Non-fermenting Gram Research Articles

Bloodstream infections in a Brazilian Pediatric Tertiary Oncology Hospital: 30-month analysis regarding the classification of the infection, distribution of microorganisms and their resistance profile

Abstract Background Infections are a major cause of morbidity and mortality in pediatric oncology patients during their treatment. Bloodstream infections are the main site of infection in these patients. Bacteremia in these patients can be secondary to a primary infectious focus, result from central line associated bloodstream infections (CLABSIs) or mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI). Methods Descriptive study of bloodstream infections in pediatric patients undergoing oncological treatment and hematopoietic stem cell transplantation in a tertiary pediatric oncology hospital in Brazil from January 1st, 2021 to June 30th, 2023. Infections were classified according to the Centers for Disease Control and Prevention/ National Healthcare Safety Network (CDC/NHSN) criteria into CLABSIs, MBI-LCBIs and secondary bloodstream infections. Among the bloodstream infections that met CDC/NHSN criteria for CLABSI, were analyzed separately those who also met the criteria of catheter-related bloodstream infection (CRBSI) according to Infectious Diseases Society of America (IDSA). Results During this period were diagnosed 335 episodes of bloodstream infection (123 episodes in 2021, 150 in 2022 and 62 episodes in the first 6 months of 2023). There were 378 microorganisms isolated. These infections were classified into: 35% CLABSIs, 27% MBI-LCBIs, 23% CRBSIs, and 15% secondary bloodstream infections. Among the CLABSIs, the most common microorganisms were non-fermenting gram negative bacilli (NFGNB) 38%, enterobacteriaceae 35% and coagulase-negative staphylococcus (CoNS) 11%. Between CRBSIs, there were 31% enterobacteriaceae, 22% CoNS and 19% NFGNB. Among the MBI-LCBIs there were 66% enterobacteriaceae and 23% group viridans streptococci (VGS). Streptococcus pneumoniae (33%) was the most common microorganism in secondary infections followed by Staphylococcus aureus (17%). Assessing all infections together, the main enterobacteriaceae were Klebsiella spp. (40%) and only 50% of them were sensitive to cefepime while 10% were carbapenems resistant. Among NFGNB, 13% of Pseudomonas spp. and 5% of Acinetobacter spp. were carbapenems resistant. Between the gram-positive bacteria, 77% of the S. aureus were methicillin sensitive, the same percentage of the VGS were sensitive to cefepime. Conclusion Among bloodstream infections, there were a predominance of CLABSI followed by MBI-LCBIs. Antimicrobial resistance between gram-positive bacteria, is of little concern in our institution. In the case of gram-negative bacteria, resistance to cefepime is becoming worrying among enterobacteriaceae.

Respiratory tract infections: an update on the complexity of bacterial diversity, therapeutic interventions and breakthroughs.

Respiratory tract infections (RTIs) have a significant impact on global health, especially among children and the elderly. The key bacterial pathogens Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Staphylococcus aureus and non-fermenting Gram Negative bacteria such as Acinetobacter baumannii and Pseudomonas aeruginosa are most commonly associated with RTIs. These bacterial pathogens have evolved a diverse array of resistance mechanisms through horizontal gene transfer, often mediated by mobile genetic elements and environmental acquisition. Treatment failures are primarily due to antimicrobial resistance and inadequate bacterial engagement, which necessitates the development of alternative treatment strategies. To overcome this, our review mainly focuses on different virulence mechanisms and their resulting pathogenicity, highlighting different therapeutic interventions to combat resistance. To prevent the antimicrobial resistance crisis, we also focused on leveraging the application of artificial intelligence and machine learning to manage RTIs. Integrative approaches combining mechanistic insights are crucial for addressing the global challenge of antimicrobial resistance in respiratory infections.

