1887

Abstract

is an important multidrug-resistant nosocomial pathogen associated with high mortality. Our aim was to examine antimicrobial susceptibility, biofilm production and clonal relatedness of clinical isolates of . isolates were collected between 2006 and 2013 from two tertiary care hospitals in Mexico. Antimicrobial susceptibility was evaluated by the broth microdilution method. PCR was used to determine the presence of β-lactamase genes L1 and L2. Biofilm formation was assessed with crystal violet staining. Clonal relatedness was determined by PFGE. Among the 119 collected isolates, 73 (61.3 %) were from the respiratory tract. Resistance levels exceeded 75 % for imipenem, meropenem, ampicillin, aztreonam, gentamicin and tobramycin. Resistance to trimethoprim-sulfamethoxazole was 32.8 %. L1 and L2 genes were detected in 77.1 % (91/118) and 66.9 % (79/118) of isolates, respectively. All strains were able to produce biofilms. Strains were classified as weak (47.9 %, 57/119), moderate (38.7 %, 46/119), or strong (13.4 %, 16/119) biofilm producers. A total of 89 distinct PFGE types were identified and 21.6 % (22/102) of the isolates were distributed in nine clusters. This is the first study in Mexico to reveal characteristics of clinical isolates of . Clonal diversity data indicate low cross-transmission of in a hospital setting. The high antibiotic resistance underscores the need for continuous surveillance of in hospital settings in Mexico.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.074385-0
2014-11-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/63/11/1524.html?itemId=/content/journal/jmm/10.1099/jmm.0.074385-0&mimeType=html&fmt=ahah

References

  1. Abbassi M. S., Touati A., Achour W., Cherif A., Jabnoun S., Khrouf N., Ben Hassen A. 2009; Stenotrophomonas maltophilia responsible for respiratory infections in neonatal intensive care unit: antibiotic susceptibility and molecular typing. Pathol Biol (Paris) 57:363–367 [View Article][PubMed]
    [Google Scholar]
  2. Avison M. B., Higgins C. S., Ford P. J., von Heldreich C. J., Walsh T. R., Bennett P. M. 2002; Differential regulation of L1 and L2 β-lactamase expression in Stenotrophomonas maltophilia. J Antimicrob Chemother 49:387–389 [View Article][PubMed]
    [Google Scholar]
  3. Berg G., Roskot N., Smalla K. 1999; Genotypic and phenotypic relationships between clinical and environmental isolates of Stenotrophomonas maltophilia. J Clin Microbiol 37:3594–3600[PubMed]
    [Google Scholar]
  4. Brooke J. S. 2012; Stenotrophomonas maltophilia: an emerging global opportunistic pathogen. Clin Microbiol Rev 25:2–41 [View Article][PubMed]
    [Google Scholar]
  5. Cantón R., Valdezate S., Vindel A., Sánchez Del Saz B., Maíz L., Baquero F. 2003; Antimicrobial susceptibility profile of molecular typed cystic fibrosis Stenotrophomonas maltophilia isolates and differences with noncystic fibrosis isolates. Pediatr Pulmonol 35:99–107 [View Article][PubMed]
    [Google Scholar]
  6. Christensen G. D., Simpson W. A., Younger J. J., Baddour L. M., Barrett F. F., Melton D. M., Beachey E. H. 1985; Adherence of coagulase-negative staphylococci to plastic tissue culture plates: a quantitative model for the adherence of staphylococci to medical devices. J Clin Microbiol 22:996–1006[PubMed]
    [Google Scholar]
  7. Chung H. S., Hong S. G., Lee Y., Kim M., Yong D., Jeong S. H., Lee K., Chong Y. 2012; Antimicrobial susceptibility of Stenotrophomonas maltophilia isolates from a Korean tertiary care hospital. Yonsei Med J 53:439–441 [View Article][PubMed]
