Emergence of Unusual Nonfermenting Gram-Negative Nosocomial Pathogens in a Saudi Hospital

Abstract

This study aimed to determine the frequency of isolation and prevalence of drug resistance in nonfermenting Gram-negative bacilli (NFGNB) other than Pseudomonas aeruginosa and predisposing factors for the acquisition of nosocomial infections caused by these emerging pathogens in a Saudi tertiary care hospital. A total of 125 nonduplicating NFGNB nosocomial strains were isolated, of these, 68 (54.4%) were Acinetobacter baumannii, 26 (20.8%) Stenotrophomonas maltophilia, 14 (11.2%) Alcaligenes faecalis, 12 (9.6%) Chryseobacterium indologenes, and 5 (4%) Ralstonia pickettii. MICs of 11 antibiotics were determined using the reference broth microdilution method. With the exception of colistin that inhibited 100% of A. baumannii isolates, trimethoprim/sulfamethoxazole that inhibited 100% of S. maltophilia isolates, and carbapenems that inhibited 100% of A. faecalis isolates, none of the tested antimicrobial agents inhibited 100% of the other NFGNB spp. Our results emphasize that clinicians and microbiologists should consider A. faecalis, C. indologenes, and R. pickettii as emerging nosocomial pathogens. In addition, local resistance data are essential for helping physicians in deciding an appropriate antibiotic for empirical therapy of infections with these emerging and unusual NFGNB.