{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T19:45:35Z","timestamp":1761767135527,"version":"3.40.5"},"reference-count":37,"publisher":"Microbiology Society","issue":"10","funder":[{"DOI":"10.13039\/501100005612","name":"Shionogi","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005612","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,28]]},"abstract":"Introduction<\/jats:bold>.Stenotrophomonas maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>is an important multidrug-resistant Gram-negative pathogen. While largely a hospital-acquired pathogen, there have been increasing reports of the pathogen in the community.<\/jats:p>Gap Statement<\/jats:bold>. Trends inS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>prevalence and resistance rates that include outpatient isolates are unknown.<\/jats:p>Aim<\/jats:bold>. We described recent trends in prevalence and resistance ofS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>in the national Veterans Affairs (VA) Healthcare system.<\/jats:p>Methodology<\/jats:bold>. The study identified positiveS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>clinical cultures among VA adult patients from 2010 to 2018 across all VA hospitals, long-term care facilities\/units, and outpatient settings. AnnualS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>resistance rates were evaluated. Multidrug resistant (MDR) was defined as resistance to sulfamethoxazole\/trimethoprim (SMX\/TMP) and minocycline or levofloxacin. Time trends were assessed with regression analyses to estimate annual average percent changes (AAPC) with 95\u200a% confidence intervals using Joinpoint software.<\/jats:p>Results<\/jats:bold>. Over the 9\u2009year study period, 18\u2009285\u2009S<\/jats:ext-link><\/jats:named-content><\/jats:italic>.maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>cultures were identified (57\u200a% hospital, 3\u200a% long-term care, 40\u200a% outpatient). The most common source ofS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>cultures were respiratory cultures (34.6\u200a%) followed by urine cultures (30.4\u200a%). In VA hospitals and long-term care facilities, the number ofS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>cultures decreased significantly (by 5.4% and 8.4\u200a% per year respectively). Overall, 3.1\u200a% of isolates were MDR which remained stable over the study period. Resistance to other antibiotics assessed mostly remained stable, except SMX\/TMP resistance decreased significantly by 8.5\u200a% (2010, 15\u200a%; 2018, 6\u200a%) per year in VA hospitals.<\/jats:p>Conclusion<\/jats:bold>. While previous work has recognizedS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>as primarily a nosocomial pathogen, the present study found that 40\u200a% of cultures collected were among outpatients. Between 2010 and 2018, the number of positiveS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>cultures decreased significantly in the national VA Healthcare System. Resistance to SMX\/TMP decreased over the study period in VA hospitals and now more closely reflects previously reported resistance rates worldwide (0\u201310\u200a%). MDRS. maltophilia<\/jats:ext-link><\/jats:named-content><\/jats:italic>remained stable and low in the national VA Healthcare System.<\/jats:p>","DOI":"10.1099\/jmm.0.001594","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T16:16:22Z","timestamp":1666973782000},"source":"Crossref","is-referenced-by-count":6,"title":["Trends in Stenotrophomonas maltophilia antibiotic resistance rates in the United States Veterans Affairs Health System"],"prefix":"10.1099","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2407-7032","authenticated-orcid":false,"given":"Haley J.","family":"Appaneal","sequence":"first","affiliation":[{"name":"Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA"},{"name":"College of Pharmacy, University of Rhode Island, Kingston, RI, USA"},{"name":"Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vrishali V.","family":"Lopes","sequence":"additional","affiliation":[{"name":"Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-4275","authenticated-orcid":false,"given":"Kerry L.","family":"LaPlante","sequence":"additional","affiliation":[{"name":"Warren Alpert Medical School of Brown University, Providence, RI"},{"name":"Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA"},{"name":"Brown University School of Public Health, Providence, RI"},{"name":"Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI, USA"},{"name":"College of Pharmacy, University of Rhode Island, Kingston, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4180-027X","authenticated-orcid":false,"given":"Aisling R.","family":"Caffrey","sequence":"additional","affiliation":[{"name":"Brown University School of Public Health, Providence, RI"},{"name":"Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA"},{"name":"Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI, USA"},{"name":"College of Pharmacy, University of Rhode Island, Kingston, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases7020041"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.00893"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00019-11"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-009-0709-5"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-008-0518-2"},{"key":"R6","doi-asserted-by":"crossref","first-page":"826","DOI":"10.47102\/annals-acadmedsg.V37N10p826","article-title":"Independent predictors for mortality in patients with positive Stenotrophomonas maltophilia cultures","volume":"37","author":"Kwa","year":"2008","journal-title":"Ann Acad Med Singap"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1086\/646136"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01682-13"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2014.01.007"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2014.06.005"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1002\/pds.4574"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv456"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02488-19"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2018.11.007"},{"journal-title":"Statistics at a Glance","article-title":"Department of Veterans Affairs","year":"2020 Updated 12\/31\/2019","key":"R15"},{"year":"2020","key":"R16","article-title":"Review of VHA Community Living Centers and corresponding star ratings"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v42i04a04"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2012.08.014"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1007\/s13670-015-0120-2"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1086\/320183"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy293"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2014.01.032"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-014-0058-9"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1007\/BF02490061"},{"key":"R25","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1001\/archinte.1996.00440040111012","article-title":"Stenotrophomonas (Xanthomonas) maltophilia urinary tract infection. 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