High Genetic Diversity among Stenotrophomonas maltophilia Isolates from Single Hospital: Nosocomial Outbreaks or Genotypic Profile Changes during Subcultures
	    		
		   		
	    	
    	
    	
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Meryem GÜVENIR
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Baris OTLU
			        		
			        		;
		        		
		        		
		        		
			        		Emine TUNC
			        		
			        		;
		        		
		        		
		        		
			        		Elif AKTAS
			        		
			        		;
		        		
		        		
		        		
			        		Kaya SUER
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Near East University, Vocational School of Health Services, Nicosia, Cyprus
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Stenotrophomonas maltophilia;
			        		
			        		
			        		
				        		multiclonal outbreaks;
			        		
			        		
			        		
				        		hypermutation
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:Malaysian Journal of Medical Sciences
	            		
	            		 2018;25(2):40-49
	            	
            	
 
            
            
            	- CountryMalaysia
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	Background: Stenotrophomonas maltophilia is a non-fermentative gram-negativebacillus which is widely recognised as an important nosocomial pathogen causing pneumonia,blood-stream, wound and urinary tract infections, particularly in immunosuppressed patients. Theaim of this study was to evaluate a nosocomial outbreak of by S. maltophilia in an intensive careunit of a tertiary hospital and evaluate unexpected multiclonality.Methods: A total of 11 isolates from respiratory cultures in intensive care unit of a 24 bedtertiary hospital obtained over a one months period and one isolate obtained from the nebuliserduring environmental screening were investigated. The bacteria were identified by Phoenix 100system. The clonal relatedness was evaluated by PFGE and semi-automated repetitive sequencebasedPCR. Genotyping tests were repeated for 10 serial subcultures.Results: PFGE and DiversiLab yielded 10 genotypic profiles for 12 isolates. Four to eightdifferent genotypes were observed from 10 subcultures of the same isolate.Conclusion: We conclude that, high genetic diversity and supposed multiclonalappearance of the outbreak isolates may be due to changing profiles during subcultures mostprobably depending on hypermutation.