Skip to main content

Advertisement

Log in

Community-acquired Stenotrophomonas maltophilia infections: a systematic review

  • Review
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Stenotrophomonas maltophilia is a pathogen that causes infections mainly in immunocompromised patients. However, community-acquired S. maltophilia infections have been occasionally reported. The objective of this paper was to collect and evaluate the available published data referring to community-acquired S. maltophilia infections. We searched PubMed, the Cochrane Library, and Scopus for articles providing data for patients with community-acquired S. maltophilia infections. Eight case series and 23 case reports (involving 77 and 26 patients with community-acquired S. maltophilia infections, respectively) were regarded as eligible for inclusion in our review. Regarding the 77 patients with community-acquired S. maltophilia infections included in the identified case series, 45 had bacteremia, six ocular infections, five respiratory tract infections, four wound/soft tissue infections, two urinary tract infections, one conjunctivitis, one otitis, and one cellulitis; data were not reported for the remaining 12 patients. Comorbidity (such as malignancy, HIV infection, prior hospitalization) was common. Data included in the eight case series regarding the outcome of infection were limited. From the 26 patients with community-acquired S. maltophilia infections reported in the case reports, 22 were cured from the infection, whereas 4 of 26 patients died; one death was attributed to septic shock due to S. maltophilia. Several publications report patients with community-acquired S. maltophilia infections; the majority of them refer to patients with some kind of comorbidity. Physicians should be aware that S. maltophilia infections are not restricted to hospitalized patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Denton M, Kerr KG (1998) Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia. Clin Microbiol Rev 11:57–80

    PubMed  CAS  Google Scholar 

  2. Elting LS, Bodey GP (1990) Septicemia due to Xanthomonas species and non-aeruginosa Pseudomonas species: increasing incidence of catheter-related infections. Medicine (Baltimore) 69:296–306. doi:10.1097/00005792-199009000-00003

    CAS  Google Scholar 

  3. Zuravleff JJ, Yu VL (1982) Infections caused by Pseudomonas maltophilia with emphasis on bacteremia: case reports and a review of the literature. Rev Infect Dis 4:1236–1246

    PubMed  CAS  Google Scholar 

  4. Muder RR, Harris AP, Muller S, Edmond M, Chow JW, Papadakis K, Wagener MW, Bodey GP, Steckelberg JM (1996) Bacteremia due to Stenotrophomonas (Xanthomonas) maltophilia: a prospective, multicenter study of 91 episodes. Clin Infect Dis 22:508–512

    PubMed  CAS  Google Scholar 

  5. Gutiérrez Rodero F, Masiá MM, Cortés J, Ortiz de la Tabla V, Mainar V, Vilar A (1996) Endocarditis caused by Stenotrophomonas maltophilia: case report and review. Clin Infect Dis 23:1261–1265

    PubMed  Google Scholar 

  6. Shimoni S, Abend Y, Shimon A, Landau Z, Caspi A (1998) Stenotrophomonas maltophilia endocarditis following dental treatment in a previously healthy patient. J Infect 37:305–306. doi:10.1016/S0163-4453(98)92386-6

    Article  PubMed  CAS  Google Scholar 

  7. Muder RR, Yu VL, Dummer JS, Vinson C, Lumish RM (1987) Infections caused by Pseudomonas maltophilia. Expanding clinical spectrum. Arch Intern Med 147:1672–1674. doi:10.1001/archinte.147.9.1672

    Article  PubMed  CAS  Google Scholar 

  8. Elsner HA, Dührsen U, Hollwitz B, Kaulfers PM, Hossfeld DK (1997) Fatal pulmonary hemorrhage in patients with acute leukemia and fulminant pneumonia caused by Stenotrophomonas maltophilia. Ann Hematol 74:155–161. doi:10.1007/s002770050275

    Article  PubMed  CAS  Google Scholar 

  9. Fujita J, Yamadori I, Xu G, Hojo S, Negayama K, Miyawaki H, Yamaji Y, Takahara J (1996) Clinical features of Stenotrophomonas maltophilia pneumonia in immunocompromised patients. Respir Med 90:35–38. doi:10.1016/S0954-6111(96)90242-5

    Article  PubMed  CAS  Google Scholar 

  10. Harlowe HD (1972) Acute mastoiditis following Pseudomonas maltophilia infection: case report. Laryngoscope 82:882–883. doi:10.1288/00005537-197205000-00015

    Article  PubMed  CAS  Google Scholar 

  11. Caylan R, Aydin K, Köksal I (2002) Meningitis caused by Stenotrophomonas maltophilia: case report and review of the literature. Ann Saudi Med 22:216–218

    PubMed  Google Scholar 

  12. Papadakis KA, Vartivarian SE, Vassilaki ME, Anaissie EJ (1997) Stenotrophomonas maltophilia meningitis. Report of two cases and review of the literature. J Neurosurg 87:106–108

