Xanthomonas (Stenotrophomonas) maltophilia

Pathology

• commonly causes nosocomial infections.

Pharmacology

• resistant to:
  • imipenem
  • meropenem
  • aminoglycosides
  • quinolones
  • beta-lactam antibiotics (penicillins, cephalosporins)
• generally susceptible to:
  • trimethoprim-sulfamethoxazole (Bactrim)
  • ticarcillin/clavulanate (Timentin)
  • minocycline

Laboratory

• Stenotrophomonas maltophilia DNA
• culture
  • glucose oxidizer; lysine decarboxylase +
  • pigment yellow; motility +; MacConkey +
  • cytochrome-oxidase -

Management

• in order of preference
  • cefiderocol (with a second agent)
  • ceftazidime-avibactam & aztreonam,
  • minocycline (with a second agent)
  • trimethoprim-sulfamethoxazole (with a second agent)
  • levofloxacin (with a second agent)
  • tigecycline is no longer listed as a component of combination therapy

More general terms

• Xanthomonas