Prevalence and antibiogram of non-fermenting Gram-negative bacilli in blood stream infections: Study in a tertiary care centre, Western Uttar Pradesh, India

Sarwat, Tarana; Yousuf, Mariyah; Khan, Ambreen Shafaat; Kakru, Dalip K; Dutta, Renu

doi:10.1177/0049475520979298

Cited by 3 publications

(9 citation statements)

References 10 publications

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“…Varied isolation rates were recorded in different studies. The results of our study were parallel with those conducted by Nazir et al, Sarwat et al, Juyal et al, Grewal et al, Manjunath et al, and Chang and Huang, who have reported a positivity rate of 9.3%, 11.2%, 11.6%, 16.9%, 28.3%, and 31.62%, respectively, in their studies [ 1 , 4 , 7 , 8 - 10 ]. Malini et al, in their study, reported a 4.5% isolation rate [ 11 ].…”

Section: Discussionsupporting

confidence: 91%

“…The correct and rapid identification of such bacteria in a clinical microbiology lab, along with antimicrobial susceptibility testing, is an essential step toward the effective treatment of septicemic patients. BSIs caused by NFGNB pose a challenge for clinicians and microbiologists because the laboratories have limited facilities for their identification and emerging antimicrobial resistance [ 4 ]. An increase in resistance to antimicrobials is common among NFGNB; few strains are resistant to commonly used antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“…They invade and colonize the sterile site, which leads to the disruption of natural barriers. These organisms contribute to about 15% of all bacterial isolates in a clinical microbiology laboratory [ 4 ]. Data obtained from the Surveillance and Control of Pathogens of Epidemiological Importance (SCOPE) study revealed that approximately one-fourth of Gram-negative bacteremias were attributed to NFGNB [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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The Role of Automation for Early Diagnosis of Non-fermenter Superbugs in Critically Ill Septicemic Hospitalized Patients

Agarwal¹,

Agrawal²,

Begum³

et al. 2023

Cureus

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Introduction Non-fermenting Gram-negative bacilli (NFGNB) are emerging superbugs of bloodstream infections (BSI), causing increased mortality in hospitalized patients. NFGNB are challenging to identify using conventional identification techniques. Hence, automation is beneficial for accurate and fast diagnosis; it also facilitates rapid treatment and recovery of patients. This study aims to isolate/identify NFGNB from BSI and determine its antimicrobial susceptibility pattern. Material and methods This study was conducted in the Department of Microbiology, LLRMMC, Meerut, for a period of six months (June to November 2022). The samples were processed using automated blood culture (BD BACTEC) and an identification/sensitivity testing system (BD Phoenix). Results Out of 1340 blood cultures, 347 (25.7%) were flagged positive for microbial growth. A total of 103 (7.6%) NFGNB were isolated, showing their strong association with BSI. The NFGNB isolates were Pseudomonas species 23 (22.3%), Acinetobacter baumannii 19 (18.4%), Salmonella spp. 19 (18.4%), Sphingomonas paucimobilis 17 (16.5%), Aeromonas hydrophila 5 (4.8%), Rhizobium radiobacter sp. 4 (3.8%), Stenotrophomonas maltophila 3 (2.9%), Burkholderia cepacian 3 (2.9%), Proteus mirabilis 2 (1.9%), Achromobacter xylosoxidans 2 (1.9%), Elizabethkingia meningoseptica 2 (1.9%), Ochromobacter anthropic 2 (1.9%), Cuprivadus pauculus 1 (0.9%), and Ralstonia mannitolilytica 1 (0.9%). Conclusions Automation helps in the prompt reporting of NFGNB and their antibiogram pattern by microbiology laboratories, facilitating the early and accurate management of patients with BSI.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Role of Automation for Early Diagnosis of Non-fermenter Superbugs in Critically Ill Septicemic Hospitalized Patients

Agarwal¹,

Agrawal²,

Begum³

et al. 2023

Cureus

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“…Blood and LRT specimens had comparable frequencies of NFGNB (4). An Indian teaching hospital reported 10% of clinical isolates to be NFGNB, while in another report, 16.9% of all pathogens from BSIs were NFGNB [17 ▪ ,18]. In a Chinese multicentre laboratory-based study of paediatric blood stream pathogens, P. aeruginosa and S. maltophilia were positioned among the top 10 pathogens, 6th and 8th, respectively [19].…”

Section: Text Of Reviewmentioning

confidence: 98%

“…It is noteworthy that Elizabethkingia spp. and S. maltophilia , due to the intrinsic resistance, are associated with infections after prolonged carbapenem therapy [18,49 ▪▪ ].…”

