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. 2024 Dec;43(12):2453-2457.
doi: 10.1007/s10096-024-04932-6. Epub 2024 Sep 19.

Understanding the rationale and clinical impact of the revised CLSI 2024 minocycline susceptibility breakpoints against Stenotrophomonas maltophilia

Yamuna Devi Bakthavatchalam  1 , Yuvashri Manoharan  1 , Abirami Shankar  2 , Karthik Gunasekaran  3 , Kamini Walia  1 , Balaji Veeraraghavan  4
Affiliations

Understanding the rationale and clinical impact of the revised CLSI 2024 minocycline susceptibility breakpoints against Stenotrophomonas maltophilia

Yamuna Devi Bakthavatchalam et al. Eur J Clin Microbiol Infect Dis. 2024 Dec.

Abstract

Stenotrophomonas maltophilia is challenging to treat due to the presence of multiple intrinsic and acquired resistance mechanisms. TMP-SMZ is the standard care of therapy for treating S. maltophilia infections; levofloxavin and minocycline are the preferred potential alternatives. Recently, in 2024, CLSI has lowered the susceptibility breakpoints for minocycline against S. maltophilia. Applying the revised minocycline's susceptibility breakpoint of ≤ 1 mg/L, susceptibility to minocycline dropped significantly from 77% (previous breakpoint, ≤ 4 mg/L) to 35% (revised breakpoint of ≤ 1 mg/L). In the wake of this change, minocycline's dependency has been questioned for treating S. maltophilia infections.

Keywords: S. maltophilia; Aztreonam/avibactam; Cefiderocol; Ceftazidime; Minocycline.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval: statement: Not applicable.

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