Subtopic Deep Dive

Stenotrophomonas maltophilia Antibiotic Resistance
Research Guide

What is Stenotrophomonas maltophilia Antibiotic Resistance?

Stenotrophomonas maltophilia antibiotic resistance refers to the intrinsic and acquired mechanisms enabling this nosocomial pathogen to evade multiple antibiotics, including efflux pumps, L1/L2 metallo-β-lactamases, and resistance to trimethoprim-sulfamethoxazole.

S. maltophilia causes opportunistic infections in immunocompromised patients, particularly in cystic fibrosis and hospital settings. Key mechanisms include multidrug efflux systems identified by Zhang et al. (2000, 181 citations) and genomic resistance determinants mapped by Crossman et al. (2008, 541 citations). Recent surveillance highlights ST11 clones and therapeutic failures (Chang et al., 2015, 406 citations). Over 2,000 papers document its epidemiology.

Curated Papers

Key Challenges

Why It Matters

S. maltophilia's intrinsic resistance to carbapenems and last-resort antibiotics like trimethoprim-sulfamethoxazole drives nosocomial mortality exceeding 30% in vulnerable patients (Chang et al., 2015). Genomic analysis by Crossman et al. (2008) revealed 53 resistance genes shielding the bacterium, complicating treatments in cystic fibrosis and ICU settings. Sánchez (2015) detailed efflux pumps and β-lactamases limiting options, while Doi (2019, 636 citations) emphasized the lack of alternatives for such Gram-negative infections. This fuels global surveillance needs.

Key Research Challenges

Efflux Pump Overexpression

Multidrug efflux systems confer resistance to quinolones and β-lactams in clinical isolates (Zhang et al., 2000). Sánchez (2015) showed these pumps reduce intracellular antibiotic levels. Inhibitor development remains elusive despite genomic insights (Crossman et al., 2008).

L1/L2 Metallo-β-Lactamases

L1 and L2 enzymes hydrolyze carbapenems, evading standard therapies (Chang et al., 2015). Nordmann and Poirel (2019, 670 citations) noted their role in Gram-negative epidemics. Combinations like aztreonam-avibactam show promise but require validation (Mauri et al., 2021).

Genomic Surveillance Gaps

Tracking ST11 clones demands real-time sequencing amid therapeutic failures (Adegoke et al., 2017). Crossman et al. (2008) mapped resistance islands, but horizontal transfer complicates monitoring. Ruppé et al. (2015) highlighted ICU spread challenges.

Essential Papers

Epidemiology and Diagnostics of Carbapenem Resistance in Gram-negative Bacteria

Patrice Nordmann, Laurent Poirel · 2019 · Clinical Infectious Diseases · 670 citations

Abstract Carbapenem resistance in gram-negative bacteria has caused a global epidemic that continues to grow. Although carbapenemase-producing Enterobacteriaceae have received the most attention be...

Treatment Options for Carbapenem-resistant Gram-negative Bacterial Infections

Yohei Doi · 2019 · Clinical Infectious Diseases · 636 citations

Abstract Antimicrobial resistance has become one of the greatest threats to public health, with rising resistance to carbapenems being a particular concern due to the lack of effective and safe alt...

The complete genome, comparative and functional analysis of Stenotrophomonas maltophiliareveals an organism heavily shielded by drug resistance determinants

Lisa Crossman, Virginia C. Gould, J. Maxwell Dow et al. · 2008 · Genome biology · 541 citations

Abstract Background Stenotrophomonas maltophilia is a nosocomial opportunistic pathogen of the Xanthomonadaceae. The organism has been isolated from both clinical and soil environments in addition ...

Mechanisms of antimicrobial resistance in Gram-negative bacilli

Étienne Ruppé, Paul‐Louis Woerther, François Barbier · 2015 · Annals of Intensive Care · 472 citations

The burden of multidrug resistance in Gram-negative bacilli (GNB) now represents a daily issue for the management of antimicrobial therapy in intensive care unit (ICU) patients. In Enterobacteriace...

Update on infections caused by Stenotrophomonas maltophilia with particular attention to resistance mechanisms and therapeutic options

Ya-Ting Chang, Chun-Yu Lin, Yen‐Hsu Chen et al. · 2015 · Frontiers in Microbiology · 406 citations

Stenotrophomonas maltophilia is a Gram-negative, biofilm-forming bacterium. Although generally regarded as an organism of low virulence, S. maltophilia is an emerging multi-drug resistant opportuni...

