Multidrug-resistant Stenotrophomonas maltophilia in residential aged care facilities: An emerging threat.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101588314 Publication Model: Print Cited Medium: Internet ISSN: 2045-8827 (Electronic) Linking ISSN: 20458827 NLM ISO Abbreviation: Microbiologyopen Subsets: MEDLINE

Original Publication: Oxford : Wiley-Blackwell

Stenotrophomonas maltophilia*/drug effects ; Stenotrophomonas maltophilia*/genetics ; Stenotrophomonas maltophilia*/isolation & purification ; Stenotrophomonas maltophilia*/classification ; Drug Resistance, Multiple, Bacterial*/genetics ; Microbial Sensitivity Tests* ; Anti-Bacterial Agents*/pharmacology ; Gram-Negative Bacterial Infections*/microbiology ; Gram-Negative Bacterial Infections*/epidemiology; Humans ; Genotype ; Australia ; Wastewater/microbiology ; Prevalence ; Genetic Variation ; Colistin/pharmacology ; Carbapenems/pharmacology ; Aged ; Residential Facilities

Stenotrophomonas maltophilia is a multidrug-resistant (MDR), Gram-negative bacterium intrinsically resistant to beta-lactams, including last-resort carbapenems. As an opportunistic pathogen, it can cause serious healthcare-related infections. This study assesses the prevalence, resistance profiles, and genetic diversity of S. maltophilia isolated from residential aged care facilities (RACFs). RACFs are known for their overuse and often inappropriate use of antibiotics, creating a strong selective environment that favors the development of bacterial resistance. The study was conducted on 73 S. maltophilia isolates recovered from wastewater and facility swab samples obtained from three RACFs and a retirement village. Phenotypic and genotypic assessments of the isolates revealed high carbapenem resistance, exemplifying their intrinsic beta-lactam resistance. Alarmingly, 49.3% (36/73) of the isolates were non-wild type for colistin, with minimum inhibitory concentration values of > 4 mg/L, and 11.0% (8/73) were resistant to trimethoprim-sulfamethoxazole. No resistance mechanisms were detected for either antimicrobial. Genotypic assessment of known lineages revealed isolates clustering with Sm17 and Sm18, lineages not previously reported in Australia, suggesting the potential ongoing spread of MDR S. maltophilia. Lastly, although only a few isolates were biocide tolerant (2.7%, 2/73), their ability to grow in high concentrations (64 mg/L) of triclosan is concerning, as it may be selecting for their survival and continued dissemination.
(© 2024 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

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GN1152556 Medical Research Future Fund

Keywords: aged care; antimicrobial resistance; biocide tolerance; multidrug resistance; older persons; selective pressure

0 (Anti-Bacterial Agents)
0 (Wastewater)
Z67X93HJG1 (Colistin)
0 (Carbapenems)

Date Created: 20240429 Date Completed: 20240429 Latest Revision: 20240501

20240501

PMC11057060

10.1002/mbo3.1409

38682784