Emerging infections in vulnerable hosts: Stenotrophomonas maltophilia and Elizabethkingia anophelis.

Autor:	Lee YL; Department of Internal Medicine, Chung Shan Medical University Hospital.; School of Medicine, Chung Shan Medical University.; PhD Program in Medical Biotechnology, National Chung-Hsing University., Hsueh PR; Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital.; School of Medicine.; PhD Program for Aging, School of Medicine, China Medical University, Taichung.; Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	Current opinion in infectious diseases [Curr Opin Infect Dis] 2023 Dec 01; Vol. 36 (6), pp. 481-494. Date of Electronic Publication: 2023 Aug 02.
DOI:	10.1097/QCO.0000000000000953
Abstrakt:	Purpose of Review: This systematic review aimed to explore the recent trends in the epidemiology, risk factors, and antimicrobial susceptibility of two emerging opportunistic pathogens, Stenotrophomonas maltophilia and Elizabethkingia anophelis . Recent Findings: Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia . Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis , there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis . The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported. Summary: Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis , but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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