    [Google Scholar]
  8. CLSI 2012; Performance Standards for Antimicrobial Susceptibility Testing; 22nd Informational Supplement M100–S22. Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  9. Crispino M., Boccia M. C., Bagattini M., Villari P., Triassi M., Zarrilli R. 2002; Molecular epidemiology of Stenotrophomonas maltophilia in a university hospital. J Hosp Infect 52:88–92 [View Article][PubMed]
    [Google Scholar]
  10. Cullmann W., Dick W. 1990; Heterogeneity of β-lactamase production in Pseudomonas maltophilia, a nosocomial pathogen. Chemotherapy 36:117–126 [View Article][PubMed]
    [Google Scholar]
  11. Denton M., Kerr K. G. 1998; Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia. Clin Microbiol Rev 11:57–80[PubMed]
    [Google Scholar]
  12. Denton M., Todd N. J., Kerr K. G., Hawkey P. M., Littlewood J. M. 1998; Molecular epidemiology of Stenotrophomonas maltophilia isolated from clinical specimens from patients with cystic fibrosis and associated environmental samples. J Clin Microbiol 36:1953–1958[PubMed]
    [Google Scholar]
  13. Di Bonaventura G., Spedicato I., D’Antonio D., Robuffo I., Piccolomini R. 2004; Biofilm formation by Stenotrophomonas maltophilia: modulation by quinolones, trimethoprim-sulfamethoxazole, and ceftazidime. Antimicrob Agents Chemother 48:151–160 [View Article][PubMed]
    [Google Scholar]
  14. Falagas M. E., Kastoris A. C., Vouloumanou E. K., Rafailidis P. I., Kapaskelis A. M., Dimopoulos G. 2009; Attributable mortality of Stenotrophomonas maltophilia infections: a systematic review of the literature. Future Microbiol 4:1103–1109 [View Article][PubMed]
    [Google Scholar]
  15. Farrell D. J., Sader H. S., Jones R. N. 2010; Antimicrobial susceptibilities of a worldwide collection of Stenotrophomonas maltophilia isolates tested against tigecycline and agents commonly used for S. maltophilia infections. Antimicrob Agents Chemother 54:2735–2737 [View Article][PubMed]
    [Google Scholar]
  16. Fedler K. A., Biedenbach D. J., Jones R. N. 2006; Assessment of pathogen frequency and resistance patterns among pediatric patient isolates: report from the 2004 SENTRY Antimicrobial Surveillance Program on 3 continents. Diagn Microbiol Infect Dis 56:427–436 [View Article][PubMed]
    [Google Scholar]
  17. Furushita M., Okamoto A., Maeda T., Ohta M., Shiba T. 2005; Isolation of multidrug-resistant Stenotrophomonas maltophilia from cultured yellowtail (Seriola quinqueradiata) from a marine fish farm. Appl Environ Microbiol 71:5598–5600 [View Article][PubMed]
    [Google Scholar]
  18. Gales A. C., Jones R. N., Forward K. R., Liñares J., Sader H. S., Verhoef J. 2001; 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 32:Suppl 2S104–S113 [View Article][PubMed]
    [Google Scholar]
  19. Goncalves-Vidigal P., Grosse-Onnebrink J., Mellies U., Buer J., Rath P. M., Steinmann J. 2011; Stenotrophomonas maltophilia in cystic fibrosis: improved detection by the use of selective agar and evaluation of antimicrobial resistance. J Cyst Fibros 10:422–427 [View Article][PubMed]
    [Google Scholar]
  20. Gülmez D., Hasçelik G. 2005; Stenotrophomonas maltophilia: antimicrobial resistance and molecular typing of an emerging pathogen in a Turkish university hospital. Clin Microbiol Infect 11:880–886 [View Article][PubMed]
    [Google Scholar]
