Advances in the Microbiology of Stenotrophomonas maltophilia.

Stenotrophomonas maltophilia is an opportunistic pathogen of significant concern to susceptible patient populations. This pathogen can cause nosocomial and community-acquired respiratory and bloodstream infections and various other infections in humans. Sources include water, plant rhizospheres, animals, and foods. Studies of the genetic heterogeneity of S. maltophilia strains have identified several new genogroups and suggested adaptation of this pathogen to its habitats. The mechanisms used by S. maltophilia during pathogenesis continue to be uncovered and explored. S. maltophilia virulence factors include use of motility, biofilm formation, iron acquisition mechanisms, outer membrane components, protein secretion systems, extracellular enzymes, and antimicrobial resistance mechanisms. S. maltophilia is intrinsically drug resistant to an array of different antibiotics and uses a broad arsenal to protect itself against antimicrobials. Surveillance studies have recorded increases in drug resistance for S. maltophilia, prompting new strategies to be developed against this opportunist. The interactions of this environmental bacterium with other microorganisms are being elucidated. S. maltophilia and its products have applications in biotechnology, including agriculture, biocontrol, and bioremediation.

Polysorbate 80 and polymyxin B inhibit Stenotrophomonas maltophilia biofilm.

Stenotrophomonas maltophilia is an opportunistic multiple-drug-resistant human pathogen that forms biofilms on implanted medical devices. We examined the potential inhibitory activity of polysorbate 80 and polymyxin B against S. maltophilia. A combination of subMIC polymyxin B and polysorbate 80 was the most effective inhibitor of growth and biofilm formation.

Stenotrophomonas maltophilia biofilm reduction by Bdellovibrio exovorus.

Stenotrophomonas maltophilia, a bacterium ubiquitous in the environment, is also an opportunistic, multidrug-resistant human pathogen that colonizes tissues and medical devices via biofilm formation. We investigated the ability of an isolate from sewage of the bacterial predator Bdellovibrio exovorus to disrupt preformed biofilms of 18 strains of S. maltophilia isolated from patients, hospital sink drains and water fountain drains. B. exovorus FFRS-5 preyed on all S. maltophilia strains in liquid co-cultures and was able to significantly disrupt the biofilms of 15 of the S. maltophilia strains tested, decreasing as much as 76.7% of the biofilm mass. The addition of ciprofloxacin and kanamycin in general reduced S. maltophilia biofilms but less than that of B. exovorus alone. Furthermore, when antibiotics and B. exovorus were used together, B. exovorus was still effective in the presence of ciprofloxacin whereas the addition of kanamycin reduced the effectiveness of B. exovorus. Overall, B. exovorus was able to decrease the mass of preformed biofilms of S. maltophilia in the presence of clinically relevant antibiotics demonstrating that the predator may prove to be a beneficial tool to reduce S. maltophilia environmental or clinically associated biofilms.

New strategies against Stenotrophomonas maltophilia: a serious worldwide intrinsically drug-resistant opportunistic pathogen.

Stenotrophomonas maltophilia is a worldwide human opportunistic pathogen associated with serious infections in humans, and is most often recovered from respiratory tract infections. In addition to its intrinsic drug resistance, this organism may acquire resistance via multiple molecular mechanisms. New antimicrobial strategies are needed to combat S. maltophilia infections, particularly in immunocompromised patients, cystic fibrosis patients with polymicrobial infections of the lung, and in patients with chronic infections. This editorial reports on newer drugs and antimicrobial strategies and their potential for use in treatment of S. maltophilia infections, the development of new technologies to detect this organism, and identifies strategies currently in use to reduce transmission of this pathogen.

Stenotrophomonas maltophilia: an emerging global opportunistic pathogen.

Stenotrophomonas maltophilia is an emerging multidrug-resistant global opportunistic pathogen. The increasing incidence of nosocomial and community-acquired S. maltophilia infections is of particular concern for immunocompromised individuals, as this bacterial pathogen is associated with a significant fatality/case ratio. S. maltophilia is an environmental bacterium found in aqueous habitats, including plant rhizospheres, animals, foods, and water sources. Infections of S. maltophilia can occur in a range of organs and tissues; the organism is commonly found in respiratory tract infections. This review summarizes the current literature and presents S. maltophilia as an organism with various molecular mechanisms used for colonization and infection. S. maltophilia can be recovered from polymicrobial infections, most notably from the respiratory tract of cystic fibrosis patients, as a cocolonizer with Pseudomonas aeruginosa. Recent evidence of cell-cell communication between these pathogens has implications for the development of novel pharmacological therapies. Animal models of S. maltophilia infection have provided useful information about the type of host immune response induced by this opportunistic pathogen. Current and emerging treatments for patients infected with S. maltophilia are discussed.

Potential pathogens and effective disinfectants on public telephones at a large urban United States university.

