This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Denton, M.
Right arrow Articles by Kerr, K. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Denton, M.
Right arrow Articles by Kerr, K. G.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, May 2002, p. 1884, Vol. 40, No. 5
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.5.1884.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

LETTER TO THE EDITOR

Molecular Epidemiology of Stenotrophomonas maltophilia Isolated from Cystic Fibrosis Patients


arrow
LETTER
 
We read with interest the recent study of Krzewinski and colleagues (2). However, we wish to clarify some issues in relation to our own work (1), to which they refer. They suggested that we had found a genotype of Stenotrophomonas maltophilia in cystic fibrosis (CF) patients that was distinct from those isolated from other patient groups or from the environment. This is not our interpretation of our findings (1). We genotyped isolates of S. maltophilia obtained from 41 CF patients attending our pediatric CF unit between 1993 and 1995 using enterobacterial repetitive intergenic consensus-PCR and pulsed-field gel electrophoresis (PFGE). Thirty-three of the 41 patients were colonized with unique strains, and four pairs of patients shared strains. We found PFGE to be more discriminatory as a typing method than the PCR-based methodology. There was no supporting epidemiological evidence to suggest patient-to-patient transmission, but there was some microbiological and genotypical evidence to implicate the ward environment as the source for a small number of the patient strains. In light of these findings, we do not believe that segregation of S. maltophilia-positive patients would be beneficial as an infection control measure. The ease of isolation of S. maltophilia from moist environmental sites associated with plumbing systems (e.g., water, faucets, and sink drains) within both the home and hospital environments suggests that controls directed towards these may be more helpful. The practice of rinsing reusable equipment for the delivery of aerosolized antibiotics in tap water is one such issue. We are currently investigating the incidence of contamination of reusable aerosolization equipment with S. maltophilia and shall report our findings shortly. It is interesting that studies assessing the efficacy of aerosolized tobramycin in the management of chronic Pseudomonas aeruginosa infections in CF patients have reported high conversion rates to S. maltophilia positivity during trial periods (3). Forty-one (16%) of 258 patients receiving aerosolized tobramycin and 58 (22%) of 262 patients receiving an aerosolized placebo had S. maltophilia newly isolated from their respiratory tract secretions. These findings suggest that the use of nebulizer equipment per se is a more important risk factor for S. maltophilia acquisition than the selection pressure exerted by the antibiotics delivered by this route. We agree with Krzewinski and colleagues when they suggest that further studies are needed to fully understand how patients with CF acquire S. maltophilia and the clinical impact of long-term S. maltophilia colonization. However, the importance of the environment should not be overlooked.


arrow
Editor’s Note:
 
The authors of the published article did not respond.


arrow
REFERENCES
 
    1
  1. Denton, M., N. J. Todd, K. G. Kerr, P. M. Hawkey, and J. M. Littlewood. 1998. Molecular epidemiology of Stenotrophomonas maltophilia isolated from clinical specimens from patients with cystic fibrosis and associated environmental samples. J. Clin. Microbiol. 36:1953-1958.[Abstract/Free Full Text]
    2. 2
  2. Krzewinski, J. W., C. D. Nguyen, J. M. Foster, and J. L. Burns. 2001. Use of random amplified polymorphic DNA PCR to examine epidemiology of Stenotrophomonas maltophilia and Achromobacter (Alcaligenes) xylosoxidans from patients with cystic fibrosis. J. Clin. Microbiol. 39:3597-3602.[Abstract/Free Full Text]
    3. 3
  3. Ramsey, B. W., M. S. Pepe, J. M. Quan, K. L. Otto, A. B. Montgomery, J. Williams-Warren, M. Vasiljev-K, D. Borowitz, C. M. Bowman, B. C. Marshall, S. Marshall, A. L. Smith, et al. 1999. Intermittent administration of inhaled tobramycin in patients with cystic fibrosis. N. Engl. J. Med. 340:23-30.[Abstract/Free Full Text]
Miles Denton*
Kevin G. Kerr
Department of Microbiology,The Leeds Teaching Hospitals NHS Trust,Leeds LS1 3EX, United Kingdom

* Phone: (44) 113-392-2922 Fax: (44) 113-233-5649 E-mail: milesd{at}pathology.leeds.ac.uk.

Journal of Clinical Microbiology, May 2002, p. 1884, Vol. 40, No. 5
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.5.1884.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.




This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Denton, M.
Right arrow Articles by Kerr, K. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Denton, M.
Right arrow Articles by Kerr, K. G.

Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»