bacterium (Stenotrophomonas maltophilia)

Question

Should a 2 years-old CF child with a newly diagnosed Stenotrophomonas maltophilia in sputum be systematically treated with appropriate antibiotics ? This child who chronically coughs has a current cough increase.
On the other hand, we have in our circle of acquaintances a person with a tracheotomy that we rarely visit. Should contacts be totally avoided ?
Thanks for your response.

Answer

Hello and thanks for your question.
Stenotrophomonas maltophilia is an emerging bacterium in CF, i.e. more and more frequently found. The reported incidences range from 2 to 14% in CF patients. When this bacterium is identified and when a respiratory exacerbation is noted, it seems logical to propose adapted antibiotics to eradicate if possible the bacterium and to improve the clinical status. However, this bacterium is difficult to treat because of various natural resistances to antibiotics. In non-CF patients, but immunocompromised patients or patients with ventilator support or tracheotomy, this bacterium may induce sometimes severe infection. That's why, as long as your child is colonized with this bacterium, visits between your child and the person with tracheotomy should be avoided as much as possible. If it is not possible, your child must wear a face mask during all the visit duration.
I hope I have answered your question. With my best regards,
Jean-Christophe Dubus

10.01.2011