    PubMed  CAS  Google Scholar 

  13. Patrick S, Hindmarch JM, Hague RV, Harris DM (1975) Meningitis caused by Pseudomonas maltophilia. J Clin Pathol 28:741–743. doi:10.1136/jcp.28.9.741

    Article  PubMed  CAS  Google Scholar 

  14. Chen YF, Chung PC, Hsiao CH (2005) Stenotrophomonas maltophilia keratitis and scleritis. Chang Gung Med J 28:142–150

    PubMed  Google Scholar 

  15. Penland RL, Wilhelmus KR (1996) Stenotrophomonas maltophilia ocular infections. Arch Ophthalmol 114:433–436

    PubMed  CAS  Google Scholar 

  16. Baltimore RS, Jenson HB (1990) Puncture wound osteochondritis of the foot caused by Pseudomonas maltophilia. Pediatr Infect Dis J 9:143–144. doi:10.1097/00006454-199002000-00017

    Article  PubMed  CAS  Google Scholar 

  17. Papadakis KA, Vartivarian SE, Vassilaki ME, Anaissie EJ (1996) Septic prepatellar bursitis caused by Stenotrophomonas (Xanthomonas) maltophilia. Clin Infect Dis 22:388–389

    PubMed  CAS  Google Scholar 

  18. Vartivarian SE, Papadakis KA, Anaissie EJ (1996) Stenotrophomonas (Xanthomonas) maltophilia urinary tract infection. A disease that is usually severe and complicated. Arch Intern Med 156:433–435. doi:10.1001/archinte.156.4.433

    Article  PubMed  CAS  Google Scholar 

  19. Vartivarian SE, Papadakis KA, Palacios JA, Manning JT Jr, Anaissie EJ (1994) Mucocutaneous and soft tissue infections caused by Xanthomonas maltophilia. A new spectrum. Ann Intern Med 121:969–973

    PubMed  CAS  Google Scholar 

  20. Sattler CA, Mason EO Jr, Kaplan SL (2000) Nonrespiratory Stenotrophomonas maltophilia infection at a children’s hospital. Clin Infect Dis 31:1321–1330. doi:10.1086/317473

    Article  PubMed  CAS  Google Scholar 

  21. Muder RR (2007) Optimizing therapy for Stenotrophomonas maltophilia. Semin Respir Crit Care Med 28:672–677. doi:10.1055/s-2007-996414

    Article  PubMed  Google Scholar 

  22. Barchitta M, Cipresso R, Giaquinta L, Romeo MA, Denaro C, Pennisi C, Agodi A (2008) Acquisition and spread of Acinetobacter baumannii and Stenotrophomonas maltophilia in intensive care patients. Int J Hyg Environ Health (in press)

  23. Marshall WF, Keating MR, Anhalt JP, Steckelberg JM (1989) Xanthomonas maltophilia: an emerging nosocomial pathogen. Mayo Clin Proc 64:1097–1104

    PubMed  CAS  Google Scholar 

  24. Morrison AJ Jr, Hoffmann KK, Wenzel RP (1986) Associated mortality and clinical characteristics of nosocomial Pseudomonas maltophilia in a university hospital. J Clin Microbiol 24:52–55

    PubMed  Google Scholar 

  25. Schaumann R, Stein K, Eckhardt C, Ackermann G, Rodloff AC (2001) Infections caused by Stenotrophomonas maltophilia—a prospective study. Infection 29:205–208. doi:10.1007/s15010-001-1055-4

    Article  PubMed  CAS  Google Scholar 

  26. Villarino ME, Stevens LE, Schable B, Mayers G, Miller JM, Burke JP, Jarvis WR (1992) Risk factors for epidemic Xanthomonas maltophilia infection/colonization in intensive care unit patients. Infect Control Hosp Epidemiol 13:201–206

    Article  PubMed  CAS  Google Scholar 

  27. Elting LS, Khardori N, Bodey GP, Fainstein V (1990) Nosocomial infection caused by Xanthomonas maltophilia: a case–control study of predisposing factors. Infect Control Hosp Epidemiol 11:134–138

    PubMed  CAS  Google Scholar 

  28. Lai CH, Chi CY, Chen HP, Chen TL, Lai CJ, Fung CP, Yu KW, Wong WW, Liu CY (2004) Clinical characteristics and prognostic factors of patients with Stenotrophomonas maltophilia bacteremia. J Microbiol Immunol Infect 37:350–358

    PubMed  Google Scholar 

  29. Goss CH, Otto K, Aitken ML, Rubenfeld GD (2002) Detecting Stenotrophomonas maltophilia does not reduce survival of patients with cystic fibrosis. Am J Respir Crit Care Med 166:356–361. doi:10.1164/rccm.2109078

