Stenotrophomonas Maltophilia

Aka: Stenotrophomonas Maltophilia, Xanthomonas Maltophilia

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II. Pathophysiology

  1. Stenotrophomonas Maltophilia (previously in genus Xanthomonas)
    1. Aerobic Gram Negative Rod
    2. Identifying features
      1. Oxidase negative
      2. Non-lactose fermenter
  2. Sources
    1. Soil
    2. Plants (rhizospheres)
    3. Water
    4. Colonizes the normal respiratory tract

III. Risk Factors

  1. Cystic Fibrosis
  2. Immunocompromised State
  3. Hospitalized patients

IV. Associated Conditions

  1. Nosocomial Infections (common)
    1. Ocular infections
    2. Ventilator-Associated Pneumonia (esp. Cystic Fibrosis)
    3. Central Line-Associated Bloodstream Infection (CLABSI)
  2. Other associated infections (uncommon, case reports)
    1. Endocarditis
    2. Medical Implant Infections
    3. Soft tissue and Bone Infections
    4. Meningitis and other CNS Infections
    5. Urinary Tract Infections
    6. Gastrointestinal Infections

V. Management

  1. Multi-drug Resistance (covered by a narrow Antibiotic spectrum)
  2. First-Line Empiric Antibiotics in Mild Infections
    1. Trimethoprim-sulfamethoxazole
  3. Combination Empiric Therapy in moderate to severe infections (choose 2 agents)
    1. Trimethoprim-sulfamethoxazole
    2. Levofloxacin
    3. Minocycyline
    4. Cefiderocol
  4. Alternative, empiric 2 drug regimen in severe infections
    1. Ceftazidime-Avibactam AND
    2. Aztreonam

VI. References

  1. Gladwin, Trattler and Mahan (2014) Clinical Microbiology, Medmaster, Fl, p. 94-5
  2. Sanford Guide, accessed on IOS 2/2/2025
  3. Brooke (2021) Clin Microbiol Rev 34(3):e0003019 +PMID: 34043457 [PubMed]
  4. Brooke (2012) Clin Microbiol Rev 25(1):2-41 +PMID: 22232370 [PubMed]

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