Will Stenotrophomonas maltophilia respond to meropenem or other beta-lactams if it appears susceptible in vitro ?
No. Susceptibility tests on this species are markedly influenced by medium etc. The species produces an intrinsic class B carbapenemase that confers resistance to carbapenems. The combination of this carbapenemse and a second beta-lactamase effectively renders most beta-lactams unsuitable for this species. The treatment of choice is co-trimoxazole, although Timentin (ticarcillin/clavulanic acid) may be considered as an alternative for cotrimoxazole-resistant isolates. Note also, that the S. maltophilia commonly appears resistant to trimethoprim and sulfonamdes when they are tested separately; it usually remains susceptible to the combination.
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