Stenotrophomonas maltophilia in Malaysia: Molecular epidemiology and trimethoprim-sulfamethoxazole resistance

Vasanthakumari Neela, Seyedeh Zahra Rouhani Rankouhi, Alex van Belkum, Richard V. Goering, Rukman Awang

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives: Stenotrophomonas maltophilia is a recently identified nosocomial pathogen in Malaysia. Despite limited pathogenicity, its rate of isolation has increased in recent years. The aim of this study was to investigate the antibiotic susceptibility patterns, antibiotic resistance determinants, and the epidemiology of S. maltophilia at the largest tertiary care hospital in Malaysia. Methods: This study was carried out from January to December 2008. Sixty-four S. maltophilia isolates were investigated for their antibiotic susceptibility patterns by disk diffusion test and E-test. The antibiotic resistance mechanism for trimethoprim-sulfamethoxazole (TMP-SMX) was assessed by PCR for sul1, sul2, qac/. smr, and class 1 integrons in general. Epidemiological relatedness among isolates was determined by pulsed-field gel electrophoresis (PFGE). Results: The highest number of S. maltophilia infections was observed in the intensive care unit (ICU) (n=13; 20.3%), while the lowest number of infections was seen in the neurology, psychiatric, and dermatology wards (each n=1; 1.6%). All isolates were susceptible to minocycline. One isolate was resistant to TMP-SMX with a minimum inhibitory concentration (E-test) >32. mg/l. The strain carried the sul1 gene and class 1 integron. None of the isolates were positive for the qac/. smr genes. Although the data suggest the potential for patient to patient transmission, most of the S. maltophilia strains showed unrelated PFGE patterns and were considered to be genetically diverse. Conclusion: The increasing number of S. maltophilia isolates seen in the ICU, their resistance to mainstay antibiotics, their genetically diverse nature, and possible cross-transmission within the hospital, strongly underscores the need for continuous surveillance for S. maltophilia in the hospital setting.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Volume16
Issue number8
DOIs
StatePublished - Aug 2012

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Trimethoprim Resistance
Stenotrophomonas maltophilia
Molecular Epidemiology
Malaysia
Sulfamethoxazole Drug Combination Trimethoprim
Integrons
Pulsed Field Gel Electrophoresis
Microbial Drug Resistance
Anti-Bacterial Agents
Intensive Care Units
Minocycline
Microbial Sensitivity Tests
Tertiary Healthcare
Neurology
Dermatology
Infection
Tertiary Care Centers
Genes
Psychiatry
Virulence

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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Stenotrophomonas maltophilia in Malaysia : Molecular epidemiology and trimethoprim-sulfamethoxazole resistance. / Neela, Vasanthakumari; Rankouhi, Seyedeh Zahra Rouhani; van Belkum, Alex; Goering, Richard V.; Awang, Rukman.

In: International Journal of Infectious Diseases, Vol. 16, No. 8, 08.2012.

Research output: Contribution to journalArticle

Neela, Vasanthakumari ; Rankouhi, Seyedeh Zahra Rouhani ; van Belkum, Alex ; Goering, Richard V. ; Awang, Rukman. / Stenotrophomonas maltophilia in Malaysia : Molecular epidemiology and trimethoprim-sulfamethoxazole resistance. In: International Journal of Infectious Diseases. 2012 ; Vol. 16, No. 8.
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