Molecular epidemiology of Xanthomonas maltophilia colonization and infection in the hospital
Between April 1992 and December 1993, 80 Xanthomonas maltophilia isolates were collected from 63 patients in
three acute-care hospitals in Calgary, Alberta, Canada. On the basis of Centers for Disease Control and Prevention
definitions, 48 patients had nosocomial and 15 had community-acquired X. maltophilia. Thirty-eight of the patients
were colonized and 25 were infected. Sixty-four percent of patients who acquired X. maltophilia in the intensive care
unit (ICU) became infected, whereas 32% of patients in a non-ICU setting became infected. ICU patients tended to be
hospitalized for a shorter period of time than non-ICU patients before the onset of X. maltophilia infection. Regardless
of being colonized or infected, all patients had debilitating conditions, with respiratory disease being the most common
underlying illness (35%). Forty-two patients (88%) with hospital-acquired X. maltophilia received prior antibiotic
therapy which included gentamicin, tobramycin, ceftazidime, piperacillin, and imipenem. Agar dilution MICs showed
that patient isolates were resistant to these antimicrobial agents that patients had received. Pulsed-field gel
electrophoresis of SpeI-digested genomic DNA revealed that six epidemiologically linked patient isolates from the ICU
of one acute-care hospital had identical DNA profiles. In contrast, isolates from patients from the other two hospitals
had unique genotype profiles (n = 57) regardless of the presence or absence of an epidemiologic association. In
these patients there was genetic evidence against the acquisition of a resident hospital clone. These results indicate
that pulsed-field gel electrophoresis can resolve genotypically distinct strains of X. maltophilia and, consequently, is a
useful tool for evaluating nosocomial infections caused by X. maltophilia.
J Clin Microbiol. 1995 March; 33(3): 513–518.
Xanthomonas maltophilia—a growing problem in the haemodialysis population
Two haemodialysed patients were recently infected with Xanthomonas maltophilia, a Gram-negative
bacterium related to the genus Pseudomonas. Xanthomonas maltophilia has recently emerged as an
important nosocomial pathogen, with at least three reports documenting this problem in haemodialysed
patients [4–10]. Relevant histories of both patients are outlined, and the discussion details therapeutic
considerations that are important in the management of these patients.
Nephrol Dial Transplant (1997) 12: 2174–2176
Last Updated: May 12, 2006
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Burdge DR, Noble MA, Campbell ME: Xanthomonas maltophilia misidentified as Pseudomonas cepacia in cultures of
sputum from patients with cystic fibrosis: a diagnostic pitfall with major clinical implications.
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Xanthomonas maltophilia, and Pseudomonas cepacia. Curr Clin Top Infect Dis 1996; 16: 52-83[Medline].
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