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Journals / ANKEM Dergisi / 2025 / Cilt: 39 Sayı: 3

Investigation of the Antibiotic Resistance Profiles and Epidemiological Trends of Stenotrophomonas maltophilia Strains Isolated from Clinical Specimens in a City Hospital (2023–2025)

Bir Şehir Hastanesinde Klinik Örneklerden İzole Edilen Stenotrophomonas maltophilia Suşlarının Antibiyotik Direnç Profilleri ve Epidemiyolojik Eğilimlerinin İncelenmesi (2023–2025)

Abdurrahman Gülmez(Aydın Atatürk Devlet Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı)0000-0003-3953-5267
Selda Kömeç(İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı)0000-0002-6726-0048
Ayşe Nur Ceylan(İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi, Tıbbi Mikrobiyoloji Laboratuvarı)0000-0002-0049-6873
Pages
120–127
Publication Date
2025-12-31
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Overall resistance rates were 6.0% for SXT and 9.2% for LEV, with a slight decreasing trend in SXT resistance over the study period.

📌 3 Key Takeaways

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Objective & Hypothesis:Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen associated with healthcare related infections due to its intrinsic and acquired multidrug resistance mechanisms.
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Key Findings & Data:This study aimed to evaluate the antibiotic resistance profiles and epidemiological trends of S. maltophilia isolates obtained from clinical specimens in a city hospital between 2023 and 2025.
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Conclusion & Impact:Overall resistance rates were 6.0% for SXT and 9.2% for LEV, with a slight decreasing trend in SXT resistance over the study period.
🔬Design:Araştırma Makalesi
📍Scope:2023 Verileri
⚙️Variables:Stenotrophomonas maltophilia · antibiyotik direnci · trimetoprim-sülfametoksazol

Abstract

Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen associated with healthcare related infections due to its intrinsic and acquired multidrug resistance mechanisms. This study aimed to evaluate the antibiotic resistance profiles and epidemiological trends of S. maltophilia isolates obtained from clinical specimens in a city hospital between 2023 and 2025. This retrospective, descriptive study included non duplicate S. maltophilia isolates recovered from various clinical samples. Identification was performed using the Bruker SMART MALDI Biotyper MALDI TOF MS system. Antimicrobial susceptibility to trimethoprim sulfamethoxazole (SXT) and levofloxacin (LEV) was determined by the BD Phoenix M50 automated system and disk diffusion, interpreted according to current CLSI/EUCAST criteria. Ceftazidime minimum inhibitory concentrations (MICs) were determined by gradient test (bioMérieux Etest). Descriptive analyses were performed using Microsoft Excel 16.0 and IBM SPSS Statistics 26.0. A total of 1,745 unique S. maltophilia isolates were analyzed. Most isolates originated from adult intensive care units (49.2%) and respiratory samples (62.4%). Overall resistance rates were 6.0% for SXT and 9.2% for LEV, with a slight decreasing trend in SXT resistance over the study period. For ceftazidime, the MIC₅₀ was 16 mg/L and the MIC₉₀ was >256 mg/L. S. maltophilia remains a significant healthcare associated pathogen, predominantly isolated from intensive care and respiratory specimens. The low and decreasing resistance rate to SXT indicates that this agent remains an effective treatment option. Regular surveillance and rational antibiotic use are crucial to prevent the development of resistance.

Özet

Stenotrophomonas maltophilia, sahip olduğu doğal ve kazanılmış çoklu antibiyotik direnç mekanizmaları nedeniyle sağlık hizmetleri ile ilişkili enfeksiyonlarda giderek önem kazanan fırsatçı bir patojendir. Bu çalışma, 2023 2025 yılları arasında bir şehir hastanesinde klinik örneklerden izole edilen S. maltophilia suşlarının antibiyotik direnç profillerini ve epidemiyolojik eğilimlerini değerlendirmeyi amaçlamaktadır. Retrospektif ve tanımlayıcı nitelikteki bu çalışmada, klinik örneklerden elde edilen tekrarsız S. maltophilia izolatları incelenmiştir. Tür tanımlaması Bruker SMART MALDI Biotyper MALDI TOF MS sistemi ile yapılmıştır. Trimetoprim sülfametoksazol (SXT) ve levofloksasin (LEV) duyarlılığı BD Phoenix M50 otomatize sistemi ve disk difüzyon yöntemiyle belirlenmiş; sonuçlar güncel CLSI/EUCAST kriterlerine göre yorumlanmıştır. Seftazidim için minimum inhibitör konsantrasyon (MİK) değerleri gradient test (bioMérieux Etest) ile belirlenmiştir. Tanımlayıcı istatistikler Microsoft Excel 16.0 ve IBM SPSS Statistics 26.0 programları kullanılarak yapılmıştır. Toplam 1.745 benzersiz S. maltophilia izolatı analiz edilmiştir. İzolatların çoğu erişkin yoğun bakım ünitelerinden (%49,2) ve solunum yolu örneklerinden (%62,4) elde edilmiştir. Genel direnç oranları SXT için %6,0, LEV için %9,2 olup, SXT direncinde yıllar içinde hafif bir azalma eğilimi gözlenmiştir. Seftazidim için MİK₅₀ değeri 16 mg/L, MİK₉₀ değeri ise >256 mg/L olarak bulunmuştur. S. maltophilia, özellikle yoğun bakım ve solunum yolu örneklerinde izole edilen önemli bir sağlık hizmeti ile ilişkili patojen olmaya devam etmektedir. SXT’ye karşı düşük ve azalma eğilimindeki direnç oranı, bu ajanın halen etkili bir tedavi seçeneği olduğunu göstermektedir. Direnç gelişiminin önlenmesi için düzenli sürveyans ve akılcı antibiyotik kullanımı büyük önem taşımaktadır.

