Emergence of Stenotrophomonas maltophilia in bloodstream infections identified by MALDI-TOF MS: Antibiogram and virulence traits
Abstract
BACKGROUND & OBJECTIVES: Non-fermenting Gram-negative bacilli (NFGNB) have emerged as important opportunistic pathogens associated with bloodstream infections, particularly in critical care settings where antimicrobial resistance poses a growing challenge. This study investigated the prevalence of NFGNB in bloodstream infections, with emphasis on Stenotrophomonas maltophilia, including its antimicrobial susceptibility profile, virulence-associated traits, and resistance determinants.
METHODS: In this prospective study (2023-2025) conducted at a tertiary care centre in Mangalore, Karnataka, India, NFGNB isolated from bloodstream infections were identified by MALDI-TOF MS. S. maltophilia isolates were further evaluated for antimicrobial susceptibility, biofilm formation, extracellular virulence enzyme production, cytotoxicity on Vero cells, and selected drug resistance genes.
RESULTS: A total of 442 NFGNB were identified, among which Acinetobacter species were predominant (163; 36.69%), followed by Burkholderia species (79; 17.86%), S maltophilia (53; 11.99%), and Pseudomonas species (47; 10.65%). S. maltophilia demonstrated retained in vitro susceptibility to trimethoprim-sulfamethoxazole, levofloxacin, moxifloxacin, and minocycline, while resistance was observed against multiple β-lactam agents and aminoglycosides. Most isolates exhibited moderate to strong biofilm-forming ability, frequent production of protease, lipase, and lecithinase, and concentration-dependent…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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