  21. Guyot A., Turton J. F., Garner D. 2013; Outbreak of Stenotrophomonas maltophilia on an intensive care unit. J Hosp Infect 85:303–307 [View Article][PubMed]
    [Google Scholar]
  22. Magiorakos A.-P., Srinivasan A., Carey R. B., Carmeli Y., Falagas M. E., Giske C. G., Harbarth S., Hindler J. F., Kahlmeter G.& other authors ( 2012; Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 18:268–281 [View Article][PubMed]
    [Google Scholar]
  23. Nazik H., Ongen B., Erturan Z., Salcioğlu M. 2007; Genotype and antibiotic susceptibility patterns of Pseudomonas aeruginosa and Stenotrophomonas maltophilia isolated from cystic fibrosis patients. Jpn J Infect Dis 60:82–86[PubMed]
    [Google Scholar]
  24. Neela V., Rankouhi S. Z., van Belkum A., Goering R. V., Awang R. 2012; Stenotrophomonas maltophilia in Malaysia: molecular epidemiology and trimethoprim-sulfamethoxazole resistance. Int J Infect Dis 16:e603–e607 [View Article][PubMed]
    [Google Scholar]
  25. Nicodemo A. C., Paez J. I. 2007; Antimicrobial therapy for Stenotrophomonas maltophilia infections. Eur J Clin Microbiol Infect Dis 26:229–237 [View Article][PubMed]
    [Google Scholar]
  26. Paez J. I., Costa S. F. 2008; Risk factors associated with mortality of infections caused by Stenotrophomonas maltophilia: a systematic review. J Hosp Infect 70:101–108 [View Article][PubMed]
    [Google Scholar]
  27. Paton R., Miles R. S., Amyes S. G. 1994; Biochemical properties of inducible β-lactamases produced from Xanthomonas maltophilia. Antimicrob Agents Chemother 38:2143–2149 [View Article][PubMed]
    [Google Scholar]
  28. Pompilio A., Pomponio S., Crocetta V., Gherardi G., Verginelli F., Fiscarelli E., Dicuonzo G., Savini V., D’Antonio D., Di Bonaventura G. 2011; Phenotypic and genotypic characterization of Stenotrophomonas maltophilia isolates from patients with cystic fibrosis: genome diversity, biofilm formation, and virulence. BMC Microbiol 11:159 [View Article][PubMed]
    [Google Scholar]
  29. Potera C. 1999; Forging a link between biofilms and disease. Science 283:1837–1839 [View Article][PubMed]
    [Google Scholar]
  30. Rhee J. Y., Choi J. Y., Choi M. J., Song J. H., Peck K. R., Ko K. S. 2013; Distinct groups and antimicrobial resistance of clinical Stenotrophomonas maltophilia complex isolates from Korea. J Med Microbiol 62:748–753 [View Article][PubMed]
    [Google Scholar]
  31. Rios-Licea M. M., Bosques F. J., Arroliga A. C., Galindo-Galindo J. O., Garza-Gonzalez E. 2010; Quadruplex real-time quantitative PCR assay for the detection of pathogens related to late-onset ventilator-associated pneumonia: a preliminary report. J Microbiol Methods 81:232–234 [View Article][PubMed]
    [Google Scholar]
  32. Samonis G., Karageorgopoulos D. E., Maraki S., Levis P., Dimopoulou D., Spernovasilis N. A., Kofteridis D. P., Falagas M. E. 2012; Stenotrophomonas maltophilia infections in a general hospital: patient characteristics, antimicrobial susceptibility, and treatment outcome. PLoS ONE 7:e37375 [View Article][PubMed]
    [Google Scholar]
  33. San Gabriel P., Zhou J., Tabibi S., Chen Y., Trauzzi M., Saiman L. 2004; Antimicrobial susceptibility and synergy studies of Stenotrophomonas maltophilia isolates from patients with cystic fibrosis. Antimicrob Agents Chemother 48:168–171 [View Article][PubMed]
    [Google Scholar]
  34. Schaumann R., Laurin F., Rodloff A. C. 2008; Molecular typing of clinical isolates of Stenotrophomonas maltophilia by pulsed-field gel electrophoresis and random primer PCR fingerprinting. Int J Hyg Environ Health 211:292–298 [View Article][PubMed]