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Cite This Article

Gülmez, A., Kömeç, S., Ceylan, A. N. (2025). Investigation of the Antibiotic Resistance Profiles and Epidemiological Trends of Stenotrophomonas maltophilia Strains Isolated from Clinical Specimens in a City Hospital (2023–2025). ANKEM Dergisi, Cilt: 39 Sayı: 3, 120–127. https://doi.org/10.54962/ankemderg.1804665

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References (27)

  1. Akkaya Y, Yılmaz AM, Nalça Erdin B, Kılıç IH, Aşçı Toraman Z. Distribution and antibiotic susceptibilities of Stenotrophomonas maltophilia isolates detected in Ümraniye Training and Research Hospital. East J Med. 2025;30(3):354-60. https://doi.org/10.5505/ejm.2025.40111.
  2. Arslan GK ETF, Doğan M. Sınırlı antibiyotik seçeneği olan Stenotrophomonas maltophilia enfeksiyonlarında antibiyotik direnç profili. Turk Mikrobiyol Cemiy Derg. 2021;51(4):334-40. https://doi.org/10.5222/TMCD.2021.26817.
  3. Baek JH, Kim CO, Jeong SJ, et al. Clinical factors associated with acquisition of resistance to levofloxacin in Stenotrophomonas maltophilia. Yonsei Med J. 2014;55(4):987-93. https://doi.org/10.3349/ymj.2014.55.4.987.
  4. Banar M, Sattari-Maraji A, Bayatinejad G, et al. Global prevalence and antibiotic resistance in clinical isolates of Stenotrophomonas maltophilia: a systematic review and meta-analysis. Front Med (Lausanne). 2023;10:1163439. https://doi.org/10.3389/fmed.2023.1163439.
  5. Bilgin M İH, Başbulut E, Mutlu Yılmaz E. Stenotrophomonas maltophilia klinik suşlarında antimikrobiyal direnç: 10 yıllık sürveyans. ANKEM Derg. 2022;36(1):16-22. https://doi.org/10.54962/ankemderg.1107833.
  6. Bostanghadiri N, Sholeh M, Navidifar T, et al. Global mapping of antibiotic resistance rates among clinical isolates of Stenotrophomonas maltophilia: a systematic review and meta-analysis. Ann Clin Microbiol Antimicrob. 2024;23(1):26. https://doi.org/10.1186/s12941-024-00685-4.
  7. Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogen. Clin Microbiol Rev. 2012;25(1):2-41. https://doi.org/10.1128/cmr.00019-11.
  8. Dağı H AU, Tuncer İ. Kan kültürlerinden izole edilen Stenotrophomonas maltophilia suşlarının antibiyotik direnci. ANKEM Derg. 2011;25(1):27-30. https://doi.org/10.5222/ankem.2011.27.
  9. Elg Abu Elhassan U, Alghamdi A, Mahmoud I, et al. Severe community-acquired Stenotrophomonas maltophilia Pneumonıa In 80-Year-Old Hypertensive Male Patient. Chest. 2023;164(4):A749-A50. https://doi.org/10.1016/j.chest.2023.07.554.
  10. Falagas ME, Kastoris AC, Vouloumanou EK, Dimopoulos G. Community-acquired Stenotrophomonas maltophilia infections: a systematic review. Eur J Clin Microbiol Infect Dis. 2009;28(7):719-30. https://doi.org/10.1007/s10096-009-0709-5.
  11. Gajdács M, Urbán E. Prevalence and Antibiotic Resistance of Stenotrophomonas maltophilia in Respiratory Tract Samples: A 10-Year Epidemiological Snapshot. Health Serv Res Manag Epidemiol. 2019;6:2333392819870774. https://doi.org/10.1177/2333392819870774.
  12. Gibb J, Wong DW. Antimicrobial treatment strategies for Stenotrophomonas maltophilia: A focus on novel therapies. Antibiotics (Basel). 2021;10(10):1226. https://doi.org/10.3390/antibiotics10101226.
  13. Gil-Gil T, Martínez JL, Blanco P. Mechanisms of antimicrobial resistance in Stenotrophomonas maltophilia: a review of current knowledge. Expert Rev Anti Infect Ther. 2020;18(4):335-47. https://doi.org/10.1080/14787210.2020.1730178.
