MULTIDRUG RESISTANT NONFERMENTING GRAM-NEGATIVE BACILLI OTHER THAN P. AERUGINOSA AND A. BAUMANNII COMPLEX CAUSING INFECTIONS AT A TERTIARY CARE HOSPITAL: A THERAPEUTIC CONCERN

Abstract

Abstract

Introduction

Nonfermenting Gram-negative bacilli (NFGNB) have emerged as important healthcare-associated pathogens particularly due to injudicious empirical use of antibiotics. This study aimed to identify the various unusual multi-drug resistant non fermenters other than Pseudomonas aeruginosa and Acinetobacter species  isolated from the clinical specimens  and to evaluate their antibiotic susceptibility pattern.

Method

This cross-sectional study conducted from January 2021- June 2022 at a tertiary care teaching hospital identified MDR NFGNB from clinical specimens using standard procedures and antibiotic susceptibility was done as per Clinical Laboratory Standards Institute (CLSI) guidelines  [including colistin susceptibility testing by Broth Microdilution (BMD)]

Results

A total 523 unusual  NF-GNB were isolated from 21,019 culture positive clinical samples, of which 185 (35.3%) were MDR. Majority of these unusual NF-GNB isolated were from pus specimen (43.2%) followed by blood (22.7%). Out of 185 non-duplicate MDR non-fermenters, the most common were Acinetobacter lwoffii, Acinetobacter haemolyticus ,Pseudomonas fluorescens , Pseudomonas putida, Pseudomonas stutzeri ,Pseudomonas luteola, Stenotrophomonas maltophilia ,Burkholderia cepacia , Elizabethkingia meningoseptica  , Alcaligenes, Ralstonia pickettii , Sphingomonas , and Chryseobacterium indologenes .

Conclusion

Any NFGNB culture isolate from clinically significant infections should be correlated clinically for its pathogenic potential and identified using standard methods, so as to institute appropriate and timely antibiotic coverage.