Stenotrophomonas maltophilia infections

Nocardia infections have been treated successjully, but failures also have been reported. Although a combination of doxycycline and streptomycin or gentamicin is considered the treatment of choice for brucellosis, trimethoprim—sulfamethoxazole may be an effective substitute for the doxy-cyctine combination. Trimethoprim—sulfamethoxazole also has been used successjully for Whipple s disease, Stenotrophomonas maltophilia infection, and infection by the intestinal parasites Cyclospora and Isospora. 

Trimethoprim is fairly active against a variety of Grampositive cocci and Gram-negative rods. Established indications for co-trimoxazole are infections of the sinuses, ears, lungs, and urinary tract, and infections due to Salmonella, Nocardia, Brucella, Stenotrophomonas maltophilia, Pneumocystis proved, and Toxoplasma (1,6). Co-trimoxazole is also used in the treatment of Wegener s granulomatosis, for prevention of spontaneous bacterial peritonitis, and in patients with advanced HIV infection for the prophylaxis of opportunistic infections (1,6). 

In addition to the impact on P. aeruginosa MICs, the use of inhaled tobramycin is also associated with an increased rate of isolation of fungus in the sputum, including Candida albicans and Aspergillus species [32]. The increased presence of these fungi did not appear to be associated with deterioration in clinical status. The chronic use of inhaled tobramycin has not been associated with an increased risk of colonization or infection with other bacteria, including Burkholderia cepacia, Stenotrophomonas maltophilia, and Alcaligenes xylosoxidans. 

Carmeli Y, Samore MH. Comparison of treatment with imipenem vs. ceftazidime as a predisposing factor for nosocomial acquisition of Stenotrophomonas maltophilia a historical cohort study. Clin Infect Dis 1997 24 1131-1134. Papadakis KA, Vartivarian SE, Anaissie EJ, Samonis G. Xanthomonas maltophilia bacteremia in cancer patients an analysis of 44 episodes. Clin Infect Dis 1994 19 558. 

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