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Xanthomonas (Stenotrophomonas) maltophilia
Pathology:
- commonly causes nosocomial infections.
Pharmacology:
1) resistant to:
a) imipenem
b) meropenem
c) aminoglycosides
d) quinolones
e) beta-lactam antibiotics (penicillins, cephalosporins)
2) generally susceptible to:
a) trimethoprim-sulfamethoxazole (Bactrim)
b) ticarcillin/clavulanate (Timentin)
c) minocycline [3]
Laboratory:
- Stenotrophomonas maltophilia DNA [2]
- culture
- glucose oxidizer; lysine decarboxylase +
- pigment yellow; motility +; MacConkey +
- cytochrome-oxidase -
Management:
- in order of preference [4]
- cefiderocol (with a second agent)
- ceftazidime-avibactam & aztreonam,
- minocycline (with a second agent)
- trimethoprim-sulfamethoxazole (with a second agent)
- levofloxacin (with a second agent)
- tigecycline is no longer listed as a component of combination therapy [4]
General
Xanthomonas
Properties
KINGDOM: monera
DIVISION: SCHIZOMYCETES
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed)
Lippincott-Raven, Philadelphia, 1998, pg 499
- Loinc
- Medical Knowledge Self Assessment Program (MKSAP) 18,
American College of Physicians, Philadelphia 2018
- Tamma PD, Heil EL, Justo JA, Mathers AJ, Satlin MJ, Bonomo RA.
Infectious Diseases Society of America 2024 Guidance on the Treatment of
Antimicrobial-Resistant Gram-Negative Infections.
Clin Infect Dis. 2024 Aug 7:ciae403.
PMID: 39108079
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciae403/7728556