Stenotrophomonas Maltophilia

[jleigh5570]

I am a 34 yr old CF patient.  I have cultured steno twice in the past 5 months.  The first time I experienced hemoptysis (mild), low grade fever and cough.  I was given a 3 week course of Bactrim and felt better.  The second time I cultured it I had extreme fatigue for a couple weeks before the culture and had been coughing up dark yellow/green sputum.  Also my May PFT's, although still good, went down about 10% since my Feb ones.  I was again given a course of Bactrim.

All that I have been able to find on steno (and it's not much) says that although it is considered a more uncommon antibiotic resistant pathogen in CF, it doesn't really say much about it's virulence as a pathogen.  Obviously both times the bug has invaded my lungs it has made me sick, but I do not know if steno is actually causing any significant harm to my lungs.

Do you know anything about steno or if it can damage the lungs??  I plan to ask my CF doc at my next clinic appt but that is not until mid Aug.  

Thanks in advance,
jleigh5570

[National Jewish]

There is a good chance that you might also have other pathogens, such as Pseudomonas and/or Staphylococcus that could be causing the decrease in your pulmonary function tests (PFTs).  The way to identify what pathogens are in your sputum is by doing serial sputum cultures.  You'll collect a small amount of your sputum once a week for 3 to 4 weeks.  This is cultured in a laboratory to see what germs grow each week.  Your sputum should also be tested for acid-fast bacilli (AFB).  This test will identify if you have nontuberculous mycobacteria (NTM) in your sputum.  This pathogen is closely related to tuberculosis, but is not spread from person to person.  Often a sensitivity test is done along with the culture to identify the antibiotic that will work the best.

[AndyRRT]

Hi there...

i did some research on Stenotrophomonas Maltophilia on my hospital website and I found that its actually classified as Pseudomonas. But unlike Pseudomonas, S maltophilia is an organism of low virulence with limited ability to cause infection in people.

What I do know about Pseudomonas and Steno is it easily contaminated your respiratory equipment! YES! Be sure your nebulizers, inhaled medication devices, and whatever else you may come in contact with is CLEAN. Soaking mouth pieces in a warm soapy water with a little vinegar is sufficient.

Goodluck....and keep the questions coming. CF is one of my specialties. (Although on the more critical care end of it)


Andy, RRT, CPFT