Risk factors and molecular mechanisms associated with trimethoprim–sulfamethoxazole resistance in Stenotrophomonas maltophilia in Mexico

Herrera Heredia, Sandra Abril y Pezina Cantú, César y Garza González, Elvira y Bocanegra Ibarias, Paola y Mendoza Olazarán, Soraya Sarahí y Morfín Otero, Rayo y Camacho Ortiz, Adrián y Villarreal Treviño, Licet y Rodríguez Noriega, Eduardo y Palau Davila, Laura y Maldonado Garza, Héctor Jesús y Flores Treviño, Samantha Maribel (2017) Risk factors and molecular mechanisms associated with trimethoprim–sulfamethoxazole resistance in Stenotrophomonas maltophilia in Mexico. Journal of Medical Microbiology, 66 (8). pp. 1102-1109. ISSN 0022-2615

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URL o página oficial: http://doi.org/10.1099/jmm.0.000550

Resumen

Abstract Purpose. Stenotrophomonas maltophilia is a multidrug-resistant opportunistic pathogen causing an increasing number of nosocomial infections. Our aim was to evaluate the risk factors and mechanisms associated with trimethoprim– sulfamethoxazole (SXT) resistance in S. maltophilia infections in Mexico. Methodology. Clinical isolates and patients’ demographic and clinical data were collected from February 2007 to August 2015 in two tertiary-care hospitals in Mexico. Antimicrobial susceptibility and analysis of sul and SmeABC and SmeDEF efflux pump overexpression were performed in all isolates. Results/Key findings. In the 9-year period, 196 patients infected with S. maltophilia were identified. Most patients were male, and the mean age was 46.2years. The mean Charlson score was 1.42, and the most frequent comorbidities were arterial hypertension (26.7%), type 2 diabetes (21.2%) and cerebral infarction (11.6%). High drug resistance to meropenem (93.4%), gentamicin (55.1%), ceftazidime (52.3%), cefotaxime (51.5%), amikacin (42.3%) and cefepime (32.1%), and lower resistance to ciprofloxacin (26.0%), SXT (25.0%), chloramphenicol (14.3%) and levofloxacin (2.6%) were detected. SXT resistance was not associated with the sul genes. SmeABC overexpression was associated with gentamicin (P=0.001) and levofloxacin resistance (P=0.041), whereas SmeDEF overexpression was associated with ceftazidime resistance (P=0.003). Prolonged hospitalization (�15days) was an independent risk factor for SXT-resistant S. maltophilia infections (OR=3.05; 95%CI=1.12– 8.86; P=0.029). Conclusion. Given the high SXT resistance rate, SXT is not an effective first-line therapy for our patients; instead, levofloxacin could be used as an appropriate therapeutic option against S. maltophilia infections.

Tipo de elemento: Article
Divisiones: Ciencias Biológicas
Usuario depositante: Editor Repositorio
Creadores:
CreadorEmailORCID
Herrera Heredia, Sandra AbrilNO ESPECIFICADONO ESPECIFICADO
Pezina Cantú, CésarNO ESPECIFICADONO ESPECIFICADO
Garza González, ElviraNO ESPECIFICADONO ESPECIFICADO
Bocanegra Ibarias, PaolaNO ESPECIFICADONO ESPECIFICADO
Mendoza Olazarán, Soraya SarahíNO ESPECIFICADONO ESPECIFICADO
Morfín Otero, RayoNO ESPECIFICADONO ESPECIFICADO
Camacho Ortiz, AdriánNO ESPECIFICADONO ESPECIFICADO
Villarreal Treviño, LicetNO ESPECIFICADONO ESPECIFICADO
Rodríguez Noriega, EduardoNO ESPECIFICADONO ESPECIFICADO
Palau Davila, LauraNO ESPECIFICADONO ESPECIFICADO
Maldonado Garza, Héctor JesúsNO ESPECIFICADONO ESPECIFICADO
Flores Treviño, Samantha Maribelsamflorest@gmail.comNO ESPECIFICADO
Fecha del depósito: 28 Abr 2020 14:28
Última modificación: 29 Mayo 2020 18:35
URI: http://eprints.uanl.mx/id/eprint/17568

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