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Volume 48, Number 3, June 2015

Risk factors for levofloxacin resistance in Stenotrophomonas maltophilia from respiratory tract in a regional hospital 


Chien-Jung Pien, Han-Yueh Kuo, Shu-Wen Chang, Pei-Ru Chen, Hui-Wen Yeh, Chih-Chin Liu, Ming-Li Liou


Received: April 30, 2013    Revised: August 20, 2013    Accepted: August 31, 2013   

 

Corresponding author:

Ming-Li Liou

Department of Medical Laboratory Medicine and Biotechnology, Yuanpei University, Hsin-Chu City, Taiwan
Department of Computer Science and Information Engineering, Providence University, Taichung City, Taiwan
Correspondence
Corresponding author. Department of Medical Laboratory Medicine and Biotechnology, Yuanpei University, Hsin-Chu City, Taiwan; Department of Computer Science and Information Engineering, Providence University, Taichung City, Taiwan. 



 

Background and purpose: 

Stenotrophomonas maltophilia is a bacterial pathogen associated with health-care associated infections, particularly in immunocompromised patients. Members of the fluoroquinolone drug class are frequently used to treat S. maltophilia infection; however, S. maltophilia resistance to fluoroquinolones, especially levofloxacin, has been increasing. 



 

Methods:

We sought to identify risk factors associated with levofloxacin resistance using a case-control study. We examined sputum from 76 S. maltophilia-positive patients admitted to our hospital between January 1, 2010 and June 30, 2011. Case groups were defined as patients who had S. maltophilia infections resistant to levofloxacin, and control groups were defined as patients who had S. maltophilia infections susceptible to levofloxacin treatment. Patient information including demographics, previous antibiotic use, and other traits were recorded. In addition, S. maltophilia isolates from patient sputum were assessed for antibiotic resistance as well as for the presence of genes associated with drug resistance. 



 

Results:

Previous antibiotic treatment with first- or second-generation cephalosporin was found more often in the levofloxacin-susceptible group; by contrast, previous piperacillin/tazobactam treatment occurred more often in the levofloxacin-resistant group. Three genes associated with drug resistance, including SmeA, SmeD, and SpgM were not significantly different between these groups. 



 

Conclusion:

Piperacillin/tazobactam treatment is associated with subsequent isolation of levofloxacin-resistant S. maltophilia from the respiratory tract. 



 

Key words:

Levofloxacin, Microbial sensitivity tests, Risk factors, Stenotrophomonas maltophilia