Telephones can carry potential bacterial pathogens, posing a risk for transfer of pathogens to users' hands. This study examined 25 mouthpieces of public telephones at a large urban U.S. university located in an area of rising incidence of community-acquired staphylococcal infections. Coagaulase-negative staphylococci were most commonly isolated (64% of mouthpieces). Potential pathogens isolated included Staphylococcus aureus, vancomycin-susceptible Enterococcus, and Klebsiella ozaenae. The efficacy of disinfectants on reducing bacterial counts on telephone mouthpieces was also investigated. Staphyloccocus aurens, Pseudomonas aeruginosa, and Enterococcusfaecalis were inoculated onto mouthpieces and challenged with disinfectant wipes. Bacterial counts were reduced substantially for all three organisms by wipes containing either 70% isopropyl alcohol, 1.84% sodium hypochlorite, or quaternary ammonium compounds. The sodium hypochlorite-based cleaner demonstrated 100% efficacy at removing or killing test organisms from telephone mouthpieces. These data suggest that tested cleaners may be appropriate and needed for public telephone disinfection.

Investigation of bacterial pathogens on 70 frequently used environmental surfaces in a large urban U.S. university.

After reports of increased severity of bacterial infections from community institutions, a broad spectrum of 70 surfaces was sampled for potential bacterial pathogens in the morning and afternoon of one day per week over three consecutive weeks in a large U.S. university. Surfaces included public telephone mouthpieces, water fountain drains, student computer keyboards and desks, and buttons on elevators, vending machines, and photocopiers. A total of 420 samples was obtained. Bacterial counts were high on telephone mouthpieces, up to 168.8 colony-forming units (CFUs).cm(-2) of surface area. Stenotrophomonas maltophilia was isolated from 60% of fountain drains. Ninety percent of the keyboards showed positive bacterial cultures in the afternoon sampling. Staphylococcus aureus was identified on keyboards, telephone mouthpieces, and an elevator button. No S. aureus were methicillin-resistant. The swab sampling method reduced bacterial counts to less than or equal to 2.0 CFU.cm(-2) on keyboards and telephone mouthpieces. Disinfectants for possible use in cleaning of telephones, water fountain drains, and keyboards are discussed.

Receptor-based antidote for diphtheria.

Although equine diphtheria antitoxin may be an effective therapy for human diphtheria, its use often induces serum sickness. We describe here a strategy for developing an alternative treatment based on the human diphtheria toxin (DT) receptor/heparin-binding epidermal growth factor-like growth factor (HB-EGF) precursor. Recombinant mature human HB-EGF acts as a soluble receptor analog, binding radioiodinated DT and preventing its binding to the cellular DT receptor/HB-EGF precursor. However, the possibility existed that radioiodinated DT-HB-EGF complexes associate with cells due to the binding of the heparin-binding domain of recombinant HB-EGF to cell surface heparan sulfate proteoglycans. This possibility was confirmed by performing DT binding studies in the presence of heparin. A recombinant truncated HB-EGF (residues 106 to 149), which lacks most of the heparin-binding domain, showed an essentially heparin-independent binding of radioiodinated DT to cells. Furthermore, it was a more effective inhibitor of DT binding than was recombinant mature HB-EGF. Since mature HB-EGF is a known ligand for the EGF receptor and is thus highly mitogenic (tumorigenic), we then changed amino acid residues in the EGF-like domain of the recombinant truncated HB-EGF and demonstrated that this DT receptor analog (I117A/L148A) displayed a low mitogenic effect. The truncated (I117A/L148A) HB-EGF protein retained high DT binding affinity, as confirmed by using surface plasmon resonance. Our results suggest that the truncated (I117A/L148A) HB-EGF protein could be an effective, safe antidote for human diphtheria.

Latent transforming growth factor beta-binding protein-3 and fibulin-1C interact with the extracellular domain of the heparin-binding EGF-like growth factor precursor.

BACKGROUND: The membrane-bound cell-surface precursor and soluble forms of heparin-binding epidermal growth factor-like growth factor (HB-EGF) contribute to many cellular developmental processes. The widespread occurrence of HB-EGF in cell and tissue types has led to observations of its role in such cellular and tissue events as tumor formation, cell migration, extracellular matrix formation, wound healing, and cell adherence. Several studies have reported the involvement of such extracellular matrix proteins as latent transforming growth factor beta-binding protein, TGF-beta, and fibulin-1 in some of these processes. To determine whether HB-EGF interacts with extracellular matrix proteins we used the extracellular domain of proHB-EGF in a yeast two-hybrid system to screen a monkey kidney cDNA library. cDNA clones containing nucleotide sequences encoding domains of two proteins were obtained and their derived amino acid sequences were evaluated. RESULTS: From approximately equal to 3 x 10(6) screened monkey cDNA clones, cDNA clones were recovered that contained nucleotide sequences encoding domains of the monkey latent transforming growth factor-beta binding protein-3 (MkLTBP-3) and fibulin-1C protein. The amino acid sequence derived from the MkLTBP-3 gene shared 98.6% identity with human LTBP-3 and 86.7% identity with mouse LTBP-3 amino acid sequences. The amino acid sequence derived from the monkey fibulin-1C gene shared 97.2% identity with human fibulin-1C. Yeast two-hybrid screens indicate that LTBP-3 and fibulin-1C interact with proHB-EGF through their calcium-binding EGF-like modules. CONCLUSIONS: The interactions of the extracellular domain of proHB-EGF with LTBP-3 and fibulin-1C suggest novel functions for HB-EGF between cell and tissue surfaces.