title: Isolation of Stenotrophomonas maltophilia in asymptomatic lung transplant recipients: effects of treatment on eradication and outcome.
abstract: In this retrospective, single-center data analysis, we audited our clinical practice to treat Stenotrophomonas maltophilia in asymptomatic lung transplant recipients (LTRs). Eighteen LTRs with confirmed isolation of S. maltophilia were identified. Twelve of these LTRs have been treated with antibiotics, while 6 were managed without treatment. Treatment was based on antibiograms (trimethoprim/sulfamethoxazole [TMP/SMX] (8/12), levofloxacin (1/12), or both (3/12). Clearance (12/12 vs 6/6), eradication (10/12 vs 3/6, P=.27), and freedom from S. maltophilia recurrence (83%±11% vs 40%±22% after one year, log-rank P=.09) were not found to differ significantly between treated and untreated patients. None of the patient groups showed significant changes in lung function or biochemical variables. Creatinine levels at the end of the study period were found to be higher in treated patients compared to the untreated group (P=.049). De novo acquired TMP/SMX resistance in S. maltophilia strains was not observed. These results indicate no evidence that antibiotic treatment for S. maltophilia in asymptomatic LTRs alters lung function or the clinical outcome.
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hofmann
authors.affiliation: Institute of Medical Microbiology, University Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Hombach
authors.affiliation: Institute of Epidemiology, Biostatistics and Prevention, University Zurich, Zurich, Switzerland.
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Macé M
authors.initials: MM
authors.lastname: Schuurmans
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Bürgi
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Bruno
authors.initials: B
authors.lastname: Isenring
authors.affiliation: Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Nicolas J
authors.initials: NJ
authors.lastname: Mueller
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Benden
authors.affiliation: Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Lars C
authors.initials: LC
authors.lastname: Huber
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D024881:Drug Resistance, Bacterial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008168:Lung / Q000382:microbiology*; D017563:Lung Diseases, Interstitial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016040:Lung Transplantation; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification*; D066027:Transplant Recipients; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: Stenotrophomonas maltophilia; Treatment; lung transplant recipients