Characterization and Antimicrobial Susceptibility Profile of Non Lactose Fermenting Gram-Negative Bacterial Isolates in a Tertiary Care Teaching Hospital of Central India

Abstract

Objectives: The non-lactose fermenting Gram-negative bacilli (NLF-GNB) are notorious pathogens reportedly acquiring multiple drug resistance alarmingly and emerging as a public health threat globally. This study was conducted to isolate and identify these pathogens from clinical samples received routinely in our Bacteriology Laboratory and to analyze their antibiotic susceptibility patterns. Methods: In this cross-sectional study, the first 100 NLF-GNB strains isolated consecutively from 1218 clinical samples were included through convenience sampling. The samples were processed using standard microbiological techniques. Results: The most common isolate was Pseudomonas aeruginosa followed by Acinetobacter spp, Proteus spp, Shigella spp, Salmonella typhi, Providencia spp., and Morganella spp. P. aeruginosa and Acinetobacter spp. isolates were found to exhibit high susceptibility toward Colistin and Imipenem. Proteus spp. exhibited high sensitivity toward Imipenem, Aminoglycosides, Ceftazidime, and Cefepime. All Providencia isolates were susceptible to Amikacin, Cefepime, and Ceftriaxone. The only isolate of Morganella spp. was found to be susceptible to Amikacin, Cefepime, Ceftazidime, Piperacillin tazobactam, Ciprofloxacin, Imipenem, and Aztreonam. Shigella isolates exhibited very high susceptibility toward Imipenem followed by Gentamicin and Ceftazidime. All the isolates of S. typhi exhibited susceptibility toward Imipenem, Piperacillin tazobactam, Ceftazidime, Ceftriaxone, Cefoperazone sulbactam, and Chloramphenicol. 24% of test isolates were found to be Multidrug resistant. Conclusion: Antimicrobial surveillance is needed to implement appropriate timely interventions to restrict the spread of multidrug-resistant clones. Strict infection prevention and control practices, with judicious antibiotic prescription policy, may help in tackling this problem by obviating the selection pressure.

Prevalence and antibiogram of non-urinary isolates among patients attending a tertiary care hospital

“…(33%). These isolates in our study showed high resistance to ceftriaxone (83%) as compared to the study by Mehta et al who reported these organisms as sensitive to aminoglycosides and ceftazidime (10).…”

Prevalence and Phenotypic Characterization of Multi-Drug-Resistant Isolates Causing Wound Infections in a Tertiary Care Centre

“…The multidrug-resistant E. coli, Klebsiella species, Citrobacter, Pseudomonas aeruginosa and Acinetobacter baumannii showed more resistance against ampicillin, followed by gentamicin, ceftriaxone, ceftazidime, piperacillin and ciprofloxacin [26][27][28][29]33]. The antibiotics like amikacin, and imipenem worked well against all gram-negative multi-drug-resistant organisms in our study about 72%, and 85% respectively except a few isolates of Acinetobacter baumannii and Pseudomonas aeruginosa.…”

“…The polymicrobial wound infections with these organisms make eradicating microorganisms more difficult. The Horizontal gene transfer between microorganisms enhances the non-healing tendency or chronic wound infections by polymicrobial organisms [24][25][26][27][28][29]. In the present study, we detected 18.8% of isolates showed multi-drug-resistance against at least five antimicrobial agents; in particular, the species involved were E. coli, K. pneumoniae, P. aeruginosa, A. baumannii, Citrobacter species and frequently seen isolate was methicillin-resistant Staphylococcus but not multi-drugresistant.…”

“…The management of polymicrobial wound infections and its challenges are multi-drug resistance, biofilm formation, and tolerance to antimicrobials. The multi-target drugs or combination of a different group of drugs make them more bactericidal than giving higher antibiotics alone [28][29][30][31][32].…”

Case Series of Emerging Nosocomial Multiple Drug Resistant Pathogen Providencia Rettgeri Causing Urinary Tract Infection

“…P. rettgeri showed earlier sensitivity to antibiotics like ciprofloxacin, cephalosporin, carbapenems and amoxicillinclavulanate. However, emerging resistance to ciprofloxacin has been reported among Providencia species with a shift in sensitivity pattern from 100% to 46% in a study carried out by Fass RJ et al [16][17][18]. In our case series, we isolated multi-drug-resistant strains of P. rettgeri showed resistance to piperacillin-tazobactam, cefuroxime, ceftriaxone, cefepime, ertapenem, imipenem, meropenem, gentamicin, tobramycin, ciprofloxacin, tigecycline, amikacin, colistin and sensitive only to fosfomycin.…”