Spectrum of non-fermenting gram negative bacilli isolated from patients with blood stream infections in a tertiary care hospital in North India

Abstract

Background: Non-fermenting Gram-negative bacilli (NFGNB) are emerging as important causes of blood stream infections (BSI) and they are a major cause of morbidity and mortality worldwide. High intrinsic resistance of NFGNB to antimicrobial compounds makes the treatment of BSIs caused by them difficult and expensive. The aim of this study was to assess frequency and antibiotic susceptibility pattern of non-fermenting gram-negative rods isolated from blood culture of patients. Methods: A total of 3016 blood samples were received in the Department of Microbiology during the study period. All samples were processed according to standard microbiological procedures. Blood culture was done by automated blood culture system, (BacT/Alert) and identification and antibiotic susceptibility of non-fermenting gram negative bacilli was done by VITEK2 Compact System. Results: A total of 120 NFGNB were identified out of which the most common non-fermenters isolated were Acinetobacter sp. (95) followed by Pseudomonas aeruginosa (11), Burkholderia cepacia (09) Sternotrophomonas maltophilia (03) and Sphingomonas sp. (02). Most of the non -fermenters were multi drug resistant showing a high level of antibiotic resistance to most of the first-and second-line drugs. The most effective drugs were colistin and tigecycline. Conclusions: This study underlines the need to identify NFGNB in tertiary care hospitals and to monitor their susceptibility pattern to guide the clinician for better care and management of patients. Improved antibiotic stewardship and strict infection control measures especially hand washing need to be implemented to prevent emergence and spread of multidrug resistant NFGNB in health care settings.

Characterization and Antimicrobial Susceptibility Profile of Non Lactose Fermenting Gram-Negative Bacterial Isolates in a Tertiary Care Teaching Hospital of Central India

“…2, the most common test organism isolated was P. aeruginosa followed by Acinetobacter spp. This finding is as per the similar studies by Upgade et [1,2,5,7,8,12,13,[17][18][19][20][21].…”

“…In the current scenario due to rapidly emerging multiple drug resistance, the polymixins (polymyxin B and colistin) are being used frequently as the last line therapeutic option. However, the clinicians should restrict the use of the reserve drugs in exceptional conditions only [19].…”

Gram negative organisms isolated from Blood Cultures and their Susceptibility Pattern

“…were isolated in 15.9% cases each and only one isolate (2.2%) of Stenotrophomonas maltophila was isolated. These results differ from various Indian studies where Acinetobacter boumannii was the most common organism, followed by Strenotrophomonas maltophilia, and Pseudomonas aeruginosa 21,22 .…”

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

“…The two most frequently encountered organisms, Pseudomonas aeruginosa and Acinetobacter baumanii complex, were also found in other studies. 11,12 Their antibiotic sensitivity was likewise similar, [13][14][15] thus suggesting a universality in our findings. Thus, to avoid increasing multidrug resistance, antibiotics need to be used only when their use is justified.…”