    Article  PubMed  Google Scholar 

  30. Lambiase A, Raia V, Del Pezzo M, Sepe A, Carnovale V, Rossano F (2006) Microbiology of airway disease in a cohort of patients with cystic fibrosis. BMC Infect Dis 6:4. doi:10.1186/1471-2334-6-4

    Article  PubMed  Google Scholar 

  31. Spicuzza L, Sciuto C, Vitaliti G, Di Dio G, Leonardi S, La Rosa M (2008) Emerging pathogens in cystic fibrosis: ten years of follow-up in a cohort of patients. Eur J Clin Microbiol Infect Dis (in press)

  32. 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. doi:10.1016/j.jcf.2007.06.006

    Article  PubMed  CAS  Google Scholar 

  33. McGowan JE Jr (2006) Resistance in nonfermenting gram-negative bacteria: multidrug resistance to the maximum. Am J Infect Control 34:S29–S37; discussion S64–S73. doi:10.1016/j.ajic.2006.05.226

    Article  PubMed  Google Scholar 

  34. Aisenberg G, Rolston KV, Dickey BF, Kontoyiannis DP, Raad II, Safdar A (2007) Stenotrophomonas maltophilia pneumonia in cancer patients without traditional risk factors for infection, 1997–2004. Eur J Clin Microbiol Infect Dis 26:13–20. doi:doi:10.1007/s10096-006-0243-7

    Article  PubMed  CAS  Google Scholar 

  35. Friedman ND, Korman TM, Fairley CK, Franklin JC, Spelman DW (2002) Bacteraemia due to Stenotrophomonas maltophilia: an analysis of 45 episodes. J Infect 45:47–53. doi:10.1053/jinf.2002.0978

    Article  PubMed  CAS  Google Scholar 

  36. Heath T, Currie B (1995) Nosocomial and community-acquired Xanthomonas maltophilia infection in tropical Australia. J Hosp Infect 30:309–313. 10.1016/0195-6701(95)90266-X

    Article  PubMed  CAS  Google Scholar 

  37. Laing FP, Ramotar K, Read RR, Alfieri N, Kureishi A, Henderson EA, Louie TJ (1995) Molecular epidemiology of Xanthomonas maltophilia colonization and infection in the hospital environment. J Clin Microbiol 33:513–518

    PubMed  CAS  Google Scholar 

  38. Wang WS, Liu CP, Lee CM, Huang FY (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 

  39. Pereira O, Velho GC, Lopes V, Mota F, Santos C, Massa A (2001) Acral necrosis by Stenotrophomonas maltophilia. J Eur Acad Dermatol Venereol 15:334–336. 10.1046/j.1468-3083.2001.00273.x

    Article  PubMed  CAS  Google Scholar 

  40. Platsouka E, Routsi C, Chalkis A, Dimitriadou E, Paniara O, Roussos C (2002) Stenotrophomonas maltophilia meningitis, bacteremia and respiratory infection. Scand J Infect Dis 34:391–392. doi:10.1080/00365540110080520

    Article  PubMed  Google Scholar 

  41. Aydin K, Köksal I, Kaygusuz S, Kaklikkaya I, Caylan R, Ozdemir R (2000) Endocarditis caused by Stenotrophomonas maltophilia. Scand J Infect Dis 32:427–430. doi:10.1080/003655400750045060

    Article  PubMed  CAS  Google Scholar 

  42. Spencer MT, Baron BJ (2001) Stenotrophomonas maltophilia meningitis—a rare cause of headache in the ED. Am J Emerg Med 19:532–533. doi:10.1053/ajem.2001.27149

    Article  PubMed  CAS  Google Scholar 

  43. Gunnarsson G, Steinsson K (2002) Sinusitis due to Stenotrophomonas maltophilia. Scand J Infect Dis 34:136–137. doi:10.1080/00365540110077164

    Article  PubMed  CAS  Google Scholar 

  44. Hellmig S, Ott S, Musfeldt M, Kosmahl M, Rosenstiel P, Stüber E, Hampe J, Fölsch UR, Schreiber S (2005) Life-threatening chronic enteritis due to colonization of the small bowel with Stenotrophomonas maltophilia. Gastroenterology 129:706–712

    PubMed  Google Scholar 

  45. Ramos-Esteban JC, Jeng BH (2008) Posttraumatic Stenotrophomonas maltophilia infectious scleritis. Cornea 27:232–235. doi:10.1097/ICO.0b013e318176189e

    Article  PubMed  Google Scholar 

  46. Aydemir C, Aktaş E, Eldeş N, Kutsal E, Demirel F, Ege A (2008) Community-acquired infection due to Stenotrophomonas maltophilia: a rare cause of septic arthritis. Turk J Pediatr 50:89–90

