190
    PubMedGoogle Scholar
  • 97 Shimoni S, Abend Y, Shimon A, Landau Z, Caspi A. Stenotrophomonas maltophilia endocarditis following dental treatment in a previously healthy patient [letter].  J Infect . 1998;  37 305-306
    PubMedGoogle Scholar
  • 98 Subbannayya K, Ramnarayan K, Shivananda P G, Shatapathy P, Mathai A. Pseudomonas maltophilia endocarditis.  Indian J Pathol Microbiol . 1984;  27 311-315
    PubMedGoogle Scholar
  • 99 Yu V L, Rumans L W, Wing E J. Pseudomonas maltophilia causing heroin-associated infective endocarditis.  Arch Intern Med . 1978;  138 1667-1671
    CrossrefPubMedGoogle Scholar
  • 100 Aydin K, Koksal I, Kaygusuz S, Kaklikkaya I, Caylan R, Ozdemir R. Endocarditis caused by Stenotrophomonas maltophilia Scan J Infect Dis .  2000;  32 427-430
    PubMedGoogle Scholar
  • 101 Mehta N J, Khan I A, Mehta R N, Gulati A. Stenotrophomonas maltophilia endocarditis of prosthetic aortic valve: report of a case and review of the literature.  Heart Lung . 2000;  29 351-355
    CrossrefPubMedGoogle Scholar
  • 102 Meimoun P, Mainardi J L, Berrebi A. Stenotrophomonas maltophilia endocarditis following mitral valve prosthesis implantation: report of a case.  Arch Mal Coeur Vaiss . 1999;  92 1389-1392
    PubMedGoogle Scholar
  • 103 Khan I A, Mehta N J. Stenotrophomonas maltophilia endocarditis: a systematic review.  Angiology . 2002;  53 49-55
    PubMedGoogle Scholar
  • 104 Papadakis K A, Vartivarian S E, Vassilaki M E, Anaissie E J. Stenotrophomonas maltophilia: an unusual cause of biliary sepsis.  Clin Infect Dis . 1995;  21 1032-1034
    PubMedGoogle Scholar
  • 105 Berbari N, Johnson D H, Cunha B A. Xanthomonas maltophilia peritonitis in a patient undergoing peritoneal dialysis.  Heart Lung . 1993;  22 282-283
    PubMedGoogle Scholar
  • 106 Pasadakis P, Thodis E, Eftimimiadou A. Treatment and prevention of relapses of CAPD Pseudomonas peritonitis.  Adv Perit Dial . 1993;  9 206-210
    PubMedGoogle Scholar
  • 107 Szeto C C, Li P K, Leung C B, Yu A W, Lui S F, Lai K N. Xanthomonas maltophilia peritonitis in uremic patients receiving continuous ambulatory peritoneal dialysis.  Am J Kidney Dis . 1997;  29 91-95
    PubMedGoogle Scholar
  • 108 Taber T E, Hegeman T F, York S M, Kinney R A, Webb D H. Treatment of Pseudomonas infections in peritoneal dialysis patients.  Perit Dial Int . 1991;  11 213-216
    PubMedGoogle Scholar
  • 109 Monkemuller K E, Morgan D E, Baron T H. Stenotrophomona (Xanthomonas) maltophilia infection in necrotizing pancreatitis.  Int J Pancreatol . 1999;  25 59-63
    PubMedGoogle Scholar
  • 110 Calza L, Manfredi R, Marinacci G, Fortunato L, Chiodo F. Liver abscess caused by Stenotrophomona (Xanthomonas) maltophilia in a patient with AIDS.  AIDS 2001 . 2001;  7 2464-2467
    PubMedGoogle Scholar
  • 111 Ortiz Cansado A, Morales Blanco J P, Arrobas Vaca I, Lopez Cupido V. [Cholangitis with hepatosplenomegaly caused by Xanthomonas maltophilia in a patient with AIDS (letter)].  Rev Clin Esp . 1997;  197 382-383
    PubMedGoogle Scholar
  • 112 Girijaratnakumari T, Raja A, Ramani R, Antony B, Shivananda P G. Meningitis due to Xanthomonas maltophilia J Postgrad Med .  1993;  39 153-155
    PubMedGoogle Scholar
  • 113 Nguyen M H, Muder R R. Meningitis due to Xanthomonas maltophilia: case report and review.  Clin Infect Dis . 1994;  19 325-326
    PubMedGoogle Scholar
  • 114 Papadakis K A, Vartivarian S E, Vassilaki M E, Anaissie E J. Stenotrophomonas maltophilia meningitis: report of two cases and review of the literature.  J Neurosurg . 1997;  87 106-108
    PubMedGoogle Scholar
  • 115 Patrick S, Hindmarch J M, Hague R V, Harris D M. Meningitis caused by Pseudomonas maltophilia J Clin Pathol .  1975;  28 741-743
    PubMedGoogle Scholar
  • 116 Kaiser G M, Tso P C, Morris R, McCurdy D. Xanthomonas maltophilia endophthalmitis after cataract extraction.  Am J Ophthalmol . 1997;  123 410-411
    PubMedGoogle Scholar
  • 117 Chaundhry N A, Flynn H W, Smiddy W E, Miller D. Xanthomonas maltophilia endophthalmitis after cataract surgery.  Arch Ophthalmol . 2000;  118 572-575
    PubMedGoogle Scholar
  • 118 Horio H, Horiguchi M, Murakami K, Yamamoto E, Miyake Y. Stenotrophomonas maltophilia endophthalmitis after intraocular lens implantation.  Graefes Arch Clin Exp Ophthalmol . 2000;  238 299-301
    CrossrefPubMedGoogle Scholar
  • 119 Benian O, Alimgil L, Erda N. Two cases of Stenotrophomonas maltophilia endophthalmitis.  Ophthalmic Surg Lasers . 2002;  33 253-256
    PubMedGoogle Scholar
