Stenotrophomonas maltophilia

Stenotrophomonas maltophilia


General Information

Mild Infections

  • Minocycline

Moderate to Severe Disease

  • Initiate TMP/SMX and add a second agent if appropriate clinical response is not observed

Mild Infections:

  • Levofloxacin

Moderate to Severe Disease:

  • Combination therapy with two of the following: TMP/SMX, minocycline, levofloxacin, or cefiderocol 

Moderate to Severe Disease where TMP/SMX and/or Minocycline Cannot be Used

  • Consider the combination of ceftazidime/avibactam and aztreonam, infused simultaneously; synergy testing recommended

Aerobic, non-fermenting, gram-negative rod

  • May be acquired from diverse environmental sources (e.g. tap water)

  • Colonization may occur in patients with structural lung disease

  • Must distinguish colonization from clinically significant infection

Most common:

  • Bloodstream infection (usually from vascular catheter)

  • Pneumoniae rare):

  • Urinary tras

  • Intra-abdominal infection


  • May require contact precautions
  • Resistance has been shown to be related to overuse of carbapenems