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CASE REPORT article

Front. Pediatr.

Sec. Neonatology

Volume 13 - 2025 | doi: 10.3389/fped.2025.1619075

Successful Sequential Therapy for Stenotrophomonas maltophilia Infection in a Preterm Neonate: A Case Report

Provisionally accepted
Majed H NahariMajed H Nahari1,2*Mohammed AlAboudMohammed AlAboud1,2Syed M MohinuddinSyed M Mohinuddin3,4Maheer FadenMaheer Faden1,2Yasser BalharethYasser Balhareth1Noura M AlsaleemNoura M Alsaleem1
  • 1King Abdullah bin Abdulaziz University Hospital (KAAUH), Riyadh, Saudi Arabia
  • 2Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
  • 3Ottawa University, Ottawa, Kansas, United States
  • 4The Ottawa Hospital, Ottawa, Ontario, Canada

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Abstract Background: A multidrug-resistant pathogen increasingly seen in newborn intensive care units, stenotrophomonas maltophilia presents treatment difficulties for preterm babies. Case Presentation: A 28-week preterm neonate developed S. maltophilia sepsis following prolonged mechanical ventilation. Initial therapy with trimethoprim-sulfamethoxazole (TMP-SMX) was ineffective, prompting a switch to levofloxacin, which led to clinical recovery and infection clearance. Conclusion: This case highlights the need for tailored antimicrobial strategies in neonatal S. maltophilia infections. Sequential therapy with TMP-SMX and levofloxacin was effective, supporting the judicious use of fluoroquinolones in resistant cases.

Keywords: Stenotrophomonas maltophilia, Neonatal sepsis, multidrug resistance, trimethoprim-sulfamethoxazole, levofloxacin

Received: 27 Apr 2025; Accepted: 19 Aug 2025.

Copyright: © 2025 Nahari, AlAboud, Mohinuddin, Faden, Balhareth and Alsaleem. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Majed H Nahari, King Abdullah bin Abdulaziz University Hospital (KAAUH), Riyadh, Saudi Arabia

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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