Prevalence of bacterial isolates and change in their antibiotic susceptibility patterns in urinary tract infections- A five year retrospective study

Urinary Tract Infection (UTI) continues to be one of the commonly occurring infections in medical practice despite the widespread availability of antibiotics. Presence of risk factors like elderly age, diabetes, immune-suppression, and other comorbidity pose a challenge in its treatment. Over the years, the etiology and antibiotic resistance of the uropathogens has been inconsistent. Therefore, it is important to determine the causative agents of UTI and their resistance patterns locally, in each region, so that appropriate empiric therapy can be started before the culture and antibiotic sensitivity results are available. This study aims to highlight the prevalence of uropathogens and determine the antibiotic sensitivity pattern over the period of five years.The urine samples from patients with suspected urinary tract infections (UTI) received in the laboratory at Nanavati Max Super speciality hospital were processed by standard protocol from January 2018 to December 2022. Antibiotic susceptibility test for the bacterial isolates was carried out by the VITEK2 automated system and interpreted as per CLSI guidelines. The data collected over the study period of five years was interpreted by using the WHO Net Antibiotic Susceptibility Surveillance Software in February 2023. From a total of 8068 urine samples received over five years, uropathogens were isolated in 4209 (52.16%) samples. E.coli was the most common isolate causing UTI, with prevalence of 380(46.7%) in 2018 and 480(50.6%) in 2022 of total samples. Amongst gram positive organisms, a rise in Enterococcus species was seen from 41(5%) in 2018 to 87(9%) in 2022, with significantly fewer Staphylococcus species isolated, from 32(4%) in 2018 to 7(0.7%) in 2022. The Enterobacteriaceae showed high sensitivity to Amikacin, Tigecycline and Meropenem all throughout the study. However, rise in resistance to Nitrofurantoin and Fosfomycin, antibiotics commonly used for UTIs, was observed. Also the prevalence of Extended Spectrum of Beta lactamase (ESBL) producers decreased from 213(36%) to 127(17%) with a rise in Carbapenemase producing Enterobacteriaceae from 48(8%) to 298(40%) over the five years study period.Amongst Lactose Nonfermenting gram negative bacilli only 32 % were sensitive to Carbapenems and 37% sensitive to Aminoglycosides.By 2022, Enterococcus species showed an increase in sensitivity to Nitrofurantoin (27%), High level Aminoglycosides (37%), Fluoroquinolones (25%) and Ampicillin (37%).The change in antibiotic sensitivity patterns over time and rise in resistance to antibiotics commonly used in empirical treatment of UTIs warrants the need for regular surveillance, so the physicians can be updated regarding the most prevalent organism and its susceptibility and the empirical treatment for UTIs can be modified accordingly. This can help curb indiscriminate use of antibiotics and development of antibiotic resistance.

Efficacy of Colistin with Carbapenems Combination by Checkerboard Assay against Carbapenem Resistant Non Lactose Fermenting Gram Negative Bacteria

Recent emergence of carbapenem resistant non-fermenting Gram negative bacteria (CRNFGNB) predominantly Pseudomonas and Acinetobacter species are responsible for significant proportion of nosocomial infections with increased mortality. Of the various mechanisms known, carbapenemases especially metallo beta lactamase (MBL) mediated resistance is the most concerning because of its easy transmissibility via mobile genetic elements and lack of MBL inhibitors for clinical use. In the present study we determined to estimate the prevalence of carbapenem resistant Pseudomonas and Acinetobacter species, their resistance mechanisms by phenotypic tests and synergistic studies with Colistin and carbapenems combination by checkerboard assay. Carbapenem resistance among these two bacteria is 53.2% being isolated predominantly from pus and endotracheal secretions and from patients within the age group of less than 9 years (44%) and more than 60 years (23%). The incidence of carbapenemase and MBL production in NFGNB is 89.8% and 87.9%, respectively. Only Colistin and Tigecycline show significant antibacterial activity while most of the tested antibiotics were found to be least effective against carbapenem resistant NFGNB. Colistin and Imipenem combination demonstrated synergistic activity in majority of the NFGNB species; however, translation of such in vitro efficacy models into highly variable in vivo conditions could be possible only with strong clinical support.

