Minimal inhibitory concentration of ceftazidime and Co-trimoxazole for Stenotrophomonas maltophilia using E-test

Abstract

Background : Stenotrophomonas maltophilia, previously named as Pseudomonas or Xanthomonas maltophilia, is an important nosocomial pathogen . Aim : The purpose of the present study was to investigate the prevalence of S. maltophilia in Iranian hospitals and its susceptibility to available antimicrobial agents. Setting and design: A cross-sectional study in Imam Khomeini Hospital affiliated to Tehran University of Medical Sciences. Materials and Methods : All blood specimens were sent to the laboratory for blood culture and biochemical analysis. One hundred samples were positive for S. maltophilia. We used disk diffusion and E-test in order to determine minimal inhibitory concentration (MIC) of ceftazidime and co-trimoxazole as the first line antibiotics for S. maltophilia. The tests were performed and interpreted according to the guidelines of Clinical Laboratory Standards Institute (CLSI). Statistical analysis: Chi-square test and Kappa measurement of agreement were applied as appropriate. Results : S. maltophilia was the most frequent pathogen (895 specimens; 38.9%) isolated from the samples which were mostly from emergency ward (780 specimens; 33.9%). Ceftazidime MIC 50 and MIC 90 were 2 and 32 μg/ml, respectively (sensitive ≤8 μg/ml and resistant ≥32 μg/ml according to CLSI guideline). MIC 50 and MIC 90 for co-trimoxazole were 0.5 and 2 μg/ml, respectively (sensitive ≤2 μg/ml and resistant ≥4 μg/ml according to CLSI guideline). Conclusion : S. maltophilia is the most frequent pathogen in our hospital with a high susceptibility to both ceftazidime and co-trimoxazole.

Keywords

• Ceftazidime
• Co-trimoxazole
• Minimal inhibitory concentration
• S. maltophilia
• Susceptibility testing