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Emergence of clinical strains of Stenotrophomonas maltophilia resistant to trimethoprim/sulfamethoxazole in a Bulgarian university hospital

Journal article
Authors Sashka A Mihaylova
MP Sredkova
Liselott Svensson
Edward R.B. Moore
Published in Journal of Biomedical and Clinical Research
Volume 1
Pages 18-25
ISSN 1313-9053
Publication year 2008
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 18-25
Language en
Keywords Stenotrophomonas maltophilia, trimethoprim/sulphamethoxazole, resistance, 16S rRNA, gyrB
Subject categories Infectious Medicine


Clinical strains of Stenotrophomonas maltophilia, identified by a commercial system as resistant to trimethoprim/sulfamethoxazole (TMP/SMX), were analysed in detail, to confirm their taxonomic positions, to determine their susceptibilities to various classes of antibiotics and to assess this information with respect to the epidemiological relevance. The majority of strains were isolated from respiratory and wound specimens from patients admitted to intensive care units. Multi-locus sequence analyses (MLSA) of 16S ribosomal RNA (rRNA) and gyrase subunit B (gyrB) genes were applied for genotypic-based characterisation. The minimal inhibitory concentrations (MICs) of ten antimicrobial agents were determined, using the E-test method. The MIC values of TMP/SMX for the clinical isolates of S. maltophilia were greater than 32 mg/L, which confirmed their preliminary assessment as resistant. Minocycline, levofloxacin and ciprofloxacin exhibited the lowest MICs. All strains were observed to be susceptible to minocycline and levofloxacin. The emergence of clinical strains of S. maltophilia resistant to TMP/SMX is increasingly problematic as this antimicrobial agent is accepted as the “drug of choice” for treating infections caused by this bacterium. However, minocycline and levofloxacin demonstrated excellent in vitro activities and could be considered as alternative options to counter TMP/SMX-resistant strains of S. maltophilia.

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