Stenotrophomonas maltophilia infection

Other Names: Stenotrophomonas maltophilia; S. maltophilia infection; S. maltophilia

Stenotrophomonas maltophilia (S. maltophilia) infection is a type of bacterial infection.

Cause

Stenotrophomonas maltophilia (S. maltophilia) infections are caused by the S. maltophilia bacteria. These bacteria live in wet environments. In a hospital setting, they are able to survive and multiply in fluids such as mucus of the respiratory system, urine, intravenous (IV) fluids, and irrigation fluids used to clean wounds or body cavities such as the ear canal or bladder. S. maltophilia can also grow in medical devices exposed to these fluids including urinary catheters, IV lines, and breathing machines (ventilators).

Riskfactors

Most healthy people do not get S. maltophilia infections even when exposed to the bacteria. However, people who are hospitalized and receiving treatment for other serious medical conditions may be more susceptible to an infection, especially if their immune system is weakened. Factors that increase the risk for S. maltophilia infection include admission to an intensive care unit (ICU), prolonged hospitalization, HIV infection, cancer, cystic fibrosis, neutropenia, recent surgery, serious trauma or injury, being on a breathing machine (ventilator), and previous treatment with broad-spectrum antibiotics (medications that target a wide range of bacteria).

Symptoms

Symptoms of Stenotrophomonas maltophilia (S. maltophilia) infection depend on which area of the body or organ system is infected. The most common sites of infection are the lungs and blood.

When the lungs are infected, symptoms of S. maltophilia are similar to other bacterial pneumonia and may include fever, cough, mucus, shortness of breath, and chest pain.

Symptoms of a blood infection (bacteremia) may include a fever, rapid heart rate, low blood pressure, abdominal pain, nausea, vomiting, diarrhea, and confusion.

Less commonly, people infected by S. maltophilia experience infections of the heart (endocarditis), the bone behind the ear (mastoiditis), lining of the abdomen and internal organs (peritonitis), cerebral spinal fluid (meningitis), soft tissue, wounds, urinary tract, and/or eye. The symptoms are similar to other bacterial infections of the same sites. An infection can also cause skin symptoms or complications such as cellulitis, infected ulcers, and ecthyma gangrenosum.

Diagnosis

A small sample of body fluid such as blood, mucus, urine, or abdominal fluid will be cultured to confirm which bacteria is causing the infection When an infection is suspected, other possible sites of infection including wounds, intravenous (IV) catheters, urinary catheters, and breathing machines should also be tested for the presence of the bacteria. Because S. maltophilia may sometimes grow in parts of the respiratory system or other parts of the body without causing infection (colonization), an infectious disease specialist should be consulted to determine if there is a true infection.

Treatment

Stenotrophomonas maltophilia (S. maltophilia) bacteria are resistant to many antibiotics, so treatment options may be limited. Treatment usually begins with trimethoprim-sulfamethoxazole (also called co-trimoxazole, or TMP-SMX), but this may vary due to the antibiotic resistance of the particular strain causing the infection and/or new antibiotics being developed. Potential alternatives for people unable to tolerate TMP-SMX include a class of antibiotics called fluoroquinolones, in particular, levofloxacin. Minocycline and tigecycline have also been shown to be effective in small retrospective studies. Combination therapy (using more than one antibiotic) may be necessary in life-threatening cases

Prognosis

The course of a Stenotrophomonas maltophilia (S. maltophilia) infection will depend on many factors including the site of the infection, severity of the infection, response to antibiotics, and presence and severity of other health problems. S. maltophilia infections may be life-threatening, especially for people with severely weakened immune systems.

NIH genetic and rare disease info

• NIH info on Stenotrophomonas maltophilia infection

Stenotrophomonas maltophilia infection is a rare disease.

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