Stenotrophomonas maltophilia sepsis in preterm neonates

Stenotrophomonas maltophilia, an environmentally ubiquitous microbe, is a challenging opportunistic pathogen in the hospital setting. Neonates are particularly vulnerable to infection with Stenotrophomonas but information on presentation, therapeutic response and outcome of such infection in this population is limited. To expand this knowledge, we report here a series of five cases. All the five neonates having S. maltophilia sepsis, were preterms (27-32 weeks), very low birth weight, with clinical presentation within three weeks of life, with respiratory involvement presenting as respiratory distress due to pulmonary haemorrhage, non-specific features like lethargy, altered blood sugar levels and haemodynamic instability. The microbe was sensitive to amikacin, ceftazidime, cotrimoxazole, gentamycin, levofloxacin and minocycline except in two cases showing levofloxacin resistance. All but one neonate survived with morbidities like retinopathy of prematurity, bronchopulmonary dysplasia and metabolic bone disease.