Nonfermenting Gram-Negative Bacilli Infections in a Tertiary Care Hospital in Kolar, Karnataka

Abstract

AIM:Nonfermenting gram-negative bacilli (NFGNB), which are saprophytic in nature, have emerged as important healthcare-associated pathogens. They exhibit resistance not only to beta lactam and the other groups of antibiotics, but also to carbapenems. This study was undertaken to identify the nonfermenters isolated from various clinical samples, to assess their clinical significance, to know the type of healthcare-associated infections they caused, and to know their anti-microbial sensitivity pattern.Materials and Methods:The nonfermenters were identified using a standard protocol that included tests for motility, oxidase production, oxidation-fermentation test for various sugars, gelatin liquefaction, and growth on 10% lactose agar. The clinical significance was assessed by using various criteria and susceptibility testing was performed with the help of the Kirby-Bauer disc diffusion method.Results:A total of 193 NFGNB were isolated from 189 clinical specimens. Pseudomonas aeruginosa was the most common nonfermenter, accounting for 53.8%, followed by Acinetobacter baumannii (22.2%), and Pseudomonas fluorescens (10.8%). Other significant NFGNB isolated were: Sphingobacterium species (5.2%), Acinetobacter lwoffii (3.1%), and Stenotrophomonas maltophilia (2.6%). P. aeruginosa showed good sensitivity to imipenem (94%), cefoperazone (70%), amikacin (69%), and ticarcillin (63%). A. baumannii showed 100% sensitivity to imipenem and 70% sensitivity to piperacillin.Conclusion:P. aeruginosa and A. baumannii were the common NFGNB isolated in our study from patients of, urinary tract infection, bacteremia, surgical site infections, and ventilator associated pneumonia. P. aeruginosa showed good sensitivity to imipenem, amikacin, and cefoperazone while A. baumannii showed good sensitivity to imipenem and piperacillin.

Prevalence and Susceptibility Profiles of Non-Fermentative Gram-Negative Bacilli Infection in Tertiary Care Hospital

“…Similar higher sensitivity to aminoglycosides was reported by Malini et al, (2009) (100%) and Kiran et al, (2013) (93.3%). A sensitivity of 75% to Trimethoprime/ sulphamethaxazole in this study is less as compared a sensitivity of 100% reported by Malini et al, (2009), Kiran et al, (2013 has reported a sensitivity of 86.7% for trimethoprime/ sulphamethaxazole, colistin was 100% sensitive in the present study which is much higher than 56.1% reported by Nicodemo et al, (2004). As for as sensitivity of Sphingomonas paucimobilis 100% to trimethoprime/ sulphamethaxazole, tigecycline, minocycline and meropenem and cefoperazone/ sulbactam is concerned it is difficult to comment on there therapeutic usefulness as studies for Sphingomonas paucimobilis could not be found.…”

“…The various clinical specimens from which NFGNB were isolated are pus (38), urine (21), blood (16), sputum (6), BAL (6), ET secretions (8) and other body fluids (26). The predominant isolate was Pseudomonas species (79), followed by Acinetobacter (27), Burkholderia cepacia complex (7) In recent years isolation of NFGNB has gained importance with increasing reports of these bacteria relating them to hospital outbreaks or health care associated infections (Malini et al, 2009). The most common of these NFGNB are Pseudomonas and Acinetobacter (Ramphal et al, 2008).…”

“Isolation and Characterization of Lactose and Non- Lactose Fermenting Bacteria From Tertiary Care Hospital and Their Antimicrobial Susceptibility Test”

“…Similar trends have also been reported by a study of Eastern India, where 55% patients were males and 45% were females [25]. While study from Rotak has revealed that males and females were equally susceptible to the infection [21].…”

“…In a study from Kolar, Karnataka showed saprophytic nature of non-fermenting Gram-negative bacilli as the potent pathogen that exhibits resistant not only to beta-lactam and other antibiotics but also to carbapenems [21]. The sensitivity test was performed by Kirby-Bauer disc diffusion methods.…”

Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units

“…accounted for about 20%. 14,16,17 Equally, 72.9% of infections with nonfermenter bacilli were reported in Kolar (India).…”