{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:15:00Z","timestamp":1793060100585,"version":"4.5.0"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nInfections caused by Stenotrophomonas maltophilia<\/jats:italic> and related species are increasing worldwide. Unfortunately, treatment options are limited, whereas the antimicrobial resistance is increasing.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nWe included clinical isolates identified as S<\/jats:italic>. maltophilia<\/jats:italic> by VITEK 2 Compact. Ceftazidime\/avibactam, meropenem\/vaborbactam, imipenem\/relebactam, cefiderocol, quinolones, and tetracycline family members were evaluated by broth microdilution method and compared with first-line treatment drugs. Minimum inhibitory concentrations (MICs) were reported for all antibiotics. We sequenced the Whole Genome of cefiderocol resistant strains (CRSs) and annotated their genes associated with cefiderocol resistance (GACR). Presumptive phylogenetic identification employing the 16S marker was performed.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nOne hundred and one clinical strains were evaluated, sulfamethoxazole and trimethoprim, levofloxacin and minocycline showed susceptibilities of 99.01%, 95.04% and 100% respectively. Ceftazidime was the antibiotic with the highest percentage of resistance in all samples (77.22%). Five strains were resistant to cefiderocol exhibiting MIC values \u2265 2 \u03bcg\/mL (4.95%). The \u03b2-lactamase inhibitors meropenem\/vaborbactam and imipenem\/relebactam, failed to inhibit S<\/jats:italic>. maltophilia<\/jats:italic>, preserving both MIC50<\/jats:sub> and MIC90<\/jats:sub> \u226564 \u03bcg\/mL. Ceftazidime\/avibactam restored the activity of ceftazidime decreasing the MIC range. Tigecycline had the lowest MIC range, MIC50<\/jats:sub> and MIC90.<\/jats:sub> Phylogeny based on 16S rRNA allowed to identify to cefiderocol resistant strains as putative species clustered into Stenotrophomonas maltophilia<\/jats:italic> complex (Smc). In these strains, we detected GARCs such as Mutiple Drug Resistance (MDR) efflux pumps, L1-type \u03b2-lactamases, iron transporters and type-1 fimbriae.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nAntimicrobial resistance to first-line treatment is low. The in vitro<\/jats:italic> activity of new \u03b2-lactamase inhibitors against S<\/jats:italic>. maltophilia<\/jats:italic> is poor, but avibactam may be a potential option. Cefiderocol could be considered as a potential new option for multidrug resistant infections. Tetracyclines had the best in vitro<\/jats:italic> activity of all antibiotics evaluated.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0298577","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T18:01:48Z","timestamp":1713463308000},"page":"e0298577","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["In vitro activity of ceftazidime\/avibactam, cefiderocol, meropenem\/vaborbactam and imipenem\/relebactam against clinical strains of the Stenotrophomonas maltophilia complex"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2720-8971","authenticated-orcid":true,"given":"Braulio Josu\u00e9","family":"M\u00e9ndez-Sotelo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00f3nica","family":"Delgado-Beltr\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Hern\u00e1ndez-Dur\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7280-2086","authenticated-orcid":true,"given":"Claudia Adriana","family":"Col\u00edn-Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Esquivel-Bautista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra Ang\u00e9lica","family":"Ortega-Oliva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jossue","family":"Ortiz-\u00c1lvarez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Garc\u00eda-Contreras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Franco-Cendejas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7387-0937","authenticated-orcid":true,"given":"Luis Esau","family":"Lopez Jacome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"pone.0298577.ref001","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1556\/030.2023.01920","article-title":"Analysis of biofilm formation in nosocomial Stenotrophomonas maltophilia isolates collected in Bulgaria: An 11-year study (2011\u20132022).","volume":"70","author":"T Strateva","year":"2023","journal-title":"Acta Microbiol Immunol Hung"},{"key":"pone.0298577.ref002","first-page":"13","article-title":"Upraising Stenotrophomonas maltophilia in Critically Ill Patients: A New Enemy?","author":"G Dimopoulos","year":"2023","journal-title":"Diagnostics"},{"key":"pone.0298577.ref003","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2017.02276","article-title":"Stenotrophomonas maltophilia as an emerging ubiquitous pathogen: Looking beyond contemporary antibiotic therapy.","author":"AA Adegoke","year":"2017","journal-title":"Frontiers in Microbiology. 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