الفهرس 
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Abstract
Background: Trimethoprim/sulfamethoxazole (TMP/SMX) has been the antimicrobial of choice for treatment of Stenotrophomonas maltophilia (S. maltophilia) infections. Several reports have shown that the prevalence of strains resistant to TMP/SMX is increasing. We investigated prevalence, risk factors and sulfamethoxazole resistance determinants of TMP/SMX resistant S. maltophilia in our locality. Methods: This study was conducted from January, 2009 till March, 2010 on 625 patients admitted to intensive care units (ICUs) in Mansoura University Hospitals (MUHs). Nosocomial S. maltophilia infections were detected in 90 samples. Antimicrobial susceptibilities were determined using the disk diffusion method. PCR was conducted for the detection of sul1 and sul2. Results: Out of 90 S. maltophilia isolates, 22 (24.4%) revealed resistances to TMP/SMX. Significant risk factors were: duration of ICU stay (P = 0.018), antibiotic treatment (P = 0.002) specifically carbapenems (P = 0.035) and fluoroquinolones (P < 0.001) and duration of antibiotic treatment. All TMP/SMX resistant S. maltophilia isolates were positive for sul1 gene. of the isolates carried sul2. Conclusion: The isolation of TMP/SMX resistant S. maltophilia at our locality is alarming. Strategies to prevent S. maltophilia infection should be encouraged. The resistance of S. maltophilia isolates to TMP/SMX is due to sul1 rather than to sul2.