Clinical Factors Associated with Acquisition of Resistance to Levofloxacin in Stenotrophomonas maltophilia.
10.3349/ymj.2014.55.4.987
- Author:
Ji Hyeon BAEK
1
;
Chang Oh KIM
;
Su Jin JEONG
;
Nam Soo KU
;
Sang Hoon HAN
;
Jun Yong CHOI
;
Dongeun YONG
;
Young Goo SONG
;
Kyungwon LEE
;
June Myung KIM
Author Information
1. Department of Infectious Disease, Inha University Hospital, Incheon, Korea.
- Publication Type:Original Article
- Keywords:
Stenotrophomonas maltophilia;
fluoroquinolones;
levofloxacin;
drug resistance
- MeSH:
Aged;
Anti-Bacterial Agents/*pharmacology/*therapeutic use;
Fluoroquinolones/pharmacology/therapeutic use;
Gram-Negative Bacterial Infections/drug therapy;
Humans;
Levofloxacin/*pharmacology/*therapeutic use;
Microbial Sensitivity Tests;
Middle Aged;
Retrospective Studies;
Stenotrophomonas maltophilia/drug effects/*pathogenicity
- From:Yonsei Medical Journal
2014;55(4):987-993
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Fluoroquinolones, rapidly gaining prominence in treatment of Stenotrophomonas maltophilia (SMP), are noted for their potency and tolerability. However, SMP may rapidly acquire resistance to fluoroquinolones. We evaluated associations of clinical factors with acquisition of levofloxacin resistance (LFr) in SMP. MATERIALS AND METHODS: Our retrospective cohort study was based on patient data collected between January 2008 and June 2010. Through screening of 1275 patients, we identified 122 patients with data for SMP antibiotic susceptibility testing in > or =3 serial SMP isolates. RESULTS: We assigned the 122 patients to either the SS group (n=54) in which levofloxacin susceptibility was maintained or the SR group (n=31) in which susceptible SMP acquired resistance. In multivariate regression analysis, exposure to levofloxacin for more than 3 weeks [odds ratio (OR) 15.39, 95% confidential interval (CI) 3.08-76.93, p=0.001] and co-infection or co-colonization with Klebsiella pneumoniae resistant to levofloxacin (OR 4.85, 95% CI 1.16-20.24, p=0.030) were independently associated with LFr acquisition in SMP. CONCLUSION: Acquisition of LFr during serial sampling of SMP was related to the levofloxacin exposure.
