Multicenter epidemiology of Stenotrophomonas maltophilia bloodstream infections in Indian ICUs: building digital surveillance network

Parul Singh¹, M Nizam Ahmed¹, Ashish Kumar Srivastava¹, Arpan Kumar Thakur¹, Rasna Parveen¹, Mamta Puraswani¹, Subodh Kumar², Sushma Sagar², Kapil Dev Soni³, Richa Aggarwal³, Ashish Bindra⁴, Keshav Goyal⁵, Kamran Farooque¹, Arunaloke Chakrabarti⁶, Camilla Rodrigues⁷, Veeraraghavan Balaji⁸, Pallab Ray⁶, Manisha Biswal⁶, Neelam Taneja⁶, Archana Angrup⁶, Chand Wattal⁹, Vimala Venkatesh¹⁰, Nandini Sethuraman¹¹, Sanjay Bhattacharya¹², Vibhor Tak¹³, Bijayini Behera¹⁴, Vinaykumar Hallur¹⁴, Raja Ray¹⁵, Shivaprakash M Rudramurthy⁶, Inderpaul Sehgal⁶, Sanjeev K Singh¹⁶, Sharmila Sen Gupta¹⁶, Chiranjay Mukhopadhyay¹⁷, Joy Sarojini Michael⁸, Bashir Ahmad Fomda¹⁸, Tadepalli Karuna¹⁹, Vijayshri Deotale²⁰, Amber Prasad²¹, Kanne Padmaja²², Vijeta Bajpai²³, Reema Nath²⁴, Renu Gur²⁵, Sheela Devi²⁶, Shalini Malhotra²⁷, Rajni Gaind²⁸, Ranjana Devi Khuraijam²⁹, Rajni Sharma³⁰, Summaiya Mullan³¹, John Antony Jude Prakash⁸, Hema Paul⁸, Priscilla Rupali⁸, Sheetal Verma¹⁰, Sangita Rajdev³¹, Neeraj Goel⁹, Juliah Chelliah⁷, Satyam Mukherjee¹², Aparna Sonowal²⁴, Veena Kumari³², Prachi Verma³³, Vandana Ke¹⁷, Manisha Subrao Mane³⁴, Tapan Majumder³⁵, Kamini Walia³⁶, Purva Mathur¹

Affiliations

¹ Department of Laboratory Medicine, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
² Department of Surgery, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
³ Department of Critical and Intensive Care, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
⁴ Department of Neuroanaesthesia, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
⁵ Department of Neuroanaesthesia and Critical Care, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
⁶ Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
⁷ Department of Microbiology, P.D. Hinduja National Hospital, Mumbai, India.
⁸ Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India.
⁹ Institute of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, Delhi, India.
¹⁰ Department of Microbiology, King George's Medical University, Lucknow, India.
¹¹ Department of Microbiology, Apollo Hospital, Chennai, India.
¹² Department of Microbiology, Tata Medical Center, Kolkata, India.
¹³ Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India.
¹⁴ Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India.
¹⁵ Department of Microbiology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
¹⁶ Department of Microbiology, Amrita Institute of Medical Sciences, Kochi, India.
¹⁷ Department of Microbiology, Kasturba Medical College, Manipal, India.
¹⁸ Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
¹⁹ Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India.
²⁰ Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India.
²¹ Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India.
²² Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, India.
²³ Department of Microbiology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, India.
²⁴ Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, India.
²⁵ Department of Microbiology, Dr. Baba Saheb Ambedkar Hospital, Delhi, India.
²⁶ Department of Microbiology, Pondicherry Institute of Medical Sciences, Pondicherry, India.
²⁷ Department of Microbiology, Dr. Ram Manohar Lohia Hospital and PGIMER, Delhi, India.
²⁸ Department of Microbiology, Safdarjung Hospital, Delhi, India.
²⁹ Department of Microbiology, Regional Institute of Medical Sciences, Imphal, India.
³⁰ Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India.
³¹ Department of Microbiology, Government Medical College, Surat, India.
³² Department of Neuro-Microbiology, National Institute of Mental Health and Neuro-Sciences, Bengaluru, India.
³³ Department of Microbiology, Mahatma Gandhi Medical College and Hospital, Jaipur, India.
³⁴ Department of Microbiology, ESIC Medical College and Hospital, Hyderabad, India.
³⁵ Department of Microbiology, Government Medical College, Agartala, India.
³⁶ Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, Delhi, India.

PMID: 41425938
PMCID: PMC12711849
DOI: 10.3389/fmicb.2025.1725629

Multicenter epidemiology of Stenotrophomonas maltophilia bloodstream infections in Indian ICUs: building digital surveillance network

Parul Singh et al. Front Microbiol. 2025.

. 2025 Dec 4:16:1725629.

doi: 10.3389/fmicb.2025.1725629. eCollection 2025.