    PubMed  Google Scholar 

  47. Bello G, Alberto Pennisi M, Fragasso T, Mignani V, Antonelli M (2005) Acute upper airway obstruction caused by Stenotrophomonas maltophilia soft tissue infection. Scand J Infect Dis 37:734–737. doi:10.1080/00365540510044436

    Article  PubMed  Google Scholar 

  48. Börner D, Marsch WC, Fischer M (2003) Necrotizing otitis externa caused by Stenotrophomonas maltophilia. Hautarzt 54:1080–1082. doi:10.1007/s00105-003-0551-0

    Article  Google Scholar 

  49. German V, Tsimpoukas F, Goritsas C, Ferti A (2007) Spondylodiscitis due to Stenotrophomonas maltophilia. Eur J Intern Med 18:501–503. doi:10.1016/j.ejim.2007.02.016

    Article  PubMed  Google Scholar 

  50. Petri A, Tiszlavicz L, Nagy E, Morvay Z, Kókai EL, Savanya GK, Balogh A (2003) Liver abscess caused by Stenotrophomonas maltophilia: report of a case. Surg Today 33:224–228. doi:10.1007/s005950300050

    Article  PubMed  Google Scholar 

  51. McDonald GR, Pernenkil R (1993) Community-acquired Xanthomonas maltophilia pyelonephritis. South Med J 86:967–968. doi:doi:10.1097/00007611-199308000-00025

    Article  PubMed  CAS  Google Scholar 

  52. Jang TN, Wang FD, Wang LS, Liu CY, Liu IM (1992) Xanthomonas maltophilia bacteremia: an analysis of 32 cases. J Formos Med Assoc 91:1170–1176

    PubMed  CAS  Google Scholar 

  53. Yu VL, Rumans LW, Wing EJ, McLeod R, Sattler FN, Harvey RM, Deresinski SC (1978) Pseudomonas maltophilia causing heroin-associated infective endocarditis. Arch Intern Med 138:1667–1671. doi:10.1001/archinte.138.11.1667

    Article  PubMed  CAS  Google Scholar 

  54. Pruvost C, May L, Davous N, Petit A (2002) Plantar pyoderma due to Stenotrophomonas maltophilia. Ann Dermatol Venereol 129:886–887

    PubMed  CAS  Google Scholar 

  55. Kato N, Morioka T (1991) Purpura fulminans secondary to Xanthomonas maltophilia sepsis in an adult with aplastic anemia. J Dermatol 18:225–229

    PubMed  CAS  Google Scholar 

  56. Paez JI, Costa SF (2008) Risk factors associated with mortality of infections caused by Stenotrophomonas maltophilia: a systematic review. J Hosp Infect 70:101–108. doi:10.1016/j.jhin.2008.05.020

    Article  PubMed  Google Scholar 

  57. Vidal F, Mensa J, Almela M, Olona M, Martínez JA, Marco F, López MJ, Soriano A, Horcajada JP, Gatell JM, Richart C (2003) Bacteraemia in adults due to glucose non-fermentative Gram-negative bacilli other than P. aeruginosa. QJM 96:227–234. doi:10.1093/qjmed/hcg031

    Article  PubMed  CAS  Google Scholar 

  58. Khardori N, Elting L, Wong E, Schable B, Bodey GP (1990) Nosocomial infections due to Xanthomonas maltophilia (Pseudomonas maltophilia) in patients with cancer. Rev Infect Dis 12:997–1003

    PubMed  CAS  Google Scholar 

  59. Pathmanathan A, Waterer GW (2005) Significance of positive Stenotrophomonas maltophilia culture in acute respiratory tract infection. Eur Respir J 25:911–914. doi:10.1183/09031936.05.00096704

    Article  PubMed  CAS  Google Scholar 

  60. Abbassi MS, Touati A, Achour W, Cherif A, Jabnoun S, Khrouf N, Ben Hassen A (2008) Stenotrophomonas maltophilia responsible for respiratory infections in neonatal intensive care unit: Antibiotic susceptibility and molecular typing. Pathol Biol (Paris)

  61. Verweij PE, Meis JF, Christmann V, Van der Bor M, Melchers WJ, Hilderink BG, Voss A (1998) Nosocomial outbreak of colonization and infection with Stenotrophomonas maltophilia in preterm infants associated with contaminated tap water. Epidemiol Infect 120:251–256. doi:10.1017/S0950268898008735

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. E. Falagas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Falagas, M.E., Kastoris, A.C., Vouloumanou, E.K. et al. Community-acquired Stenotrophomonas maltophilia infections: a systematic review. Eur J Clin Microbiol Infect Dis 28, 719–730 (2009). https://doi.org/10.1007/s10096-009-0709-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-009-0709-5

Keywords

Navigation