Abstract
To study the risk factors and outcome of blood stream infection caused by non-fermenting gram negative bacilli (NFGNB) and their pattern of antibiotic susceptibility and genes. We included sepsis cases with blood culture positive for NFGNB. MIC for colistin was determined by broth microdilution method. Multiplex PCR was used to detect BlaIMP, BlaVIM, BlaKPC, BlaNDM-1 genes in cephalosporin and carbapenems resistant Acinetobacter spp. isolates. Out of 4,664 cases of sepsis, 50 (1.07%) were positive for NFGNB. Acinetobacter spp. 29 (58%) was the predominant isolate, of which 16 (55.17%) isolates were resistant to cephalosporins and carbapenems. We detected BlaKPC and BlaNDM-1 genes in two of these isolates. We did not detect BlaIMP, BlaVIM, BlaKPC and BlaNDM-1 genes in any other NFGNB isolates. Majority of the strains of Pseudomonas spp. showed sensitivity to all the antibiotics tested. NFGNB sepsis patients with respiratory illness correlated well with fatal outcome (p <0.05; OR 21). More numbers of Acinetobacter spp. sepsis cases had fatal outcome (p <0.05; OR 12.83). NFGNB sepsis patients with respiratory illness and those which yielded Acinetobacter spp. correlated positively with fatal outcome. We detected BlaKPC and BlaNDM-1 genes in two strains of drug resistant Acinetobacter spp.
Highlights
Gram negative bacilli which are nonfermenters (NFGNB) are a heterogeneous category of microorganisms which do not have the ability to ferment sugars
Among non-fermenting gram negative bacilli (NFGNB) Burkholderia cepacia, Pseudomonas aeruginosa, Acinetobacter baumanni complex, Alcaligenes faecalis, Sphingomonas paucimobilis and Stenotrophomonas maltophilia are some pathogens known for causing health care associated bloodstream infections[5]
Among NFGNB Burkholderia cepacia, Pseudomonas aeruginosa, Acinetobacter baumannii complex, Alcaligenes faecalis and Sphingomonas paucimobilis are some pathogens known for causing health care associated bloodstream infections[5,6,7]
Summary
Gram negative bacilli which are nonfermenters (NFGNB) are a heterogeneous category of microorganisms which do not have the ability to ferment sugars. They are commonly found on skin of healthcare-workers, instruments such as ventilator machines, humidifiers and mattresses[2,3,4]. Among NFGNB Burkholderia cepacia, Pseudomonas aeruginosa, Acinetobacter baumanni complex, Alcaligenes faecalis, Sphingomonas paucimobilis and Stenotrophomonas maltophilia are some pathogens known for causing health care associated bloodstream infections[5]. Multidrug resistance (MDR) property of NFGNB is the reason that facilitated the way for the reconsideration of previously used antibiotic colistin into clinical use. For the treatment of infections caused by multi-drug resistant gramnegative bacilli (MDRGNB), colistin may have crucial and reliable role as potent antibiotic.[6,7] The clinical use of colistin was restricted because of reports of serious nephrotoxicity and discovery of less toxic antibiotics[6,7]. We determine MIC of Colistin and detect BlaIMP, BlaVIM, BlaKPC, BlaNDM-1 genes in cephalosporin and carbapenems resistant Acinetobacter spp. isolates
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call