Levofloxacin-resistant Stenotrophomonas maltophilia: risk factors and antibiotic susceptibility patterns in hospitalized patients
Abstract
BACKGROUND
Levofloxacin has been considered as an alternative treatment for Stenotrophomonas maltophilia infection. Levofloxacin-resistant S. maltophilia (LRSM), however, are emerging in the world.
AIM
The retrospective matched case-control-control study is aimed to investigate LRSM risk factors in hospitalized patients. Antibiotic susceptibility patterns of collected LRSM isolates were determined.
METHODS
LRSM patients (the case group) were compared with two control groups: levofloxacin-susceptible S. maltophilia (LSSM) patients (control group A) and non-S. maltophilia-infected patients (control group B). Conditional logistic regression was used to analyse risk factors for LRSM occurrence. Tigecycline, ceftazidime, colistin, and trimethoprim/sulfamethoxazole (TMP/SMX) susceptibilities in collected LRSM clinical isolates were determined.
FINDINGS
A total of 105 LRSM, 105 LSSM, and 105 non-S. maltophilia-infected patients were analysed. The first multivariable analysis (cases vs. group A) revealed that previous fluoroquinolones use was significantly associated with LRSM occurrence, and the second multivariable analysis (cases vs. group B) revealed that previous fluoroquinolones use, previous intensive care unit (ICU) stay, and the number of previous exposures to different classes of antibiotics were significantly associated with LRSM occurrence. Of all the LRSM isolates tested for antibiotic susceptibility, ceftazidime, TMP/SMX, tigecycline, and colistin resistance rates were…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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