Stenotrophomonas maltophilia ocular infections
R. L. Penland and K. R. Wilhelmus
Department of Ophthalmology, Baylor College of Medicine, Houston, Tex. USA.
OBJECTIVES: To determine if the number of ocular infections associated with
Stenotrophomonas maltophilia is increasing, to identify predisposing
factors, and to evaluate antimicrobial susceptibility. METHODS:
Retrospective review of ocular microbiology laboratory records from January
1, 1972, through December 31, 1995. RESULTS: Stenotrophomonas maltophilia
was recovered from 15 cases of ocular infection, at a rate of one in every
1339 ocular specimens in the 1970s, one in 413 in the 1980s, and one in 363
in the 1990s through 1995. The organism was the predominant isolate in five
cases and was part of a polybacterial infection in the remaining 10 cases.
Eight of the 15 cases had bacterial keratitis, including one with
infectious crystalline keratopathy. Of the remaining seven infections, S
maltophilia was recovered from two cases of acute conjunctivitis, two
infected scleral buckles (one with orbital cellulitis), two cases of
infantile dacryocystitis, and one case of preseptal cellulitis. Ocular
isolates of S maltophilia were resistant to the aminoglycosides and most
beta-lactams, and showed variable susceptibility to the fluoroquinolones.
CONCLUSIONS: Stenotrophomonas maltophilia is emerging as an important
opportunistic ocular pathogen. Most infections by this organism occur in
patients with ocular compromise, and the characteristically resistant
antibiogram of S maltophilia limits the therapeutic options.
