STENOTROPHOMONAS (XANTHOMONAS) MALTOPHILIA - A MULTIDRUG-RESISTANT NOSOCOMIAL PATHOGEN

Stenotrophomonas (Xanthomonas) maltophilia is emerging as a multidrug- resistant nosocomial pathogen. In general, the organism is opportunist ic, colonizing or infecting patients with predisposing risk factors su ch intensive care unit residence, malignancy, mechanical ventilation, and previous antibiotic exposure. It can cause a variety of infections depending on underlying patient-specific medical conditions. It is of ten part of multimicrobial infections, and determining its role as a p athogen is difficult. Trimethoprim-sulfamethoxazole (TMP-SMX) has trad itionally been the most active agent against S. maltophilia. Other cla sses of antibiotics, with few exceptions, have not been effective. Syn ergistic antimicrobial combinations are now being investigated due to the bacteriostatic nature of TMP-SMX, and increasing reports of resist ance to TMP-SMX. The combination of ticarcillin-clavulanate plus TMP-S MX appears to be the most promising regimen studied thus far.