Authors

Affiliations

¹ Department of Laboratory Medicine, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
² Department of Surgery, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
³ Department of Critical and Intensive Care, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
⁴ Department of Neuroanaesthesia, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
⁵ Department of Neuroanaesthesia and Critical Care, JPNA Trauma Center, All India Institute of Medical Sciences, Delhi, India.
⁶ Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
⁷ Department of Microbiology, P.D. Hinduja National Hospital, Mumbai, India.
⁸ Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India.
⁹ Institute of Clinical Microbiology and Immunology, Sir Ganga Ram Hospital, Delhi, India.
¹⁰ Department of Microbiology, King George's Medical University, Lucknow, India.
¹¹ Department of Microbiology, Apollo Hospital, Chennai, India.
¹² Department of Microbiology, Tata Medical Center, Kolkata, India.
¹³ Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, India.
¹⁴ Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India.
¹⁵ Department of Microbiology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
¹⁶ Department of Microbiology, Amrita Institute of Medical Sciences, Kochi, India.
¹⁷ Department of Microbiology, Kasturba Medical College, Manipal, India.
¹⁸ Department of Microbiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
¹⁹ Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India.
²⁰ Department of Microbiology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India.
²¹ Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, India.
²² Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, India.
²³ Department of Microbiology, Homi Bhabha Cancer Hospital and Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, India.
²⁴ Department of Microbiology, Assam Medical College and Hospital, Dibrugarh, India.
²⁵ Department of Microbiology, Dr. Baba Saheb Ambedkar Hospital, Delhi, India.
²⁶ Department of Microbiology, Pondicherry Institute of Medical Sciences, Pondicherry, India.
²⁷ Department of Microbiology, Dr. Ram Manohar Lohia Hospital and PGIMER, Delhi, India.
²⁸ Department of Microbiology, Safdarjung Hospital, Delhi, India.
²⁹ Department of Microbiology, Regional Institute of Medical Sciences, Imphal, India.
³⁰ Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India.
³¹ Department of Microbiology, Government Medical College, Surat, India.
³² Department of Neuro-Microbiology, National Institute of Mental Health and Neuro-Sciences, Bengaluru, India.
³³ Department of Microbiology, Mahatma Gandhi Medical College and Hospital, Jaipur, India.
³⁴ Department of Microbiology, ESIC Medical College and Hospital, Hyderabad, India.
³⁵ Department of Microbiology, Government Medical College, Agartala, India.
³⁶ Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, Delhi, India.

PMID: 41425938
PMCID: PMC12711849
DOI: 10.3389/fmicb.2025.1725629

Abstract

Background: To investigate the geospatial epidemiology, clinical features, treatment patterns, and antimicrobial resistance (AMR) trends of Stenotrophomonas maltophilia bloodstream infections (BSIs) in Indian intensive care units (ICUs) participating in a standardized healthcare-associated infection (HAI) surveillance program from 2017 to 2024.

Methods: This retrospective, multicentric study analyzed surveillance data from 54 ICUs across India. Standardized HAI definitions and protocols were applied to characterize infection types, clinical outcomes, and antimicrobial susceptibility.

Results: A total of 271 S. maltophilia isolates were identified, with the highest burden in 2023-24 (n = 76, 28.0%). Central line-associated BSIs (CLABSIs) predominated (64.9%), though their proportion decreased over time, with non-CLABSIs rising from 7.4% (2017-18) to 42.1% (2023-24). Mortality was highest in secondary BSIs (60%), followed by CLABSIs (50.3%) and non-CLABSIs (36.4%). The median ICU stay for CLABSI patients was 21 days. No significant associations were observed between infection type and time to infection or length of stay. High resistance was observed to tobramycin (92%), amikacin (80%), and piperacillin-tazobactam (70%), while trimethoprim-sulfamethoxazole (64.7-94.7%), levofloxacin (93%), and minocycline (94.1%) retained activity.

Conclusion: S. maltophilia represents a significant ICU pathogen in India, underscoring the urgent need for genomic surveillance and resistance-guided therapeutic strategies.

Keywords: BSIs; Stenotrophomonas maltophilia; bloodstream infections; healthcare-associated infections; surveillance.

Copyright © 2025 Singh, Ahmed, Srivastava, Thakur, Parveen, Puraswani, Kumar, Sagar, Soni, Aggarwal, Bindra, Goyal, Farooque, Chakrabarti, Rodrigues, Balaji, Ray, Biswal, Taneja, Angrup, Wattal, Venkatesh, Sethuraman, Bhattacharya, Tak, Behera, Hallur, Ray, Rudramurthy, Sehgal, Singh, Gupta, Mukhopadhyay, Michael, Fomda, Karuna, Deotale, Prasad, Padmaja, Bajpai, Nath, Gur, Devi, Malhotra, Gaind, Khuraijam, Sharma, Mullan, Prakash, Paul, Rupali, Verma, Rajdev, Goel, Chelliah, Mukherjee, Sonowal, Kumari, Verma, KE, Mane, Majumder, Walia and Mathur.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Data flow and processes of HAI surveillance through HAI surveillance database.

**Figure 2**
Year-wise isolation from bloodstream (2017–2024).

See this image and copyright information in PMC

References

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Multicenter epidemiology of Stenotrophomonas maltophilia bloodstream infections in Indian ICUs: building digital surveillance network

Affiliations

Multicenter epidemiology of Stenotrophomonas maltophilia bloodstream infections in Indian ICUs: building digital surveillance network

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources