Case report of Stenotrophomonas maltophilia in corneal ulcer: why is it difficult to treat?
Main Article Content
Keywords
Cornea ulcer, Corneal swab, Resistance, Stenotrophomonas maltophilia, Virulence factors
Abstract
Introduction: Stenotrophomonas maltophilia is an opportunistic bacterium and has rarely been reported as a cause of infection in the cornea. Ocular infection due to Stenotrophomonas maltophilia is an opportunistic infection followed by instability of the ocular surface. Casalita et al. (2020), in their research at Cipto Mangunkusumo Hospital, Jakarta, Indonesia found two cases of infected corneal ulcers due to Stenotrophomonas maltophilia.
Case description: A 57-year-old man came to the eye clinic with pain in the left eye and blurred vision. The patient was diagnosed with severe corneal ulcer and regularly came for the treatment. The patient felt that his eye suddenly got worse with visual acuity only to his hand movement. Corneal ulcer swab procedure is performed when the patient firstly visit the clinic. Samples are sent to the microbiology laboratory for culture examination. Culture results obtained were coagulase negative Staphylococcus and Stenotrophomonas maltophilia.
Conclusion: Stenotrophomonas maltophilia has several virulence factors, including resistance to various antibiotics, making it difficult to treat.
References
2. Asyari F, Winarto, Djohani EM, Sjamsoe S. Pedoman Nasional Pelayanan Kedokteran Ulkus Kornea Bakteri. Perdami. 2015;1–57.
3. Kemenkes R. Infodatin Situasi Gangguan Penglihatan. Kementrian Kesehatan RI Pusat Data dan Informasi. 2018;11.
4. Byrd LB, Nathan M. Corneal Ulcer [Internet]. www.ncbi.nlm.nih.gov. 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539689/#:~:text=A corneal ulcer is a,%2C blurry vision%2C and photophobia.
5. Casalita V, Nora RLD, Edwar L, Susiyanti M, Sitompul R. Amniotic membrane transplantation for infectious corneal ulcer treatment: A cohort retrospective study. Medical Journal of Indonesia. 2020;29(4):379–85.
6. Mina S. Said; Ekta Tirthani; Emil Lesho. Stenotrophomonas Maltophilia [Internet]. www.ncbi.nlm.nih.gov. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572123/
7. Denton M, Kerr KG. Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia. Clinical Microbiology Reviews. 1998;11(1):57–80.
8. Wu AL, Yeh LK, Ma DHK, Chen PYF, Lin HC, Sun CC, et al. Clinical characteristics of stenotrophomonas maltophilia keratitis. Cornea. 2016;35(6):795–800.
9. Palioura S, Gibbons A, Miller D, O’Brien TP, Alfonso EC, Spierer O. Clinical Features, Antibiotic Susceptibility Profile, and Outcomes of Infectious Keratitis Caused by Stenotrophomonas maltophilia. Cornea. 2018;37(3):326–30.
10. Park BC, Lim HR, Park SJ, Koh JW. Clinical Features and Management of Stenotrophomonas Maltophilia Keratitis. Ophthalmology and Therapy. 2021;10(3):525–33.
11. Leck A. Taking a corneal scrape and making a diagnosis. Community Eye Health Journal. 2015;28(89):8–9.
12. Astrid L. Corneal Ulcer : Appendix Preparation of Lactophenol. Community Eye Health. 1999;12(30):1999.
13. Tille PM. BAILEY & SCOTT’S DIAGNOSTIC MICROBIOLOGY, FOURTEENTH EDITION. Elsevier; 2017.
14. Miller JM. Handbook of Specimen Collection and Handling in Microbiology. Second Edition. 2006;(March):1.
15. Leal SM, Rodino KG, Fowler WC, Gilligan PH. Practical guidance for clinical microbiology laboratories: Diagnosis of ocular infections. Clinical Microbiology Reviews. 2021;34(3):1–45.
16. Mun Y, Kim MK, Oh JY. Ten-year analysis of microbiological profile and antibiotic sensitivity for bacterial keratitis in Korea. PLoS ONE. 2019;14(3):1–10.
17. Grover S, Odell WD. Partial characterization of the 30 kD Ig-binding protein from Pseudomonas maltophilia. Biochemical and Biophysical Research Communications. 1992;182(3):1075–81.
18. Fatela-Cantillo D, Crespo-González J, Fatela-Cantillo B, Fernandez-Suarez A, Benítez JMA, Nieto JAS, et al. <i>Stenotrophomonas maltophilia</i> Keratitis Related to Therapeutic Contact Lens Misidentified with an Automated Identification System. Open Journal of Clinical Diagnostics. 2015;05(02):63–7.
19. Adegoke AA, Stenström TA, Okoh AI. Stenotrophomonas maltophilia as an emerging ubiquitous pathogen: Looking beyond contemporary antibiotic therapy. Frontiers in Microbiology. 2017;8(NOV):1–18.