Trends in Antimicrobial Resistance in a Tertiary Care Hospital of Assam, India

Antimicrobial resistance (AMR) in bacterial pathogens has emerged as a challenge in health care settings resulting in high rates of morbidity and mortality. The aim of the present study was to describe the trends and burden of AMR in a tertiary care hospital. A retrospective observational study was undertaken from October 2018 to March 2021 in a clinical microbiology laboratory where local priority pathogens and their antimicrobial resistance patterns were analyzed. Organism identification and antimicrobial susceptibility testing were performed as per Clinical and Laboratory Standards Institute guidelines. Out of 9948 isolates, Enterobacteriaceae (58%) were mostly isolated followed by Staphylococci (18.6%), Non-fermenting gram negative bacilli (NFGNB) (13.7%), and Enterococci (8.4%) respectively. Highest isolation was from inpatient department (61.3%); 31.5% from outpatient, and 7.2 % from intensive care units. Klebsiella pneumoniae (26.9%) was most isolated organism, mostly from respiratory samples; Escherichia coli was isolated mostly from urine (40.7%). Almost half of the Enterobacteriaceae isolates were extended spectrum beta-lactamase producers while >50% of Enterobacteriaceae and NFGNB isolates were resistant to one or more Carbapenems. Frequency of Methicillin resistant Staphylococcus aureus was 44.7% , Vancomycin resistant Enterococci was 1.2%. A rising trend of resistance to cephalosporins and carbapenems along with fluoroquinolones was observed. Our study has witnessed a high prevalence of Gram negative pathogens with increasing resistance to commonly applied antimicrobials during the surveillance period which can act as a guiding tool in devising local antimicrobial priorities, antibiotic policy, and proper antimicrobial prescribing practices.

Evaluation of antibiotic susceptibility rates of non-fermentative Gram negative bacteria

Evaluation of antibiotic susceptibility rates of non-fermentative Gram negative bacteria

Neonatal Sepsis; Incidence and Microbiological Profile along with Antibiotic Sensitivity of Causative Microorganisms

Objective: To find the incidence of neonatal sepsis, microorganisms involved and their antibiotic sensitivityamong neonates admitted with neonatal sepsis during the study period.Study Design: Prospective observational study.Place and Duration of Study: The study was carried out at neonatal intensive care unit (NICU) of combinedmilitary Hospital (CMH), Kharian, Pakistan from January 2019 to December 2020.Materials and Methods: After getting permission from Ethical Review Board of hospital, all the neonates whowere admitted in neonatal intensive care unit (NICU) of hospital with neonatal sepsis were included in subjectstudy. All the neonates with fever, irritability, difficulty in feeding, respiratory distress, fits, bulging fontanels,jaundice, bleeding etc. were suspected as case of "Neonatal sepsis". Venous blood sample of neonates wasdrawn under aseptic technique and collected in sterile BacT/ALERT (PF) blood collecting culture bottles andsent to laboratory immediately for culture, sensitivity procedure and reporting.Results: A total of 4892 neonates were admitted in neonatal intensive care unit from January 2019 toDecember 2020. Out of these, 342 neonates were clinically diagnosed as cases of neonatal sepsis. Incidence ofneonatal sepsis was 6.99%, comprising 185 males (54.1%) and 157 females (45.9%). The age range was from 2days to 88 days with a mean age 35.47+23.40 days. Staphylococcus aureus was found to be the most commonlyinfectious microorganism (33.9%) followed by Candida species (18.5%), Klebsiella pneumoniae (14.5%) andCoagulase negative Staphylococci (12.3%). Non-fermenting Gram negative bacteria were found to be infecting26 (11.5%) out of the total positive cases (Acinetobacter baumannii complex 8.4%, Stenotrophomonasmaltophilia 3.1% and Pseudomonas aeruginosa 2.6%).Conclusion: Staphylococcus aureus was the most prevalent organism found to be responsible for neonatalsepsis with majority being resistant to Methicillin. Methicillin-resistant Staphylococcus aureus (MRSA) is a100% percent sensitive to vancomycin and Teicoplanin. On the other hand, Gram Negative organisms haveshown promising sensitivity to Colistin.

Genotypic characterization and clonal relatednessof metallo-β-lactamase-producingnon-fermentative gram negative bacteria in the first 5years of their circulation in Paraguay(2011-2015).

