K.V. UMARKAR, P.V. THAKARE AND N.A. GHANWATE
Abstract
Stenotrophomonas maltophilia (S. maltophilia) is a Gram-negative, non-fermentative bacillus that has evolved from being regarded as a low-virulence environmental microorganism to a clinically significant opportunistic pathogen, particularly in nosocomial settings. Its prevalence has notably increased among immunocompromised individuals, including those undergoing invasive procedures or receiving broad spectrum antibiotics. The organismâs intrinsic resistance to multiple antibiotic classes such as ?-lactams, aminoglycosides, and carbapenems combined with its ability to form biofilms and persist in nutrient-limited environments, contributes to its resilience and pathogenicity in healthcare environments. This resistance is mainly mediated by chromosomally encoded ?-lactamases (L1 and L2), efflux pumps and decreased outer membrane permeability which together limit the efficacy of conventional antimicrobials. Recent studies have explored its taxonomy, ecological adaptability, molecular mechanisms of resistance, epidemiology, virulence traits and clinical manifestations, underscoring the complexity of managing infections caused by multidrug-resistant (MDR) strains for which existing therapeutic approaches remain limited. This review synthesizes contemporary findings on the identification, molecular characteristics, epidemiology, and virulence factors for rising MDR S.maltophilia, highlighting the pressing need for innovative clinical solutions integrated stewardship and translational research into novel antimicrobial agents, to bridge laboratory findings with effective patient care.