BACKGROUND Levofloxacin has been considered as an alternative treatment for Stenotrophomonas maltophilia infection. However, levofloxacin-resistant S. maltophilia (LRSM) are emerging worldwide. AIM To investigate LRSM risk factors in hospitalized patients and to determine antibiotic susceptibility patterns of LRSM isolates. METHODS In a retrospective matched case-control-control study, LRSM patients (the case group) were compared with two control groups: levofloxacin-susceptible S. maltophilia (LSSM) patients (control group A) and non-S. maltophilia-infected patients (control group B). Conditional logistic regression was used to analyse risk factors for LRSM occurrence. Tigecycline, ceftazidime, colistin, and trimethoprim/sulfamethoxazole (TMP/SMX) susceptibilities in collected LRSM clinical isolates were determined. FINDINGS A total of 105 LRSM, 105 LSSM, and 105 non-S. maltophilia-infected patients were analysed. The first multivariate analysis (cases vs group A) revealed that previous fluoroquinolones use was significantly associated with LRSM occurrence, and the second multivariate analysis (cases vs group B) revealed that previous fluoroquinolone use, previous intensive care unit stay, and the number of previous exposures to different classes of antibiotics were significantly associated with LRSM occurrence. Of all the LRSM isolates tested for antibiotic susceptibility, ceftazidime, TMP/SMX, tigecycline, and colistin resistance rates were 42.0, 99.0, 78.0, and 40.0%, respectively. CONCLUSION LRSM antibiotic susceptibility patterns revealed multiple-drug resistance, which further limits treatment options for clinicians. To reduce LRSM occurrence, proper use of antibiotics, especially fluoroquinolones, is mandatory.

中文翻译：

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左氧氟沙星耐药嗜麦芽窄食单胞菌：住院患者的危险因素和抗生素敏感性模式。

背景技术左氧氟沙星已经被认为是嗜麦芽窄食单胞菌感染的替代疗法。但是，耐左氧氟沙星的麦芽链球菌（LRSM）在世界范围内正在兴起。目的调查住院患者的LRSM危险因素，并确定LRSM分离株的抗生素敏感性模式。方法在一项回顾性配对病例对照研究中，将LRSM患者（病例组）与两个对照组进行比较：左氧氟沙星易感链球菌（LSSM）患者（对照组A）和非S.。感染了嗜麦芽孢杆菌的患者（对照组B）。使用条件逻辑回归分析LRSM发生的危险因素。确定了收集的LRSM临床分离物中的替加环素，头孢他啶，粘菌素和甲氧苄氨嘧啶/磺胺甲恶唑（TMP / SMX）的敏感性。结果总共有105个LRSM，105个LSSM和105个非S。分析了感染了亲麦芽孢杆菌的患者。第一次多变量分析（病例与A组）表明，以前使用氟喹诺酮类药物与LRSM的发生显着相关，第二次多变量分析（病例与B组）显示，先前使用氟喹诺酮类药物，先前在重症监护病房的停留时间和之前的次数暴露于不同种类的抗生素与LRSM的发生显着相关。在所有LRSM分离株的抗生素敏感性测试中，头孢他啶，TMP / SMX，替加环素和粘菌素的耐药率分别为42.0％，99.0、78.0和40.0％。结论LRSM抗生素敏感性模式显示多重耐药性，这进一步限制了临床医生的治疗选择。为了减少LRSM的发生，