    [Google Scholar]
  35. Senol E. 2004; Stenotrophomonas maltophilia: the significance and role as a nosocomial pathogen. J Hosp Infect 57:1–7 [View Article][PubMed]
    [Google Scholar]
  36. Tanimoto K. 2013; Stenotrophomonas maltophilia strains isolated from a university hospital in Japan: genomic variability and antibiotic resistance. J Med Microbiol 62:565–570 [View Article][PubMed]
    [Google Scholar]
  37. Tenover F. C., Arbeit R. D., Goering R. V., Mickelsen P. A., Murray B. E., Persing D. H., Swaminathan B. 1995; Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239[PubMed]
    [Google Scholar]
  38. Toleman M. A., Bennett P. M., Bennett D. M., Jones R. N., Walsh T. R. 2007; Global emergence of trimethoprim/sulfamethoxazole resistance in Stenotrophomonas maltophilia mediated by acquisition of sul genes. Emerg Infect Dis 13:559–565 [View Article][PubMed]
    [Google Scholar]
  39. Valdezate S., Vindel A., Loza E., Baquero F., Cantón R. 2001; Antimicrobial susceptibilities of unique Stenotrophomonas maltophilia clinical strains. Antimicrob Agents Chemother 45:1581–1584 [View Article][PubMed]
    [Google Scholar]
  40. Valdezate S., Vindel A., Martín-Dávila P., Del Saz B. S., Baquero F., Cantón R. 2004; High genetic diversity among Stenotrophomonas maltophilia strains despite their originating at a single hospital. J Clin Microbiol 42:693–699 [View Article][PubMed]
    [Google Scholar]
  41. Valenza G., Tappe D., Turnwald D., Frosch M., König C., Hebestreit H., Abele-Horn M. 2008; Prevalence and antimicrobial susceptibility of microorganisms isolated from sputa of patients with cystic fibrosis. J Cyst Fibros 7:123–127 [View Article][PubMed]
    [Google Scholar]
  42. VanCouwenberghe C. J., Farver T. B., Cohen S. H. 1997; Risk factors associated with isolation of Stenotrophomonas (Xanthomonas) maltophilia in clinical specimens. Infect Control Hosp Epidemiol 18:316–321 [View Article][PubMed]
    [Google Scholar]
  43. Walsh T. R., Hall L., Assinder S. J., Nichols W. W., Cartwright S. J., MacGowan A. P., Bennett P. M. 1994; Sequence analysis of the L1 metallo-β-lactamase from Xanthomonas maltophilia. Biochim Biophys Acta 1218:199–201 [View Article][PubMed]
    [Google Scholar]
  44. Walsh T. R., MacGowan A. P., Bennett P. M. 1997; Sequence analysis and enzyme kinetics of the L2 serine β-lactamase from Stenotrophomonas maltophilia. Antimicrob Agents Chemother 41:1460–1464[PubMed]
    [Google Scholar]
  45. Wang W. S., Liu C. P., Lee C. M., Huang F. Y. 2004; Stenotrophomonas maltophilia bacteremia in adults: four years’ experience in a medical center in northern Taiwan. J Microbiol Immunol Infect 37:359–365[PubMed]
    [Google Scholar]
  46. Wu H., Wang J.-T., Shiau Y.-R., Wang H.-Y., Yang Lauderdale T.-L., Chang S.-C.TSAR Hospitals 2012; A multicenter surveillance of antimicrobial resistance on Stenotrophomonas maltophilia in Taiwan. J Microbiol Immunol Infect 45:120–126 [View Article][PubMed]
    [Google Scholar]
  47. Wu K., Yau Y. C., Matukas L., Waters V. 2013; Biofilm compared to conventional antimicrobial susceptibility of Stenotrophomonas maltophilia isolates from cystic fibrosis patients. Antimicrob Agents Chemother 57:1546–1548 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.074385-0
Loading
/content/journal/jmm/10.1099/jmm.0.074385-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error