A Study on Clinical Profile and Antimicrobial Drug Resistance in Infection with Stenotrophomonas maltophilia at a Tertiary Care Hospital of Rural Gujarat, India.

ABSTRACT

Background & objectives: Stenotrophomonas maltophilia causes opportunistic infections and is emerging as an important hospital-acquired pathogen. Present study was undertaken to investigate the prevalence, clinical profile, associated factors and antimicrobial susceptibility of S. maltophilia. Methods: Cross sectional retrospective study was conducted whereby patients’ details including type of infection, hospital stay, indwelling devices, co-morbid conditions and outcome till discharge were collected from January 2012 to March 2016. Identification and antimicrobial susceptibility were done by using Vitek2-compact-microbiological system. Results: 45 (0.17%) S.maltophilia strains were isolated from 27,132 samples received, forming 1.63% of total non-fermenters. Prevalence of S.maltophilia infection ranged from 0.06% in 2012 to 0.26% in 2015. Common sites involved were respiratory tract i.e. 55.5%, followed by bloodstream (20%), urinary tract (13.3%) and soft tissue (11.1%). 64.4% patients were male, and adults (26.7%) between 51-60 years of age. 66.7% of the isolates were from critical care units followed by wards (33.3%). Co-morbid conditions observed were COPD with respiratory complications i.e. 26.7% followed by cardiovascular diseases 22.2%, malignancy 11.1%, post surgical patients 11.1%, complicated UTI and trauma 8.8% each, CNS complications 6.7%, burns and cellulitis 2.2% each. All patients had exposure to broad-spectrum antibiotics and 66.6% had indwelling devices. 17.8% isolates were resistant to trimethoprim-sulfamethoxazole. Mortality observed was 20%. Interpretation & conclusion: S maltophilia is an emerging pathogen and its prevalence has gradually increased at our hospital. ICUs are the main hospital sites and respiratory infections main clinical condition. [Disha S NJIRM 2016; 7(5)5-8]