Pseudomonas aeruginosa and species of Acinetobacter calcoaceticus-baumanii complex are multiresistant intrahospital opportunistic pathogens, able to acquire carbapenemases and produce outbreaks with high morbidity and mortality. Pseudomonas putida has also emerged with similar characteristics. The aim of this research was to characterize the Metallo-β-lactamases (MBLs) detected by surveillance in Paraguay in the first 5years of their circulation in hospitals. The coexistence of KPC and OXA-type carbapenemases was also investigated. 70 MBL-producing strains from inpatients were detected from clinical samples and rectal swab from 11 hospitals. The strains were identified by manual, automated, and molecular methods. Antimicrobial susceptibility was studied by Kirby-Bauer and automated methods, while colistin susceptibility was determined by broth macrodilution. MBLs were investigated by synergy with EDTA against carbapenems and PCR, and their variants by sequencing. KPC and OXA-carbapenemases were investigated by PCR. Clonality was studied by pulsed-field gel electrophoresis (PFGE). The results demonstrated the circulation of blaVIM-2 (60%), blaNDM-1 (36%), and blaIMP-18 (4%). The MBL-producing species were P. putida (45.7%), P. aeruginosa (17.2%), A. baumannii (24.3%), A. pittii (5.7%), A. nosocomialis, (4.3%) A. haemolyticus (1.4%), and A. bereziniae (1.4%). PFGE analysis showed one dominant clone for A. baumannii, a predominant clone for half of the strains of P. aeruginosa, and a polyclonal spread for P. putida. In the first 5years of circulation in Paraguay, MBLs were disseminated as unique variants per genotype, appeared only in Pseudomonas spp. and Acinetobacter spp., probably through horizontal transmission between species and vertical by some successful clones.

DETECTION OF METALLO-BETA-LACTAMASE PRODUCING PSEUDOMONAS AND ACINETOBACTER SPECIES FROM DIFFERENT CLINICAL SPECIMENS IN A TERTIARY CARE HOSPITAL AT PUDUCHERRY.

Introduction Pseudomonas and Acinetobacter species are frequently isolated non-fermenting gram negative bacteria in a variety of hospital acquired infections. Metallo-beta-lactamases have become a serious threat in treating infections because of their multiple drug resistance including carbapenems. To determine Objectives the prevalence of MBL production among Pseudomonas and Acinetobacter species and to evaluate the different phenotypic MBL detection methods. A total of 104 isolates of carbapenem resistant Pseudomonas (78) and Materials and methods Acinetobacter (26) from different clinical specimens were tested for MBL production by Modied Hodge Test, Combined Disk Test and Double Disk Synergy Test. Antibiotic susceptibility was performed by Kirby- Bauer Disk Diffusion method. Results Pseudomonas aeruginosa (11.29%) Acinetobacterbaumanii (11.53%) were the predominant MBL producers. MBL production was detected 61.53%, 84.61% and 38.46 % by DDST( Doule disc synergy test), CDT (Combined disc test), and MHT (Modied Hodge test) respectively. Colistin and Polymyxin B are the only option available for treating such infections. MBL Conclusion production among Pseudomonas and Acinetobacter species are increasing due to the continuous use of carbapenems and selective antibiotic pressure. Strict antibiotic policy and infection control practices help prevent the further spread.

Epidemiology of Multidrug Resistant Non-Fermentative Gram Negative Bacilli in Patients with Hospital Acquired Pneumonia: An Alarming Report from Somalia.

