Prevalence and Antibiogram of Non-Fermenting Gram Negative Bacilli in Hospital Acquired Infections with Multidrug Resistance Burden and Extended Spectrum Beta Lactamase Detection
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 7
Abstract
Non-fermenting Gram negative bacilli (NFGNB) are taxonomically diverse group of pathogens that has emerged as a major cause of hospital acquired infections especially in immunocompromised hosts. Inappropriate antimicrobial therapy used to treat infections caused by these organisms, especially the multidrug resistant and ESBL-producing strains, often results in failure of clinical treatment. Therefore, timely detection of such infections can lead to a better selection of antibiotics and help to improve the outcome of such infections. The study aimed to determine the prevalence and antibiogram of non-fermenting Gram negative bacilli in hospital acquired infections (HAI) along with determination of multidrug resistance and extended spectrum beta lactamase (ESBL) enzymes amongst the same. The study was conducted in the department of Microbiology over a period of one year from January 2014 to December 2014. The various clinical specimens were collected from patients suspected to be suffering from HAI. These were cultured on blood agar and MacConkey agar. The growth was identified on the basis of colony morphology, Gram’s stain and various biochemical reactions. The antibiotic susceptibility was tested on Mueller Hinton agar using antibiotics from different classes which included beta lactams, aminoglycosides, macrolides and fluoroquinolones. Multidrug resistance was defined as resistance of the isolate to three or more classes of antibiotics. Extended spectrum beta lactamase detection was done by the combined disc diffusion method. A total of 180 isolates of various organisms were isolated from different clinical samples. Out of these, 47 (26.11%) isolates were identified NFGNB. Among these 47 isolates, Pseudomonas aeruginosa accounted for 78.72% (37) and Acinetobacter for 21.28% (10). Antibiogram of P. aeruginosa showed maximum sensitivity towards Imipenem i.e. 64.86% while least towards Aztreonam (16.22%). In case of Acinetobacter also, sensitivity was maximum towards Imipenem (80%) and 0% towards cephalosporins, Ampicillin/Sulbactam and Ticarcillin/Clavulanic acid. ESBL production was found to be present in 37.84% isolates of P. aeruginosa and 20% of Acinetobacter while 40.54% and 30% strains of P. aeruginosa and Acinetobacter respectively were found to be multidrug resistant. Isolation of NFGNB and their antibiotic susceptibility pattern should be regarded with all seriousness in clinical practice and epidemiology because they are emerging nosocomial pathogens and by being resistant to multiple antibiotics, their prevalence not only limits the treatment options but also acts as a reservoir of drug resistant genes.
Authors and Affiliations
Tarana Sarwat, Shaheen Bhat, Vichal Rastogi, Yogesh Chander
Keywords
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