Nonfermenting Gram-negative Bacilli other than Pseudomonas aeruginosa and Acinetobacter Spp. Causing Respiratory Tract Infections in a Tertiary Care Center

Abstract

Background:Nonfermenting gram-negative bacilli have emerged as important healthcare-associated pathogens. It is important to correctly identify all clinically significant nonfermenting gram-negative bacilli considering the intrinsic multidrug resistance exhibited by these bacteria.Materials and Methods:A retrospective study was undertaken to identify the various nonfermenting gram-negative bacilli other than Pseudomonas aeruginosa and Acinetobacter spp. isolated from respiratory samples (n = 9363), to understand their clinical relevance and to analyze their antibiotic susceptibility pattern.Results:Nonfermenting gram-negative bacilli were isolated from 830 (16.4%) samples showing significant growth. Thirty-three (4%) isolates constituted nonfermenting gram-negative bacilli other than P. aeruginosa and Acinetobacter spp. Stenotrophomonas maltophilia (15, 45.5%) was the most common isolate followed by Burkholderia cepacia (4, 12.1%), Sphingomonas paucimobilis (3, 9.1%), and Achromobacter xylosoxidans (3, 9.1%). On the basis of clinicomicrobiological correlation, pathogenicity was observed in 69.7% (n = 23) isolates. Timely and correct treatment resulted in clinical improvement in 87.9% cases.Conclusion:Any nonfermenting gram-negative bacilli isolated from respiratory tract infection should not be ignored as mere contaminant, but correlated clinically for its pathogenic potential and identified using standard methods so as to institute appropriate and timely antibiotic coverage.

Clinical Impact and Emerging Multi Drug Resistance of Acinetobacter Baumannii and Pseudomonas Aeruginosa Isolates

“…This shows similar results with Chawla et al [12] and Bala, et al [3] study. Another finding that was found in study was 60-70% of patients had low hemoglobin, low serum sodium, low albumin and low total protein in biochemical and pathological findings which is similar to Cunha,D.F.…”

“…Chawla, et al [12] study also documented the median of duration of stay in hospital as 9.00 (7.00-18.00). This may be due to empirical treatment given to the patient, or sensitive strain of the organism.…”

<p><em>Raoultella ornithinolytica</em>: Emergence and Resistance</p>

“…Similarly to other members of the Enterobacterales order, such as Aeromonas, Plesiomonas and Leclercia and non-fermenting Gramnegative bacteria, such as Stenotrophomonas maltophilia, Burkholderia cepacia complex and Alcaligenes faecalis, due to the scarcity of reported cases, the associated pathogenicity and antibiotic susceptibility testing remain overlooked. [15][16][17][18] Nonetheless, there is a rapidly emerging role for R. ornithinolytica in human infections, with some multi-drug resistant strains being increasingly reported. 4,11,19 Objective The objective of this paper is to provide a comprehensive review of available current knowledge on the emerging role of R. ornithinolytica in human infections, its virulence and resistance to antibiotic treatment.…”

Resurgence of global opportunistic multidrug-resistant Stenotrophomonas maltophilia

“…However, now, with the advent of commercial systems such as VITEK-2 or API, this has become easier. [ 8 ]…”

“…In India, the distribution of S. maltophilia infections has rarely been described with only few case reports of ocular infections, pyomyositis, respiratory tract infections, meningitis, osteomyelitis, and hemodialysis catheter-related bacteremia, etc. [ 5 6 7 8 9 10 ] Therefore, the aim of this study was to determine the incidence of S. maltophilia infection from various clinical isolates based on their specimen type, antibiotic susceptibility pattern, and impact on patient outcome. Serial levels of serum procalcitonin (PCT) and total leukocyte count (TLC) were also recorded to ascertain correlation of their levels in S. maltophilia isolates and clinical disease.…”