There is a lack of data concerning hospital-acquired pneumonia (HAP) due to multidrug resistant non-fermentative gram-negative bacilli (MDR-NFGNB) in Somalia, and this study will aim to analyze the epidemiology of MDR-NFGNB among HAP patients in tertiary care hospital in Somalia. This is a retrospective study which evaluated the presence of MDR-NFGNB among 2003 HAP patients between June 2017 and May 2022 in a tertiary care hospital in Somalia. NFGNB were cultured on blood agar and eosin methylene blue agar and were then used BBL crystal system andoxidase biochemical assays for identification. Antimicrobial sensitivity and resistance were assessed using Mueller-Hinton agar. A total of 160 confirmed cases of HAP due to NFGNB were examined. Among these, 114 (71%) were males compared to females (n = 46, 29%). The mean age was 49.49 ± 21.48. The overall prevalence rate of NFGNB among patients with HAP was 8%. It was more common in older patients and in patients with co-morbidities. Acinetobacter baumannii was the most common NFGNB with n = 93 (58%), followed by Pseudomonas aeruginosa (n = 55, 34%), and Stenotrophomonas maltophilia (n = 12, 8%). Regarding the antimicrobial sensitivity rate, Acinetobacter baumannii showed an overall resistance level of 82%, Stenotrophomonas maltophilia (81%), and Pseudomonas aeruginosa (62%). The rate of CR-NFGNB in our study was 79.4%. We found that 68.1% of NFGNB was multidrug resistant (MDR) pathogens. MDR patterns were more common in Acinetobacter baumannii infections (84%). MDR pathogens were strongly associated with ICU admissions (95% CI, 0.202-0.800, OR, 0.402, p value <0.009). Finally, the mortality rate of HAP caused by NFGNB in our study was 42.5%. The prevalence of NFGNB in HAP patients was 8%. These infections were more prevalent among men and the elderly. Acinetobacter baumannii and Stenotrophomonas maltophilia exhibited the highest antibiotic resistance rate. The MDR level of these pathogens was 68.1%.

Non-fermenting gram negative bacilli isolated from blood and their in vitro sensitivity pattern in a tertiary care hospital

Background: Bacteremia caused by non-fermenting gram negative bacilli (NFGNB) is a serious infection which is associated with high morbidity and mortality. Identification of NFGNB and monitoring their susceptibility pattern are important for proper management of these infections. Aim: Scope of the present study is to characterize the NFGNB along with their antimicrobial sensitivity pattern among the patients coming to our hospital, a tertiary care center. Materials &amp; Methods: A retrospective study was conducted to determine the NFGNB isolated from blood during the one-year study period. A total of 8223 Blood cultures were received in the laboratory which was processed by semi-automated technique in Bac-T Alert. Antibiotic susceptibility was performed by VITEK and Kirby Bauer methods and interpreted by CLSI guidelines. 102 isolates of NFGNB were obtained from the Blood culture. Results: Most commonly isolated organism is Acinetobacter species (47%) followed by Pseudomonas spp (27%) and Burkholderia spp(15.6%). Maximum isolates of Acinetobacter spp were sensitive to colistin (91.9%), cefoperazone-sulbactum (88.4%), Tigecycline (62.5%). Pseudomonas spp was sensitive to colistin (100%), ciprofloxacin (59%). Conclusion: Identification of NFGNB and monitoring their susceptibility patterns will help in proper management of infections caused by them.

A Study of Isolation, Identification &amp; Antibiotic Susceptibility Pattern of Non-Fermenting Gram Negative Bacilli Isolated From Various Clinical Samples at Tertiary Care Hospital Rajkot, Gujarat, Western India

Introduction: Nonfermenting gram-negative bacilli (NFGNB) are a taxonomically diverse group of aerobic, nonsporing, bacilli that either do not utilize glucose as a source of energy or utilize it oxidatively. They occur as saprophytes in the environment and some are also found as commensals in the human gut. In recent year NFGNB have emerged as important health care associated pathogens. They have been incriminated in infections such as bacteremia, meningitis, pneumonia, urinary tract infections, surgical site infections, wound infections, osteomyelitis etc. Materials and method: During Nine Month study period, various samples were collected aseptically and transported immediately to the bacteriology laboratory. The pathogens were identified by standard laboratory procedures including Gram’s staining, motility, culture, colony characters and biochemical reactions. Antimicrobial susceptibility testing was performed by modified Kirby Bauer method as per the CLSI guidelines using Muller-Hinton agar and available antibiotic disks. Result: A total number of 312 NFGNB were isolated from 4112 clinical samples. Most frequently isolates NFGNB were Pseudomonas aeruginosa (42.62%) and Acinetobacter spp. (25.32%). NFGNB isolates were more common in males (58.33%) as compared to females (41.67%). Maximum sensitivity was seen to Polymyxin B (100%), Meropenem (83.45) in Pseudomonas aeruginosa and Meropenem (78.48%), Pipracillin-tazobactum (62.02%) in Acinetobacter spp. Conclusion: NFGNB are emerging as important pathogens and shows resistance to commonly used antibiotics. Minimized use of available antimicrobial, regular use antimicrobial susceptibility surveillance and strict infection control measures are required to control this emerging antimicrobial resistance among NFGNB.

