Prevalence of nonfermentative gram-negative bacilli and their antimicrobial susceptibility profiles in a tertiary care hospital of Eastern India

Authors

  • Mandira Sarkar Department of Microbiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  • Jagadananda Jena Department of Microbiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  • Dipti Pattnaik Department of Microbiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
  • Bandana Mallick Department of Microbiology, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20181070

Keywords:

Acinetobacter baumannii, Antibiotic stewardship, Nonfermenters, Nosocomial infection, Pseudomonas aeruginosa

Abstract

Background: Nonfermentative gram-negative bacilli (nonfermenters) have emerged as a major concern for nosocomial infections. They exhibit resistance not only to the beta-lactam and other group of antibiotics but also to carbapenems. This study was undertaken to know the prevalence of nonfermenters from clinical samples along with their antimicrobial susceptibility profile.

Methods: A cross-sectional study over a period of 21 months in the microbiology laboratory of a tertiary care hospital was done. Clinical samples were processed by conventional bacteriological methods for isolation and identification. Susceptibility testing was done by Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute.

Results: 411 nonfermenters (13.18%) were isolated from 3116 culture positive clinical samples. Out of these nonfermenters, most were Acinetobacter baumannii (51.34%) followed by Pseudomonas aeruginosa (42.09%), Burkholderia cepacia complex (4.38%) and others (2.19%). Others included Burkholderia pseudomellei, Acinetobacter lwoffii and Stenotrophomonas maltophilia. Highest sensitivity to gentamicin and amikacin were shown by A. baumannii and P. aeruginosa respectively while both were mostly resistant to ceftriaxone. Burkholderia and Stenotrophomonas species showed 100% sensitivity to cotrimoxazole. A. baumannii was the most prevalent nonfermenter in intensive care units.

Conclusions: Timely identification of nonfermenters and monitoring their susceptibility patterns will help in proper management of infections caused by them. Improved antibiotic stewardship and infection control measures should be implemented to prevent nosocomial infections and spread of drug resistant nonfermenters.

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Author Biography

Dipti Pattnaik, Department of Microbiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India

 

 

References

Winn W Jr, Allen S, Janda W, Koneman E, Prcop G, Schreckenberger P, et al, Koneman’s Atlas and Textbook of Diagnostic Microbiology, 6thed, USA, Lippincott, William’s and Wilkin’s Company, 2006.

Mandell GL, Bennett JE, Dolin RA. Mandell. Douglas, and Bennett's principles and practice of infectious diseases, 7thed, Churchill Livingstone 2010.

Malini A, Deepa EK, Gokul BN, Prasad SR. Nonfermenting gram-negative bacilli infections in a tertiary care hospital in Kolar, Karnataka. J. Lab Physicians. 2009;1(2):62.

Gokale SK, Metgud SC. Characterization and antibiotic sensitivity pattern of nonfermenting gram negative bacilli from various clinical samples in a tertiary care hospital, Belgaum. J Pharm Biomed Sci. 2012;17(17).

Memish ZA, Shibl AM, Kambal AM, Ohaly YA, Ishaq A, Livermore DM. Antimicrobial resistance among non-fermenting Gram-negative bacteria in Saudi Arabia. J Antimicrob Chemother. 2012;67(7):1701-5.

Slama TG. Gram-negative antibiotic resistance: there is a price to pay. Crit. Care. 2008;21;12(4):1.

Meharwal SK, Taneja N, Sharma SK, Sharma M. Complicated nosocomial UTI caused by nonfermenters. Indian J Urol. 2002; 18(2):123.

Hill EB, Henry DA, Speert DP. Pseudomonas. In: Murray PR, Baron EJ, Jorgensen JH, Landry ML, Pfaller MA. Manual of Clinical Microbiology, vol. 1, 9th ed. Washington, D.C: American Society for Microbiology; 2007. p. 734-48.

Wayne PA. Clinical and Laboratory Standards Institute: Performance standards for antimicrobial susceptibility testing: Twenty-fourth informational supplement, M100-S24. Clinical and Laboratory Standards Institute (CLSI). 2014;34(1).

Rit K, Nag F, Raj HJ, Maity PK. Prevalence and Susceptibility Profiles of Non-fermentative Gram-negative Bacilli Infection in a Tertiary Care Hospital of Eastern India. Int J Clin Pract, 2013;24(5):451-5.

Sidhu S, Arora U, Devi P. Prevalence of nonfermentative gram negative bacilli in seriously ill patients with bacteraemia. JK Sci. 2010;12(4):168-71

Benachinmardi KK, Padmavathy M, Malini J, Naveneeth BV. Prevalence of non-fermenting Gram-negative bacilli and their in vitro susceptibility pattern at a tertiary care teaching hospital. ‎J Sci Soc. 2014;41(3):162.

Jayanthi S, Jeya M. Clinical distribution and antibiotic resistance pattern of nonfermenting Gram negative bacilli. Int J Pharm Bio Sci. 2012;3(1):487-94.

Eltahawy AT, Khalaf RM. Antibiotic resistance among gram-negative non-fermentative bacteria at a teaching hospital in Saudi Arabia. J Chemother. 2001 Jan 1;13(3):260-4.

KL S, Rao GG, Kukkamalla AM. Prevalence of non-fermenters in urinary tract infections in a tertiary care hospital. Webmed Central Microbiol. 2011;2(1):WMC001464.

Goel V, Hogade SA, Karadesai SG. Prevalence of extended-spectrum beta-lactamases, AmpC beta-lactamase, and metallo-beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii in an intensive care unit in a tertiary care hospital. J Sci Soc. 2013;40(1):28.

Samanta P, Gautam V, Thapar R, Ray P. Emerging resistance of non-fermenting gram negative bacilli in a tertiary care centre. Indian J Pathol Microbiol. 2011;54(3):666.

Bhargava D, Kar S, Saha M. Prevalence of non-fermentative gram negative bacilli infection in tertiary care hospital in Birgunj, Nepal. Int J Curr Microbiol App Sci. 2015;4(7):301-7.

Upgade A, Prabhu N, Gopi V, Soundararajan N. Current status of antibiotic resistant non-fermentative gram negative bacilli among nosocomial infections. Adv Appl Sci Res. 2012;3(2):738-42.

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Published

2018-03-21

How to Cite

Sarkar, M., Jena, J., Pattnaik, D., & Mallick, B. (2018). Prevalence of nonfermentative gram-negative bacilli and their antimicrobial susceptibility profiles in a tertiary care hospital of Eastern India. International Journal of Advances in Medicine, 5(2), 366–370. https://doi.org/10.18203/2349-3933.ijam20181070

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Original Research Articles