Geoffrey Peterkins Kumwenda 1, Watipaso Kasambara 1, Kenneth Chizani 1, Abel Phiri 1, Alick Banda 1,
Faheema Choonara 2, Burnet Lichapa 3
- Ministry of Health, Microbiology National Reference Laboratory, Lilongwe, Malawi
- Ministry of Health, Kamuzu Central Hospital Laboratory, Lilongwe, Malawi
- Dignitas International, Zomba, Malawi
Correspondence: Geoffrey P. Kumwenda (geoffreykumwenda@gmail.com)
Abstract
Background
Stenotrophomonas maltophilia is a significant opportunistic pathogen that is associated with high mortality in immunocompromised individuals. In this study, we describe a multidrug-resistant (MDR) S. maltophilia clinical isolate from Kamuzu Central Hospital (KCH), Lilongwe, Malawi.
Methods
A ceftriaxone and meropenem nonsusceptible isolate (Sm-MW08), recovered in December 2017 at KCH, was referred to the National Microbiology Reference Laboratory for identification. In April 2018, we identified the isolate using MALDI Biotyper mass spectrometry and determined its antimicrobial susceptibility profile using microdilution methods. Sm-MW08 was analysed by S1- PFGE, PCR, and Sanger sequencing, in order to ascertain the genotypes that were responsible for the isolate`s multidrug-resistance (MDR) phenotype.
Results
Sm-MW08 was identified as S. maltophilia and exhibited resistance to a range of antibiotics, including all β-lactams, aminoglycosides (except arbekacin), chloramphenicol, minocycline, fosfomycin and fluoroquinolones, but remained susceptible to colistin and trimethoprim-sulfamethoxazole. The isolate did not harbour any plasmid but did carry chromosomally-encoded blaL1 metallo-βlactamase and blaL2 β-lactamase genes; this was consistent with the
isolate’s resistance profile. No other resistance determinants were detected, suggesting that the MDR phenotype exhibited by Sm-MW08 was innate.
Conclusion
Herein, we have described an MDR S.maltophilia from KCH in Malawi, that was resistant to almost all locally available
antibiotics. We therefore recommend the practice of effective infection prevention measures to curtail spread of this organism.
Key Words: Stenotrophomonas maltophilia, ceftriaxone, carbapenem, Kamuzu Central Hospital, Malawi