Cureus. 2026 Jun 7;18(6):e110407. doi: 10.7759/cureus.110407. eCollection 2026 Jun.
ABSTRACT
Background and objectives: Stenotrophomonas maltophilia (S. maltophilia) is an emerging pathogen causing hospital-acquired infections, particularly in critically ill and immunocompromised patients. Limited therapeutic options are available due to its multidrug resistance (MDR) nature. Despite the availability of advanced automated diagnostic methods in Eastern India, data describing its prevalence and antibiotic susceptibility patterns are limited. The present study was conducted to evaluate the prevalence, antimicrobial susceptibility patterns, and resistance trends of S. maltophilia over five years in a tertiary care hospital in Eastern India. Materials and methods: A retrospective laboratory-based observational study was conducted in the Department of Microbiology at Kalinga Institute of Medical Sciences (KIMS), a tertiary care hospital in Eastern India. Records of patients with positive culture reports for S. maltophilia isolates between January 2021 and December 2025 were analyzed after Institutional Ethics Committee approval (KIIT/KIMS/IEC/2616/2026). Clinically significant S. maltophilia isolates from various clinical specimens of hospitalized patients aged >18 years were included in the study. Samples were processed using standard microbiological procedures. Isolate identification was performed by VITEK 2 compact automated system (bioMérieux, Marcy-l’Étoile, France) and/or MALDI-TOF MS (VITEK MS PRIME system -bioMérieux, Marcy-l’Étoile, France). Antimicrobial susceptibility testing for trimethoprim-sulfamethoxazole, levofloxacin, and minocycline was performed by automated systems and interpreted according to CLSI M100, 34th edition (2024). Demographic, clinical, and laboratory data were retrieved from the laboratory information system and analyzed using R software Version 4.4.3 (R Foundation for Statistical Computing, Vienna, Austria). Categorical data were described with frequencies and percentages. A p-value of <0.05 was considered statistically significant. Results: During the five-year period, a total of 415 clinically significant S. maltophilia isolates were identified from 88,315 culture-positive samples, with an overall prevalence of S. maltophilia infection of 0.5%. The annual prevalence of isolates increased considerably from 38/10,239 (0.37%) in 2021 to 131/20,529 (0.6%) in 2025. The majority of the isolates were from ICUs (272/415; 65.5%), and males were 281/415 (67.7%), with a median age of 54 years. Blood was the most common specimen source (138/415; 33.3%), followed by pus/tissue/wound swabs (113/415; 27.2%). During the five years, minocycline had the highest susceptibility (73.7-83.2%), followed by trimethoprim-sulfamethoxazole (66.7-74.0 %) and levofloxacin (60.5-71.4%). Most isolates remained susceptible, while resistance phenotypes persisted, especially to levofloxacin and trimethoprim-sulfamethoxazole. Conclusions: The rising isolation rate of S. maltophilia from clinical specimens, particularly from bloodstream infections, is an emerging epidemiological and clinical concern. There was an observed stable but notable resistance pattern to the antibiotics, such as fluoroquinolones and trimethoprim-sulfamethoxazole, highlighting the need for continuous surveillance and prudent antibiotic use, while minocycline remained the most effective antimicrobial during the study period.
PMID:42416956 | PMC:PMC13340860 | DOI:10.7759/cureus.110407
