Antibiotic resistance among clinical isolates of Stenotrophomonas maltophilia at a teaching hospital in Riyadh, Saudi Arabia

Abstract

Background: Stenotrophomonas maltophilia has emerged as a significant pathogen in compromised patients, causing infections which are difficult to treat. This study was carried out to comprehend the recent trend of antimicrobial resistance among clinical isolates of S. maltophilia and suggest management guidance for patients in general and in our region in particular.

Methods: A total of 222 clinical isolates were tested between Jan 2003 to Jun 2009 at King Khalid University Hospital, College of Medicine, King Saud University, Riyadh Saudi Arabia. The organisms were identified as per standard guidelines. Final identification and minimum inhibitory concentration (MIC) was determined by using Microscan.

Results: S. maltophilia showed absolute resistance to Imipenem. In vitro, least resistance was observed against Cotrimoxazole (9.45%) followed by Ceftazidime (57.21%), Piperacillin/Tazobactam (60.82%), Ciprofloxacin (77.03%), Aztreonam (86.03%). Gentamicin showed overall highest resistance (87.39%). The crude mortality rate was 47%.

Conclusion: Cotrimoxazole is still the most effective agent against S. maltophilia but, keeping in view the increasing resistance to first and second line drugs, there is an urgent need for an effective surveillance system. To discourage development of resistance and devise an effective empirical therapy, large scale study should be considered.