Abstract：
This systematic review aimed to explore the recent trends in the epidemiology, risk factors, and antimicrobial susceptibility of two emerging opportunistic pathogens, Stenotrophomonas maltophilia and Elizabethkingia anophelis .
Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia . Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis , there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis . The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported.
Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis , but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens.
Since 2020, numerous outbreaks of S. maltophilia and E. anophelis have been reported worldwide. Most of these outbreaks have been associated with healthcare facilities, although one outbreak caused by E. anophelis in France was considered a community-associated infection. In terms of antimicrobial susceptibility, trimethoprim/sulfamethoxazole (TMP-SMZ), levofloxacin, and minocycline have exhibited good efficacy against S. maltophilia . Additionally, cefiderocol and a combination of aztreonam and avibactam have shown promising results in in vitro susceptibility testing. For E. anophelis , there is currently no consensus on the optimal treatment. Although some studies have reported good efficacy with rifampin, TMP-SMZ, piperacillin/tazobactam, and cefoperazone/sulbactam, minocycline had the most favourable in vitro susceptibility rates. Cefiderocol may serve as an alternative due to its low minimum inhibitory concentration (MIC) against E. anophelis . The role of vancomycin in treatment is still uncertain, although several successful cases with vancomycin treatment, even with high MIC values, have been reported.
Immunocompromised patients are particularly vulnerable to infections caused by S. maltophilia and E. anophelis , but the optimal treatment strategy remains inconclusive. Further research is necessary to determine the most effective use of conventional and novel antimicrobial agents in combatting these multidrug-resistant pathogens.
摘要：
目的：本系统综述旨在探讨流行病学的最新趋势，危险因素，以及两种新出现的机会性病原体的抗菌敏感性，嗜麦芽窄食单胞菌和Elizabethkingia按蚊。
结果：自2020年以来，世界范围内已报道了许多嗜麦芽嗜血杆菌和按蚊肠球菌的暴发。这些疫情大多与医疗机构有关，尽管法国有一次由按蚊大肠杆菌引起的疫情被认为是与社区相关的感染。在抗菌药物敏感性方面，甲氧苄啶/磺胺甲恶唑（TMP-SMZ），左氧氟沙星,和米诺环素对嗜麦芽嗜血杆菌表现出良好的疗效。此外,头孢地洛和氨曲南和阿维巴坦的组合在体外药敏试验中显示出有希望的结果。对于E.anophelis,目前对于最佳治疗尚无共识.尽管一些研究报道了利福平的良好疗效，TMP-SMZ,哌拉西林/他唑巴坦,和头孢哌酮/舒巴坦,米诺环素具有最有利的体外敏感率。头孢地洛因其对E.anophelis的最低抑制浓度（MIC）低，可以作为替代品。万古霉素在治疗中的作用仍不确定，虽然万古霉素治疗成功的几例，即使具有高MIC值，已被报道。
结论：免疫功能低下的患者特别容易受到嗜麦芽窄食链球菌和无触角大肠杆菌引起的感染，但最佳治疗策略仍无定论。需要进一步的研究来确定在对抗这些多药耐药病原体中最有效地使用常规和新型抗微生物剂。
结果：自2020年以来，世界范围内已报道了许多嗜麦芽嗜血杆菌和按蚊肠球菌的暴发。这些疫情大多与医疗机构有关，尽管法国有一次由按蚊大肠杆菌引起的疫情被认为是与社区相关的感染。在抗菌药物敏感性方面，甲氧苄啶/磺胺甲恶唑（TMP-SMZ），左氧氟沙星,和米诺环素对嗜麦芽嗜血杆菌表现出良好的疗效。此外,头孢地洛和氨曲南和阿维巴坦的组合在体外药敏试验中显示出有希望的结果。对于E.anophelis,目前对于最佳治疗尚无共识.尽管一些研究报道了利福平的良好疗效，TMP-SMZ,哌拉西林/他唑巴坦,和头孢哌酮/舒巴坦,米诺环素具有最有利的体外敏感率。头孢地洛因其对E.anophelis的最低抑制浓度（MIC）低，可以作为替代品。万古霉素在治疗中的作用仍不确定，虽然万古霉素治疗成功的几例，即使具有高MIC值，已被报道。
结论：免疫功能低下的患者特别容易受到嗜麦芽窄食链球菌和无触角大肠杆菌引起的感染，但最佳治疗策略仍无定论。需要进一步的研究来确定在对抗这些多药耐药病原体中最有效地使用常规和新型抗微生物剂。
