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Clinical Factors Associated with Acquisition of Resistance to Levofloxacin in Stenotrophomonas maltophilia

 Ji Hyeon Baek  ;  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 
 YONSEI MEDICAL JOURNAL, Vol.55(4) : 987-993, 2014 
Journal Title
Issue Date
Aged ; Anti-Bacterial Agents/pharmacology* ; Anti-Bacterial Agents/therapeutic use* ; Fluoroquinolones/pharmacology ; Fluoroquinolones/therapeutic use ; Gram-Negative Bacterial Infections/drug therapy ; Humans ; Levofloxacin/pharmacology* ; Levofloxacin/therapeutic use* ; Microbial Sensitivity Tests ; Middle Aged ; Retrospective Studies ; Stenotrophomonas maltophilia/drug effects ; Stenotrophomonas maltophilia/pathogenicity*
Stenotrophomonas maltophilia ; drug resistance ; fluoroquinolones ; levofloxacin
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 ≥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.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, June Myung(김준명)
Kim, Chang Oh(김창오) ORCID logo https://orcid.org/0000-0002-0773-5443
Baek, Ji Hyeon(백지현)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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