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A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi

BACKGROUND: Stenotrophomonas maltophilia is a significant opportunistic pathogen that is associated with high mortality in immunocompromised individuals. In this study, we describe a multidrug-resistant (MDR) S. maltophilia clinical isolate from Kamuzu Central Hospital (KCH), Lilongwe, Malawi. METHO...

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Autores principales: Kumwenda, Geoffrey Peterkins, Kasambara, Watipaso, Chizani, Kenneth, Phiri, Abel, Banda, Alick, Choonara, Faheema, Lichapa, Burnet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Medical Association Of Malawi 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560359/
https://www.ncbi.nlm.nih.gov/pubmed/34777703
http://dx.doi.org/10.4314/mmj.v33i2.3
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author Kumwenda, Geoffrey Peterkins
Kasambara, Watipaso
Chizani, Kenneth
Phiri, Abel
Banda, Alick
Choonara, Faheema
Lichapa, Burnet
author_facet Kumwenda, Geoffrey Peterkins
Kasambara, Watipaso
Chizani, Kenneth
Phiri, Abel
Banda, Alick
Choonara, Faheema
Lichapa, Burnet
author_sort Kumwenda, Geoffrey Peterkins
collection PubMed
description BACKGROUND: Stenotrophomonas maltophilia is a significant opportunistic pathogen that is associated with high mortality in immunocompromised individuals. In this study, we describe a multidrug-resistant (MDR) S. maltophilia clinical isolate from Kamuzu Central Hospital (KCH), Lilongwe, Malawi. METHODS: A ceftriaxone and meropenem nonsusceptible isolate (Sm-MW08), recovered in December 2017 at KCH, was referred to the National Microbiology Reference Laboratory for identification. In April 2018, we identified the isolate using MALDI Biotyper mass spectrometry and determined its antimicrobial susceptibility profile using microdilution methods. Sm-MW08 was analysed by S1-PFGE, PCR, and Sanger sequencing, in order to ascertain the genotypes that were responsible for the isolate's multidrug-resistance (MDR) phenotype. RESULTS: Sm-MW08 was identified as S. maltophilia and exhibited resistance to a range of antibiotics, including all β-lactams, aminoglycosides (except arbekacin), chloramphenicol, minocycline, fosfomycin and fluoroquinolones, but remained susceptible to colistin and trimethoprim-sulfamethoxazole. The isolate did not harbour any plasmid but did carry chromosomally-encoded bla(L1) metallo-β-lactamase and bla(L2) β-lactamase genes; this was consistent with the isolate's resistance profile. No other resistance determinants were detected, suggesting that the MDR phenotype exhibited by Sm-MW08 was innate. CONCLUSION: Herein, we have described an MDR S. maltophilia from KCH in Malawi, that was resistant to almost all locally available antibiotics. We therefore recommend the practice of effective infection prevention measures to curtail spread of this organism.
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spelling pubmed-85603592021-11-12 A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi Kumwenda, Geoffrey Peterkins Kasambara, Watipaso Chizani, Kenneth Phiri, Abel Banda, Alick Choonara, Faheema Lichapa, Burnet Malawi Med J Original Research BACKGROUND: Stenotrophomonas maltophilia is a significant opportunistic pathogen that is associated with high mortality in immunocompromised individuals. In this study, we describe a multidrug-resistant (MDR) S. maltophilia clinical isolate from Kamuzu Central Hospital (KCH), Lilongwe, Malawi. METHODS: A ceftriaxone and meropenem nonsusceptible isolate (Sm-MW08), recovered in December 2017 at KCH, was referred to the National Microbiology Reference Laboratory for identification. In April 2018, we identified the isolate using MALDI Biotyper mass spectrometry and determined its antimicrobial susceptibility profile using microdilution methods. Sm-MW08 was analysed by S1-PFGE, PCR, and Sanger sequencing, in order to ascertain the genotypes that were responsible for the isolate's multidrug-resistance (MDR) phenotype. RESULTS: Sm-MW08 was identified as S. maltophilia and exhibited resistance to a range of antibiotics, including all β-lactams, aminoglycosides (except arbekacin), chloramphenicol, minocycline, fosfomycin and fluoroquinolones, but remained susceptible to colistin and trimethoprim-sulfamethoxazole. The isolate did not harbour any plasmid but did carry chromosomally-encoded bla(L1) metallo-β-lactamase and bla(L2) β-lactamase genes; this was consistent with the isolate's resistance profile. No other resistance determinants were detected, suggesting that the MDR phenotype exhibited by Sm-MW08 was innate. CONCLUSION: Herein, we have described an MDR S. maltophilia from KCH in Malawi, that was resistant to almost all locally available antibiotics. We therefore recommend the practice of effective infection prevention measures to curtail spread of this organism. The Medical Association Of Malawi 2021-06 /pmc/articles/PMC8560359/ /pubmed/34777703 http://dx.doi.org/10.4314/mmj.v33i2.3 Text en © 2021 The College of Medicine and the Medical Association of Malawi. https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under the Creative Commons Attribution 4.0 International License. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Original Research
Kumwenda, Geoffrey Peterkins
Kasambara, Watipaso
Chizani, Kenneth
Phiri, Abel
Banda, Alick
Choonara, Faheema
Lichapa, Burnet
A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi
title A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi
title_full A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi
title_fullStr A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi
title_full_unstemmed A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi
title_short A multidrug-resistant Stenotrophomonas maltophilia clinical isolate from Kamuzu Central Hospital, Malawi
title_sort multidrug-resistant stenotrophomonas maltophilia clinical isolate from kamuzu central hospital, malawi
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8560359/
https://www.ncbi.nlm.nih.gov/pubmed/34777703
http://dx.doi.org/10.4314/mmj.v33i2.3
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