Molecular epidemiology of Xanthomonas maltophilia colonization and infection in the hospital

Between April 1992 and December 1993, 80 Xanthomonas maltophilia isolates were collected from 63 patients in
three acute-care hospitals in Calgary, Alberta, Canada. On the basis of Centers for Disease Control and Prevention
definitions, 48 patients had nosocomial and 15 had community-acquired X. maltophilia. Thirty-eight of the patients
were colonized and 25 were infected. Sixty-four percent of patients who acquired X. maltophilia in the intensive care
unit (ICU) became infected, whereas 32% of patients in a non-ICU setting became infected. ICU patients tended to be
hospitalized for a shorter period of time than non-ICU patients before the onset of X. maltophilia infection. Regardless
of being colonized or infected, all patients had debilitating conditions, with respiratory disease being the most common
underlying illness (35%). Forty-two patients (88%) with hospital-acquired X. maltophilia received prior antibiotic
therapy which included gentamicin, tobramycin, ceftazidime, piperacillin, and imipenem. Agar dilution MICs showed
that patient isolates were resistant to these antimicrobial agents that patients had received. Pulsed-field gel
electrophoresis of SpeI-digested genomic DNA revealed that six epidemiologically linked patient isolates from the ICU
of one acute-care hospital had identical DNA profiles. In contrast, isolates from patients from the other two hospitals
had unique genotype profiles (n = 57) regardless of the presence or absence of an epidemiologic association. In
these patients there was genetic evidence against the acquisition of a resident hospital clone. These results indicate
that pulsed-field gel electrophoresis can resolve genotypically distinct strains of X. maltophilia and, consequently, is a
useful tool for evaluating nosocomial infections caused by X. maltophilia.
J Clin Microbiol. 1995 March; 33(3): 513–518.

Xanthomonas maltophilia—a growing problem in the haemodialysis population

Two haemodialysed patients were recently infected with Xanthomonas maltophilia, a Gram-negative          
bacterium related to the genus Pseudomonas.   Xanthomonas maltophilia has recently emerged as an     
important nosocomial pathogen, with at least three  reports documenting this problem in haemodialysed   
patients [4–10]. Relevant histories of both patients are  outlined, and the discussion details therapeutic
considerations that are important in the management of these patients.
Nephrol Dial Transplant (1997) 12: 2174–2176

Stenotrophomonas Maltophilia
Last Updated: May 12, 2006

Berbari N, Johnson DH, Cunha BA: Xanthomonas maltophilia peritonitis in a patient undergoing peritoneal dialysis.
Heart Lung 1993 May-Jun; 22(3): 282-3[Medline].

Burdge DR, Noble MA, Campbell ME: Xanthomonas maltophilia misidentified as Pseudomonas cepacia in cultures of
sputum from patients with cystic fibrosis: a diagnostic pitfall with major clinical implications.
Clin Infect Dis 1995 Feb; 20(2): 445-8[Medline].

Elting LS, Bodey GP: Septicemia due to Xanthomonas species and non-aeruginosa Pseudomonas species:
increasing incidence of catheter-related infections.
Medicine (Baltimore) 1990 Sep; 69(5): 296-306[Medline].

Elting LS, Khardori N, Bodey GP: Nosocomial infection caused by Xanthomonas maltophilia: a case-control study of
predisposing factors.
Infect Control Hosp Epidemiol 1990 Mar; 11(3): 134-8[Medline].

Fang FC, Madinger NE: Resistant nosocomial gram-negative bacillary pathogens: Acinetobacter baumannii,
Xanthomonas maltophilia, and Pseudomonas cepacia.
Curr Clin Top Infect Dis 1996; 16: 52-83[Medline].

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