  14. Hafiz TA, Aldawood E, Albloshi A, et al. Stenotrophomonas maltophilia Epidemiology, Resistance Characteristics, and Clinical Outcomes: Understanding of the Recent Three Years' Trends. Microorganisms. 2022;10(12):2506. https://doi.org/10.3390/microorganisms10122506.
  15. Ko JH, Kang CI, Cornejo-Juárez P, et al. Fluoroquinolones versus trimethoprim-sulfamethoxazole for the treatment of Stenotrophomonas maltophilia infections: a systematic review and meta-analysis. Clin Microbiol Infect. 2019;25(5):546-54. https://doi.org/10.1016/j.cmi.2018.11.008.
  16. Kullar R, Wenzler E, Alexander J, Goldstein EJC. Overcoming Stenotrophomonas maltophilia Resistance for a More Rational Therapeutic Approach. Open Forum Infect Dis. 2022;9(5):ofac095. https://doi.org/10.1093/ofid/ofac095.
  17. Looney WJ, Narita M, Mühlemann K. Stenotrophomonas maltophilia: an emerging opportunist human pathogen. Lancet Infect Dis. 2009;9(5):312-23. https://doi.org/https://doi.org/10.1016/S1473-3099(09)70083-0.
  18. Mojica MF, Rutter J, Taracila MA, et al. 1437. Biochemical characterization of L1 and L2 β-lactamases from clinical isolates of Stenotrophomonas maltophilia. Open Forum Infect Dis. 2020;7(Suppl 1):S723. https://doi.org/10.1093/ofid/ofaa439.1618.
  19. Nseir S, Di Pompeo C, Brisson H, et al. Intensive care unit-acquired Stenotrophomonas maltophilia: incidence, risk factors, and outcome. Crit Care. 2006;10(5):R143. https://doi.org/10.1186/cc5063.
  20. Payaslioğlu M, Başkiliç R, Kazak E, Akalin H. In Vitro Synergy Evaluation of Trimethoprim/Sulfamethoxazole Combined with Levofloxacin and Ceftazidime Against Stenotrophomonas maltophilia: A Comparative Study Using Checkerboard and Gradient Diffusion Methods. Acta Microbiol Hell. 2025;70(3):37. https://doi.org/10.3390/amh70030037.
  21. Phillips MC, Lee B, Miller SL, et al. Ceftazidime retains in vivo efficacy against strains of Stenotrophomonas maltophilia for which traditional testing predicts resistance. mSphere. 2025;10(6):e00840-24. https://doi.org/doi:10.1128/msphere.00840-24.
  22. Sadıç B BS, Şimşek-Yavuz S, Çağatay A, Özsüt H, Eraksoy H. Stenotrophomonas maltophilia: Results of antimicrobial susceptibility testing and in vitro activity of the combination of ceftazidime and moxifloxacin. Klimik Derg. 2019;32(1):29-34. https://doi.org/10.5152/kd.2019.08.
  23. Sánchez MB. Antibiotic resistance in the opportunistic pathogen Stenotrophomonas maltophilia. Front Microbiol. 2015;6:658. https://doi.org/10.3389/fmicb.2015.00658.
  24. Saugel B, Eschermann K, Hoffmann R, Hapfelmeier A, Schultheiss C, Phillip V, et al. Stenotrophomonas maltophilia in the respiratory tract of medical intensive care unit patients. Eur J Clin Microbiol Infect Dis. 2012;31(7):1419-28. https://doi.org/10.1007/s10096-011-1459-8.
  25. Sezen AI, Ozdemir YE, Yeşilbağ Z, et al. Seven-year evaluation of Stenotrophomonas maltophilia bacteremia in a university-affiliated hospital. J Infect Dev Ctries. 2025;19(4):498-503. https://doi.org/10.3855/jidc.20243.
  26. Wang N, Tang C, Wang L. Risk Factors for Acquired Stenotrophomonas maltophilia Pneumonia in Intensive Care Unit: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2022;8:808391. https://doi.org/10.3389/fmed.2021.808391.
  27. Zafer H, Tuncer ÖZ, Mücahide Esra K. Klinik Örneklerden İzole Edilen Stenotrophomonas maltophilia Suşlarının Antimikrobiyal Direnci Açısından İncelenmesi. Turk Mikrobiyol Cemiy Derg. 2020;50(1):44-8. https://doi.org/10.5222/TMCD.2020.044.