  • 120 Chen S, Stroh E M, Wald K, Jalkh A. Xanthomonas maltophilia endophthalmitis after implantation of sustained-release ganciclovir [letter].  Am J Ophthalmol . 1992;  114 772-773
    PubMedGoogle Scholar
  • 121 Patton N. Posttraumatic endophthalmitis caused by Xanthomonas maltophilia Eye .  2001;  15 801-802
    PubMedGoogle Scholar
  • 122 Lai T Y, Kwok A K, Fung K S, Chan W M, Fan D S, Lam D S. Stenotrophomonas maltophilia endophthalmitis after penetrating injury by a wooden splinter.  Eye . 2001;  15 353-354
    PubMedGoogle Scholar
  • 123 Spraul C W, Lang G E, Lang G K. Xanthomonas maltophilia keratitis associated with contact lenses [letter].  CLAO J . 1996;  22 158
    PubMedGoogle Scholar
  • 124 Bottone E J, Madayag R M, Qureshi M N. Acanthamoeba keratitis: synergy between amoebic and bacterial cocontaminants in contact lens care systems as a prelude to infection.  J Clin Microbiol . 1992;  30 2447-2450
    PubMedGoogle Scholar
  • 125 Sequeira W, Jones E, Siegel M E, Lorenz M, Kallick C. Pyogenic infections of the pubic symphysis.  Ann Intern Med . 1982;  96 604-606
    PubMedGoogle Scholar
  • 126 Belzunegui J, De Dios R J, Intxausti J J, Iribarren J A. Septic arthritis caused by Stenotrophomonas maltophilia in a patient with acquired immunodeficiency syndrome.  Clin Exp Rheumatol . 2000;  18 265
    PubMedGoogle Scholar
  • 127 Papadakis K A, Vartivarian S E, Vassilaki M E, Anaissie E J. Septic prepatellar bursitis caused by Stenotrophomona (Xanthomonas) maltophilia Clin Infect Dis .  1996;  22 388-389
    PubMedGoogle Scholar
  • 128 Garrison M W, Anderson D E, Campbell D M. Stenotrophomonas maltophilia: emergence of multidrug-resistant strains during therapy and in an in vitro pharmacodynamic chamber model.  Antimicrob Agents Chemother . 1996;  40 2859-2864
    PubMedGoogle Scholar
  • 129 Howe R A, Wilson M P, Walsh T R, Millar M R. Susceptibility testing of Stenotrophomonas maltophilia to carbapenems.  J Antimicrob Chemother . 1997;  40 13-17
    CrossrefPubMedGoogle Scholar
  • 130 Arpi M, Victor M A, Mortensen I, Gottschau A, Bruun B. In vitro susceptibility of 124 Xanthomonas maltophilia (Stenotrophomonas maltophilia) isolates: comparison of the agar dilution method with the E-test and two agar diffusion methods.  Apmis . 1996;  104 108-114
    PubMedGoogle Scholar
  • 131 Weiss K, Restieri C, De Carolis E, Laverdiere M, Guay H. Comparative activity of new quinolones against 326 clinical isolates of Stenotrophomonas maltophilia J Antimicrob Chemother .  2000;  45 363-365
    PubMedGoogle Scholar
  • 132 Bonfiglio G, Cascone C, Azzarelli C, Cafiso V, Marchetti F, Stefani S. Levofloxacin in vitro activity and time-kill evaluation of Stenotrophomonas maltophilia clinical isolates.  J Antimicrob Chemother . 2000;  45 115-117
    CrossrefPubMedGoogle Scholar
  • 133 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;  38 624-627
    PubMedGoogle Scholar
  • 134 Garcia Sanchez E J, Vazquez Lopez L M, Blazquez de Castro M A. Aztreonam/ clavulanic acid in the treatment of serious infections caused by Stenotrophomonas maltophilia in neutropenic patients: case reports.  J Chemother . 1997;  9 238-240
    PubMedGoogle Scholar
  • 135 Shah J, Feinfeld D A. Use of "locked-in" antibiotic to treat an unusual gram-negative hemodialysis catheter infection.  Nephron . 2000;  85 348-350
    CrossrefPubMedGoogle Scholar
  • 136 Voss A, Verweij P E. Faucet aerators: a source of patient colonization with Stenotrophomonas maltophilia Am J Infect Control .  1999;  27 459-460
    PubMedGoogle Scholar
  • 137 Rusin P A, Rose J B, Haas C N, Gerba C P. Risk assessment of opportunistic bacterial pathogens in drinking water.  Rev Environ Contam Toxicol . 1997;  152 57-83
    PubMedGoogle Scholar
  • 138 Wilkinson F H, Kerr K G. Bottled water as a source of multiresistant Stenotrophomona and Pseudomonas species for neutropenic patients.  Eur J Cancer Care (English Language Edition) . 1998;  7 12-14
    CrossrefPubMedGoogle Scholar
  • 139 Hall J, Hodgson G, Lester D, Kerr K G. Provision of safe potable water for immunocompromised patients in the Leeds Teaching Hospital Trust.  Int J Infect Dis . 2002;  6 (suppl 2) 30
    PubMedGoogle Scholar
  • 140 Bland L A, Arduino M J, Aguero S M, Favero M S. Recovery of bacteria from reprocessed high flux dialyzers after bacterial contamination of the header spaces and O-rings.  ASAIO Transactions . 1989;  35 314-316
    PubMedGoogle Scholar
  • 141 Vanholder R, Vanhaecke E, Ringoir S. Waterborne Pseudomonas septicemia.  ASAIO Transactions . 1990;  36 M215-216
    PubMedGoogle Scholar
      >