Cotrimoxasole-Resistant Stenotropomonas maltophilia Infection : Case Report

Dani Rosdiana, Dewi Anggraini


Stenotrophomonas maltophilia is an important multidrug-resistant nosocomial pathogen associated with high mortality. This infection did not elucide clearly in Riau. We reported two Cotrimoxaxole Resistant Stenotrophomonas maltophilia in patient of Arifin Achmad Hospital which refered from peripheral hospital in another region. They had similar clinical appereance such as long stay hospitalization, bad clinical appearance and had a history of meropenem exposure before. We performed urin culture to make appropriate diagnostic and treatment also. Stenotrophomonas maltophilia bacteria was found in urine isolate. The sensitivity test showed that this bacteria had Cotrimoxasole resistant that standard antibiotic of this bacteria. The management of these cases become complicated due to decrease of renal function in one patient. We had to make dose adjustment of parenteral levofloxacin, giving good nutrition,  counted fluid balance and repaired others clinical conditions.Beside of its high mortality and morbidity, the outcomes of both these patients were good.


Stenotrophomonas maltophilia, multidrug resistant, levofloxacin, insufisiensi renal.

Full Text:



Prinsloo B. Stenotrophomonas maltophilia. Lancet Lab. 2016:2:1

Sun E, Liang G, Wang L, Wei W, Lei M, Song S. et al. Antimicrobial susceptibility of hospital acquired Stenotrophomonas maltophilia isolate biofilms. Braz j infect dis. 2016;20(4):365–373

Flores TS, Gutie´rrez FJ, Morf´ın OR, Rodr´iguez N, Rivadeneyra DE, Rivas MC. Stenotrophomonas maltophilia in Mexico: antimicrobial resistance, biofilm formation and clonal diversity. Journal of Medical Microbiology.2014:63:1524–1530. DOI 10.1099/jmm.0.074385-0.

Paopradit P, Srinitiwarawong K, Ingviya N, Singkhamanan K, Vuddhakul V. Distribution and characterization of Stenotrophomonas maltophilia isolates from environmental and clinical samples in Thailand. J Hosp Inf. 2017;97(2):185-191. doi: 10.1016/j.jhin.2017.06.006.

Centers for Disease Control and Prevention US Department of Health and Human Services. Antibiotic Resistance Threats in the United States, 2013. (Online) 2013. [diakses tanggal 10 Oktober 2016].

Hawkey PM. The growing burden of antimicrobial resistance. Journal of Antimicrobial Chemotherapy (2008) 62, Suppl. 1, i1–i9 doi:10.1093/jac/dkn241.

Drilica K, Perlin DS. Antibiotic resistance: understanding and responding to an emerging crisis. Emerging Infectious Diseases. 2011; 17(10): 1984. DOI:

Menteri Kesehatan Republik Indonesia. Peraturan Menteri Kesehatan Nomor: 2406/MENKES/PER/XII/2011 tentang pedoman umum penggunaan antibiotik. Jakarta: Departemen Kesehatan. 2011.

Tsiodras S, Pittet D, Eliopoulos G, Boucher H, Harbarth S. Clinical implications of Stenotrophomonas maltophilia resistant to trimethoprim-sulfamethoxazole: a study of 69 patients at 2 university hospitals. Scandinaian Journal of Infectious diseases. 2000:32:651-656.

Dubois CL, boudreau V, Tremblay F, Lavoie A, Berthiaume Y, Rabasa-Lhoret R. Association between glucose intolerance and bacterial colonization in an adult population with cystic fibrosis, emergence of Stenotrophomonas maltophilia. J Cyst Fibrous. 2017:01.018.

Wang YL, Scipione MR, Dubrovskaya Y, Papadopoulos J. Monotherapy with

fluoroquinolone or trimethoprim-sulfamethoxazole for treatment of Stenotrophomonas maltophilia Infection. Antimicrobial Agents and Chemotherapy Journal. 2014;58(1):176–18

Hideki A, Baba M, Okada, Abe M, Kimura M, Yoneyama K. Evaluation of

trimethoprim-sulfamethoxazole based combination therapy against Stenotrophomonas maltophilia: in vitro effects and clinical efficacy in cancer patients. International Journal of Infectious disease. 2017;58:18–21

Czock D, Hu¨sig-Linde C, Langhoff A, Scho¨pke T, Hafer C, de Groot K et all.

Pharmacokinetics of moxifloxacin and levofloxacin in intensive care unit patients who have acute renal failure and undergo extended daily dialysis. Clin J Am Soc Nephrol 1. 2006: 1263–1268. doi: 10.2215/CJN.01840506


  • There are currently no refbacks.