Cutaneous bacteriological profile and antibiotic sensitivity pattern in patients with pemphigus attending tertiary care center, Northeast India

Pemphigus is an autoimmune bullous disease. Septicemia is one of the common causes of death which is usually secondary to cutaneous bacterial infection. 1: To study the cutaneous bacteriological profile and the most common cause of bacterial skin infection in pemphigus patients; 2: To find out the antibiotic sensitivity pattern in pemphigus patients of Northeastern part of India.This was a descriptive type of cross-sectional study conducted at Dermatology, Venereology and Leprosy department of Silchar Medical College from January 2021 to December 2021. A total of 33 confirmed inpatient cases of pemphigus was selected via non probability convenient sampling method. Pus for culture was collected, to study the common cause of bacterial skin infections and antibiotic sensitivity pattern in pemphigus patients. Out of 33 patients included in the study, male patients were 22 and female patients were 11. Pemphigus vulgaris was noted in 28 patients, pemphigus foliaceous was found in 4 patients and 1 patient was of pemphigus vegetans. The mean age was found to be 35.6 years and 36.36% patients were diabetics in our study. About 45.4% patient’s pus culture report showed the growth of Staphylococcus aureus, 18.1% showed the growth of Proteus mirabilis, 6.06% showed the growth of nonfermenting gram negative bacilli, 3.03% showed the growth of Klebsiella species and Beta hemolytic streptococci, 9.09% showed the growth of skin commensals and 15.15% showed no growth. Staphylococcus aureus showed 100% sensitivity to linezolid, amikacin and tetracycline; 86.6% resistance was seen for penicillin, 80% resistance was seen for levofloxacin, 60% resistance was seen for clindamycin, 66.6% resistance for cotrimoxazole was seen and 33.3% resistance was seen for azithromycin. Proteus mirabilis showed maximal sensitivity to ciprofloxacin, amikacin, gentamicin, ceftazidime, piperacillin + tazobactam and meropenem. Staphylococcus aureus is the most common organism causing skin infections in pemphigus patients and it has maximal sensitivity to linezolid, amikacin and tetracycline

Biochemical and Molecular Characterization of Klebsiella species isolated from neoplastic patients under Irradiation therapy

Neoplastic radiation therapy was able to alter the microbial flora of patients' bodies, as well as the microbial flora of radiation-exposed workers, and provided control for possible infectious consequences. Klebsiella aerogenes was a non-fermentative aerobic gram negative bacteria that was widely distributed in nature, requiring species identification in up to 25% of cases in the lab. Antibiotic susceptibility of Klebsiella species multi-resistant isolates is common, and all isolates were characterized in all cases of clinically significant infections caused by these organisms. Only 15 isolates showed significant antimicrobial activities against at least one of the tested indicator bacteria. Vancomycin is an anti-Klebsiella species antibiotic to which resistance is rarely seen, their use should be reserved for the treatment of species infections resistant to all other antibiotics, the emergence of widespread antibiotic-resistant bacteria enhanced the need for new sources of antimicrobial agents, and isolate SHM4-1 was active against all of them, with IC60 values of 3.3 and 1.1 g/ml against HCT-116 and HepG-2 cell lines, respectively. It was genotypically identified as a species with the PKS 4 biosynthetic gene cluster present. To enhance the production, mannitol, ammonium sulphate, pH 7, 2% inoculum size, and 2 days at 37°C were utilized.

