NOSOCOMIAL INFECTION BY NON-FERMENTING GRAM NEGATIVE BACILLI IN TERTIARY CARE HOSPITAL: SCREENING AND CURE
Keywords:
Nosocomial infection, Gram-negative Bacteria, Vitek-2, Drug ResistanceAbstract
Objective: The purpose of the present study was to identify the Non-Fermenting Gram Negative Bacteria from the tertiary care hospital.
Methods: The conventional method was used i.e. Antibiotic susceptibility test which was performed by Kirby–Bauer disc diffusion method and analysis of microbes was done by Vitek-2.
Results: 172 samples were identified as Non-Fermenting Gram-Negative Bacilli from 1526 respiratory samples. Acinetobacter baumanii was the predominant isolate accounting 103 (59.88%) specimens followed by Pseudomonas aeruginosa 33.13%. Other isolates were Stenotrophomonas maltophilia 5.23% and Burkholderi acepacia1.74%. From the 172 samples, Endotracheal Aspirate was found to be the most infected amongst all the other samples. Acinetobacter baumanii and Pseudomonas aeruginosa were the most common NFGNB isolated in our study from patients of Respiratory Tract Infections.
Conclusion: Both Acinetobacter baumanii and Pseudomonas aeruginosa showed good sensitivity to colistin, amikacin, cefoperazone while in most cases carbapenam is found to be highly resistant. Colistin along with amikacin and cefoperazone should be used against this pathogen for treatment.
Keywords: Nosocomial infection, Gram negative bacilli, Tertiary care hospital, Lower respiratory tract infection, Non-fermenting bacilli
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Mishra SK, Kattel HP, Acharya J, Shah NP, Shah AS, Sherch JB, Rijal BP, et al. Recent trend of bacterial aetiology of lower respiratory tract infections in a tertiary care center of Nepal. Int J Infection Microbiol 2012;1:3-82.
Panda S, Premanadini B, Ramani TV. Lower respiratory tract infection–bacteriological profile and anti-biogram pattern. Int J Curr Res Rev 2012;4:149-55.
Srivastav P, Kumar P, Nirwan PS, Sharma M. Bacteriological profile and antibiogram pattern of lower respiratory tract infections in a tertiary care hospital in Northern, India. Int J Pharm Res Bio-Sci 2013;2:225-33.
Goel N, Chaudhary U, Aggarwal R, Bala K. Antibiotic sensitivity pattern of gram-negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit. Indian Soc Critical Care Med 2009;13:148–515.
Olugbue V, Onuoha S. Prevalence and antibiotic sensitivity of bacterial agents involved in lower respiratory tract infections. Int J Biol Chem Sci 2011;5:774-81.
Fiorillo L, Zucker M, Sawyer D, Lin AN. The pseudomonas hot-foot syndrome. N Engl J Med 2001;345:335–8.
Blanc DS, Nahimana I, Petignat C. Faucets as a reservoir of endemic Pseudomonas aeruginosa colonization/infections in intensive care units. Intensive Care Med 2004;30:1964–8.
Thuong M, Arvaniti K, Ruimy R. Epidemiology of Pseudomonas aeruginosa and risk factors for carriage acquisition in an intensive care unit. J Hospital Infection 2003;53:274–82.
Crespo MP, Woodford N, Sinclair A. Outbreak of carbapenem-resistant Pseudomonas aeruginosin producing VIM-8, a novel metallo-beta-lactamase, in a tertiary care center in Cali, Colombia. J Clin Microbiol 2004;42:5094–101.
Jacoby GA. Amp C β-Lactamases. Clin Microbiol Rev 2009;22:161-82.
Venezia SN, Ben-Ami R, Carmeli Y. Update on Pseudomonas aeruginosa and Acinetobacter baumannii infections in the healthcare setting. Curr Opin Infect Dis 2005;18:306-13.
Cappuccino JG, Sherman N. Techniques for isolation of pure culture. In: Microbiology: a laboratory manual. (VI Ed.) Pearson Education, Inc. Singapore. Collee, JG, Duguid JP, Frasee AG, Marmion BP. Publishers by Pearson Education (Singapore) Pte. Ltd.; 2002. p. 63-6, 149-85, 428-31.
