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Stenotrophomonas maltophilia

Sarah S Lewis, MD
Aimee Zaas, MD, MHS
Section Editor
Daniel J Sexton, MD
Deputy Editor
Allyson Bloom, MD


Stenotrophomonas (Xanthomonas) maltophilia is a multidrug-resistant gram-negative bacillus that is an opportunistic pathogen [1-4], particularly among hospitalized patients. S. maltophilia infections have been associated with high morbidity and mortality in severely immunocompromised and debilitated individuals.

The clinical features and management of S. maltophilia infections are discussed here. The general approach to gram-negative bacillary bacteremia, catheter-associated bloodstream infections, and hospital-acquired pneumonia are discussed elsewhere. (See "Gram-negative bacillary bacteremia in adults" and "Treatment of intravascular catheter-related infections" and "Treatment of hospital-acquired and ventilator-associated pneumonia in adults".)


S. maltophilia is a ubiquitous, aerobic, non-fermentative, gram-negative bacillus that is closely related to the Pseudomonas species [5]. The name signifies "a unit feeding on few substrates," based on the Greek roots stenos (narrow), trophos (one who feeds), and monas (a unit). Maltophilia means "affinity for malt," based on the Greek roots maltum (malt) and philia (affinity).

S. maltophilia is an obligate aerobe that grows well on commonly used laboratory media, including blood and MacConkey agars. It is lactose nonfermenting, oxidase-negative, and catalase-positive and can be reliably identified in the laboratory using standard biochemical tests. In addition, it is accurately identified by commercially available automated identification systems [4]. Matrix-assisted laser desorption/ionization (MALDI) identification of Stenotrophomonas is not yet standard for many microbiology laboratories.

S. maltophilia was first isolated in 1943 and, at the time, was named Bacterium bookeri. It was later classified within the genus Pseudomonas, then Xanthomonas, and then finally Stenotrophomonas in 1993 [4,6,7]. S. maltophilia is the only species of Stenotrophomonas known to infect humans [7], whereas its closest genetic relatives are plant pathogens [7,8]. It is frequently isolated from soil, water, animals, plant matter, and hospital equipment [4,9-21]. S. maltophilia has inherent ability to adhere to foreign materials and form a biofilm, rendering protection from host defenses as well as antimicrobial agents [18,19,22-26]. Factors contributing to this behavior include its positively charged surface and fimbrial adhesions [7,22-24,26-28].

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Literature review current through: Oct 2017. | This topic last updated: Jul 10, 2017.
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