Multidrug-Resistant Stenotrophomonas maltophilia Isolated from a Pregnant Woman with Urinary Tract Infection in Al-Bayda City, Libya: A Case Report

Stenotrophomonas maltophilia is an emerging multidrug-resistant pathogen increasingly associated with urinary tract infections (UTIs). This report the isolation of S. maltophilia from a full-term pregnant woman in Al-Bayda City, Libya, who presented with symptomatic UTI. Antimicrobial susceptibility testing was performed using both broth microdilution and the automated Render MA120 system. The isolate exhibited resistance to multiple antibiotic classes, with statistically significant differences in susceptibility patterns (p < 0.001). Notably, nitrofurantoin and rifampin demonstrated unexpected in vitro activity, suggesting potential therapeutic alternatives. The patient was initially treated empirically with Trimethoprim/Sulfamethoxazole, but her symptoms persisted. Following targeted therapy with Ceftazidime and supportive care, clinical improvement was achieved. This report underscores the importance of early identification, antimicrobial stewardship, and region-specific surveillance in managing resistant infections during pregnancy, while also highlighting the need to balance maternal treatment efficacy with fetal safety.