Section: Text Of Reviewmentioning

confidence: 99%

Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains

Koulenti,

Vandana,

Rello

2023

Current Opinion in Infectious Diseases

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Purpose of review This article aims to review the epidemiology of nonfermenting Gram-negative bacilli (NFGNB) based on recent literature reports, particularly, of the less common, but with emerging clinical significance species. Recent findings The reported frequency of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa is increasing, with very significant variability, however, between different countries. Apart from the major NFGNB, that is, A. baumannii and P. aeruginosa, already recognized as of critical importance healthcare risks, several other NFGNB genera have been increasingly associated with diverse severe infections, such as Stenotrophomonas maltophilia, Burkholderia spp., Elizabethkingia spp., Chryseobacterium spp., Achromobacter spp., Alcaligenes spp., Sphingomonas spp., Shewanella spp. and Ralstonia spp., among others. Summary The exploration of the epidemiology, as well as the pathogenic potential of the of the less frequent, but emerging and increasingly reported NFGNB, is crucial, not only for immunocompromised patients, but also for critically ill patients without overt immunosuppression. As we are heading fast towards a postantibiotic era, such information would contribute to the optimal antimicrobial management, that is, providing prompt, appropriate antimicrobial coverage when needed and, at the same time, avoiding overuse and/or inappropriate use of antimicrobial therapy. Also, it would help to better understand their transmission dynamics and to develop effective prevention strategies.

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Microbiological Characterization and Clinical Facets of Elizabethkingia Bloodstream Infections in a Tertiary Care Hospital of Eastern India

Sarathi¹,

Behera²,

Mahapatra³

et al. 2023

IDR

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Purpose Elizabethkingia is an emerging non-fermenting Gram-negative bacillus (NFGNB) causing bloodstream infections (BSI) associated with high mortality. It demonstrates a unique antimicrobial profile in showing susceptibility to antimicrobials effective against Gram-positive bacteria. This study was undertaken to determine the overall frequency of Elizabethkingia BSI, associated risk factors, microbiological susceptibility, and clonal relationship of Elizabethkingia isolates using Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR). Patients and Methods Elizabethkingia isolates obtained from the blood culture of admitted patients (August 2020–December 2021) were identified by the VITEK 2 system and subjected to an antimicrobial susceptibility test by standard procedures. Demographics, co-morbidities, risk factors for survival, and outcome were summarized and analyzed by Chi-square test, Kaplan–Meier curve, and Cox regression. Clonal relatedness between Elizabethkingia isolates was analyzed using ERIC‑PCR fingerprinting with the “PAST: Paleontological statistics software package”. Results Of 13,747 blood samples received during the study period, 13.59% were culture positive, and 14.60% were NFGNBs. The frequency of Elizabethkingia spp. among all NFGNBs in BSI was 29.30%, and the overall prevalence in BSI was 4.21%. In patients with Elizabethkingia BSI, Foley’s catheter was present in 81.25% of the cases. 100% susceptibility was observed to linezolid, followed by vancomycin (98.75%) and chloramphenicol (89.5%). The 30-day mortality rate in the patients of Elizabethkingia BSI was 26.25%. The Presence of COVID-19, pneumonia, diabetes mellitus (DM), mechanical ventilation (MV), and prior antibiotics were significantly different (p<0.05) between the survival and death groups. ERIC-PCR profile dendrogram of Elizabethkingia isolates showed ten major clusters indicating high genetic diversity. Conclusion Elizabethkingia was responsible for one-third of NFGNB BSI in a single-center study, with approximately 26% of 30-day all-cause mortality. Most isolates were susceptible to linezolid, vancomycin, and chloramphenicol. COVID-19 was the most significant risk factor associated with mortality. ERIC-PCR of Elizabethkingia isolates exhibited high genetic diversity.

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Prevalence and antibiogram of non-fermenting Gram-negative bacilli in blood stream infections: Study in a tertiary care centre, Western Uttar Pradesh, India

Cited by 3 publications

References 10 publications

The Role of Automation for Early Diagnosis of Non-fermenter Superbugs in Critically Ill Septicemic Hospitalized Patients

The Role of Automation for Early Diagnosis of Non-fermenter Superbugs in Critically Ill Septicemic Hospitalized Patients

Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains

Microbiological Characterization and Clinical Facets of Elizabethkingia Bloodstream Infections in a Tertiary Care Hospital of Eastern India

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