Antibiotic Resistance in Gram-Negative Strains

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Questions and Answers

What is the primary concern regarding Hr-mdr and rpx-resistant S.maltophilia isolates?

Their association with immunosuppressants

Their resistance to minocycline and levofloxacin

The lack of proper end-point studies to assess their dangers (correct)

Their lack of response to cotrimoxazole

In what type of patients were multi-centric analyses conducted?

Critically ill pediatric patients

Patients with Acinetobacter infections

Critically ill adult patients (correct)

Patients with pneumonia and/or sepsis

What concentration of cotrimoxazole was used to define gemocin-resistant S.maltophilia isolates?

≥0.250 μg/mL (correct)

≥0.500 μg/mL

≥0.100 μg/mL

≥1.000 μg/mL

What was the outcome of using combination therapy in patients with resistant isolates?

A better temporary clinical response than monotherapy Signup and view all the answers

What percentage of isolates were summarized as resistant?

71.7% Signup and view all the answers

What was associated with the use of pan-resistant strains?

Aging, critical connection, and previous monotherapy Signup and view all the answers

How many patients received trimethoprim-sulfamethoxazole either alone or in combination?

8 Signup and view all the answers

What type of study designs are suggested to lead to controlled intervention crochet as confident best-community practice?

Competitive phase Y.S range with a wide range of distinct study designs Signup and view all the answers

What is the primary concern regarding the treatment of Stenotrophomonas maltophilia infections?

The lack of effective therapies Signup and view all the answers

Which of the following is NOT a typical characteristic of Stenotrophomonas maltophilia?

Susceptibility to most antimicrobial agents Signup and view all the answers

What is the significance of Stenotrophomonas maltophilia colonization in critical individuals?

It leads to a higher risk of death Signup and view all the answers

Which antibiotic has been associated with significant toxicities in the treatment of Stenotrophomonas maltophilia infections?

Colistin Signup and view all the answers

What is the primary reason for the increasing awareness of Stenotrophomonas maltophilia infections?

The growing awareness of S. maltophilia colonization in critical individuals Signup and view all the answers

What is the characteristic of pan-resistant Stenotrophomonas maltophilia strains?

Lacking sensitivity to all agents tested Signup and view all the answers

Which of the following patient populations is most susceptible to Stenotrophomonas maltophilia infections?

Immunocompromised patients Signup and view all the answers

What is the novel sulbactam-based β-lactamase inhibiting combination that has in vitro activity against Stenotrophomonas maltophilia?

Cefiderocol Signup and view all the answers

What is the significance of Stenotrophomonas maltophilia in hospital-acquired infections?

It is a significant cause of hospital-acquired infections, particularly in immunocompromised patients Signup and view all the answers

What is the common habitat of Stenotrophomonas maltophilia?

In a variety of environments, including food, plants, humans, animals, dust, and fiber pellets Signup and view all the answers

Study Notes

Antibiotic Resistance and Stenotrophomonas maltophilia

Lacking endpoint studies and sufficient evidence of the dangers of the international spread of Hr-mdr and rpx-resistant S. maltophilia isolates
Multiple antibiotic regimens suggested for empirical therapy due to limited options

Characteristics of Stenotrophomonas maltophilia

Typically resistant to most antimicrobial agents, except for sulfamethoxazole/trimethoprim, quinolones, or inhaled antimicrobial agents (aminoglycosides, colistin)
Found in various environments: food, plants, humans, animals, dust, fiber pellets, and aquatic environments
Also isolated from the respiratory secretions of healthy humans

Infections caused by S. maltophilia

Hospital-acquired infections: bacteremia, pneumonia, and urinary tract infections
Predominantly affect people who have:
- Leukemia
- Cancer (especially those who have had stem cell or organ transplants)
- Require critical care support

Treatment Challenges

High treatment failure of combination regimens, including trimethoprim-sulfamethoxazole
Colistin associated with significant toxicities (nephrotoxicity and neurotoxicity)
Need for new therapeutic options, especially after 10 years of warnings about antibiotic efficacy

Emerging Therapies

Novel sulbactam-based β-lactamase inhibiting combination cefiderocol has in vitro activity against Stenotrophomonas

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Description

This quiz assesses knowledge on antibiotic resistance in Gram-negative strains, effective therapies, and balancing treatment options. It covers national rates of sensitivity to resistant agents and the dilemma of deprescribing empirical broad-spectrum regimens.