Murray PR. Editor-in-chief. Manual of clinical microbiology. 7th. ed. Washington, D.C.: ASM Press; 1999.
Kalidas RIT, Falguni N, Hirak JR, Maity PK. Prevalence and susceptibility profiles of nonfermenting gram-negative bacilli infection in a tertiary care hospital of eastern India. Indian J Clin Practice 2013;24:4305-91.
Kaur A, Gupta V, Chhina D. Prevalence of metallo-ß-lactamase-producing (MBL) acinetobacter species in a tertiary care hospital. Iran J Microbiol 2014;6:22-5.
Malini A, Deepa EK, Gokul BN, Prasad SR. Non-fermenting gram-negative bacilli infections in a tertiary care hospital in Kolar, Karnataka. J Lab Physicians 2009;1:62-6.
Patel PH, Pethani JD, Rathod SD, Chauhan B, Shah PD. Prevalence of non-fermenting gram-negative bacilli infection in tertiary care hospital in ahmedabad, gujarat. Indian J Basic Appl Med Res 2013;2:608–13.
Gagneja D, Goel N, Aggarwal R, Chaudhary U. Changing trend of antimicrobial resistance among gram-negative bacilli isolated from lower respiratory tract ICU patients: A 5-year study. Indian J Crit Care Med 2011;3:164-7.
Bertrand X. Endemic city, molecular diversity and colonisation routes of Pseudomonas aeruginosa in intensive care units. Intensive Care Med 2001;27:1263-8.
Gardam MA. Is surveillance for multidrug-resistant Enterobacteriaceae an effective infection control strategy in the absence of an outbreak? J Infect Dis 2002;186:1754-60.
Harris AD, McGregor JC, Furuno JP. What infection control interventions should be undertaken to control multidrug-resistant Gram-negative bacteria? Clin Infect Dis 2006;43:57-61.
Harris AD. Patient-to-patient transmission is important in extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae acquisition. Clin Infect Dis 2007;45:1347-50.
Johnson JK. The role of patient-to-patient transmission in the acquisition of imipenem-resistant Pseudomonas aeruginosa colonization in the intensive care unit. J Infect Dis 2009;200:900-5.
Michelin A, Henderson DK. Infection controls guidelines for prevention of health care-associated transmission of hepatitis B and C viruses. Clin Liver Dis 2010;14:119-36.
Olson B, Weinstein RA, Nathan C, Chamberlin W, Kabins SA. Epidemiology of endemic Pseudomonas aeruginosa: why infection control efforts have failed. J Infect Dis 1984;150:808-16.
Ortega B, Groeneveld AB, Schultsz C. Endemic multidrug-resistant Pseudomonas aeruginosa in critically ill patients. Infect Control Hospital Epidemiol 2004;25:825-31.
Paramasivan CN, Sivadasan K, Datta M, Vallishayee RS, Prabhakar R. Non-fermenting gram-negative bacilli associated with acute respiratory infections in children in madras. Oxford University Press 1987;33:343-5.
Juyal D, Prakash R, Shanakarayan, Sharma M, Negi V, Sharma N. Prevalence of non-fermenting gram-negative bacilli and their in-vitro susceptibility pattern in a tertiary care hospital of Uttarakhand: a study from foothills of Himalayas. Saudi J Microbiol 2013;2:108-12.
Harris AD. How important is patient-to-patient transmission in extended-spectrum beta-lactamase Escherichia coli acquisition? Am J Infect Control 2007;35:97-101.
Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multidrug-resistant Gram-negative bacilli. Antimicrob Agents Chemother 2008;52:813-21.
Nicasio AM, Kuti JL, Nicolau DP. The current state of multidrug-resistant Gram-negative bacilli in North America. Pharmacotherapy 2008;28:235-49.
Lautenbach E, Patel JB, Bilker WB, Edelstein PH, Fishman NO. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for infection and impact of resistance on outcomes. Clin Infect Dis 2001;32:1162-71.