Assessment of Prevalence and Antibiogram of NFGNB isolates in a Tertiary care Hospital, Dehradun

Non-fermenting Gram Negative Bacilli (NFGNB) is emerging as a major cause of nosocomial infections as they exhibit great multidrug resistance thereby posing difficulty in combating the infections. Studies on assessing the prevalence rate and antibiogram of NFGNB is necessary for proper management of infections caused by them as there are high chances of regional variation in predominance and antimicrobial susceptibility pattern of NFGNB. Aim of the present study was to assess the prevalence rate of NFGNB along with antimicrobial sensitivity pattern revealing their drug sensitivity and resistance among the patients attending tertiary care hospital of varied age groups. A total of 1000 various clinical specimens were received in laboratory during the period of 4 months (August 2020-Novemebr 2020) and were subjected to processing using Vitek-2 compact system. Among 1000 clinical samples 328 yielded NFGNB i.e., Pseudomonas aeruginosa, Acinetobacter baumannii, Achromobacter Xylosoxidans, Stenotrophomonas maltophilia and Burkholderia cepcia. Pseudomonas aeruginosa (51.82%) and Acinetobacter baumannii (39.63%) were most prominent NFGNB isolates. Results showed that although NFGNB were found to be resistant against most of the subjected antibiotics but considerable intensity of effectiveness was also recorded against Colistin. Accurate, rapid identification and antimicrobial susceptibility testing of NFGNB by Vitek 2, is required in early diagnosis, treatment and proper management of patients will reduce emergence of MDR strains of NFGNB.

Identification and Clinical correlation of blood isolates of Non-Fermenting Gram Negative Bacilli (NFGNB) other than Pseudomonas Spp and Acinetobacter Spp from tertiary care center, South India

Identification and Clinical correlation of blood isolates of Non-Fermenting Gram Negative Bacilli (NFGNB) other than Pseudomonas Spp and Acinetobacter Spp from tertiary care center, South India

A Study of Isolation, Identification & Antibiotic Susceptibility Pattern of Non-Fermenting Gram Negative Bacilli Isolat- ed From Various Clinical Samples at Tertiary Care Hospital Rajkot

A Study of Isolation, Identification & Antibiotic Susceptibility Pattern of Non-Fermenting Gram Negative Bacilli Isolat- ed From Various Clinical Samples at Tertiary Care Hospital Rajkot

Prevalence of Multidrug resistant Non-fermenting gram negative bacilli (NFGNB) in Urinary tract infections in a tertiary care North Indian hospital-A Pilot study.

Prevalence of Multidrug resistant Non-fermenting gram negative bacilli (NFGNB) in Urinary tract infections in a tertiary care North Indian hospital-A Pilot study.

Melioidosis complicated with pericardial effusion - An emerging disease with a rare presentation

Melioidosis, caused by a non-fermenting gram negative bacilli, can mimic a variety of diseases due to its diverse clinical presentation. The incidence of cardiac involvement in melioidosis is less than 1%. We report a rare case of melioidosis in a 65 year old male with chronic kidney disease who presented with fever and pericardial effusion which was misdiagnosed and treated as tuberculous pericardial effusion. Later, on isolation of from paired blood culture samples, pericardial fluid and also from pleural fluid confirmed the diagnosis of disseminated melioidosis. The patient was treated with intravenous ceftazidime after which clinical improvement was observed. Cardiac melioidosis should always be considered in the differential diagnosis of tuberculous pericardial effusion and it should be ruled out before the start of anti-tubercular treatment. This will prevent unnecessary exposure to anti-tubercular drugs and also aids to start early treatment for melioidosis thereby reducing the mortality.

HERE, THERE AND EVERYWHERE: A HOSPITAL-BASED STUDY ON NOSOCOMIALAND ENVIRONMENTAL NON-FERMENTERS

Aim: To assess the prevalence of non-fermenting gram negative bacilli(NFGNB) as nosocomial pathogens and environmental contaminants. Material and Methods: Nonfermenting gram negative bacilli were isolated from relevant patient samples and high-touch surfaces in the hospital environment. They were identied and their antibiotic susceptibility testing was done using conventional and automated methods. Result: The prevalence of nonfermenters as hospital acquired pathogens and as environmental contaminants was 25.8% and 16.3% respectively. All clinical isolates of Acinetobacter baumanii cplx and Pseudomonas aeruginosa were multidrug resistant. Cluster analysis of clinical isolates show similar antibiotic susceptibility prole indicating an ongoing cross-transmission in the hospital.