Stenotrophomonas maltophilia as an Emerging Ubiquitous Pathogen: Looking Beyond Contemporary Antibiotic Therapy

Anthony A. Adegoke, Thor Axel Stenström, Anthony I. Okoh · 2017 · Frontiers in Microbiology · 301 citations

<i>Stenotrophomonas maltophilia</i> is a commensal and an emerging pathogen earlier noted in broad-spectrum life threatening infections among the vulnerable, but more recently as a pathogen in immu...

Antibiotic resistance in the opportunistic pathogen Stenotrophomonas maltophilia

María Blanca Sánchez · 2015 · Frontiers in Microbiology · 213 citations

Stenotrophomonas maltophilia is an environmental bacterium found in the soil, associated with plants and animals, and in aquatic environments. It is also an opportunistic pathogen now causing an in...

Reading Guide

Foundational Papers

Start with Crossman et al. (2008, 541 citations) for genome-wide resistance determinants; Zhang et al. (2000, 181 citations) for efflux mechanisms; Chang et al. (2015, 406 citations) for clinical overview.

Recent Advances

Study Doi (2019, 636 citations) for treatment gaps; Adegoke et al. (2017, 301 citations) for emerging pathogenicity; Mauri et al. (2021, 168 citations) for avibactam combinations.

Core Methods

Genome sequencing (Crossman et al., 2008); efflux assays (Zhang et al., 2000); metallo-β-lactamase kinetics (Chang et al., 2015); MIC profiling (Sánchez, 2015).

How PapersFlow Helps You Research Stenotrophomonas maltophilia Antibiotic Resistance

Discover & Search

Research Agent uses searchPapers('Stenotrophomonas maltophilia efflux pumps') to retrieve Zhang et al. (2000) and citationGraph to map 181 downstream citations. exaSearch uncovers niche surveillance studies, while findSimilarPapers on Crossman et al. (2008) reveals 541-cited genomic works.

Analyze & Verify

Analysis Agent employs readPaperContent on Chang et al. (2015) to extract L1/L2 mechanisms, then verifyResponse with CoVe cross-checks against Nordmann and Poirel (2019). runPythonAnalysis processes MIC data from Sánchez (2015) via pandas for resistance patterns, with GRADE scoring evidence quality.

Synthesize & Write

Synthesis Agent detects gaps in efflux inhibitor trials via contradiction flagging across Zhang et al. (2000) and Doi (2019). Writing Agent uses latexEditText for manuscript sections, latexSyncCitations for 10+ references, and latexCompile for figures; exportMermaid diagrams resistance networks.

Use Cases

"Analyze MIC distributions for S. maltophilia efflux mutants from Zhang 2000."

Research Agent → searchPapers → Analysis Agent → runPythonAnalysis (pandas plot MIC histograms) → matplotlib figure of resistance profiles.

"Draft LaTeX review on S. maltophilia β-lactamases citing Chang 2015."

Synthesis Agent → gap detection → Writing Agent → latexEditText + latexSyncCitations (Nordmann 2019) → latexCompile → PDF with compiled resistance table.

"Find GitHub repos analyzing S. maltophilia genomes from Crossman 2008."

Research Agent → paperExtractUrls (Crossman 2008) → paperFindGithubRepo → githubRepoInspect → summary of resistance gene annotation scripts.

Automated Workflows

Deep Research workflow scans 50+ papers via searchPapers on 'S. maltophilia resistance mechanisms', chaining citationGraph to Crossman (2008) for structured genomic report. DeepScan applies 7-step verification: readPaperContent (Chang 2015) → CoVe → runPythonAnalysis on isolates → GRADE report. Theorizer generates hypotheses on ST11 evolution from Adegoke (2017) and Sánchez (2015).

Try Doxa for Stenotrophomonas maltophilia Antibiotic Resistance Research

Frequently Asked Questions

What defines Stenotrophomonas maltophilia antibiotic resistance?

Intrinsic mechanisms include efflux pumps (Zhang et al., 2000), L1/L2 metallo-β-lactamases (Chang et al., 2015), and genomic determinants (Crossman et al., 2008).

What are primary resistance methods?

Efflux systems export multiple drugs (Sánchez, 2015); β-lactamases hydrolyze carbapenems (Nordmann and Poirel, 2019); low permeability shields the outer membrane (Crossman et al., 2008).

What are key papers?

Crossman et al. (2008, 541 citations) maps genome; Chang et al. (2015, 406 citations) reviews mechanisms; Zhang et al. (2000, 181 citations) details efflux.

What open problems exist?

Efflux inhibitors lack clinical trials (Sánchez, 2015); ST11 clone surveillance needs scaling (Adegoke et al., 2017); aztreonam-avibactam validation pending (Mauri et al., 2021).