Emergence of multidrug-resistant non-fermentative gram negative bacterial infection in hospitalized patients in a tertiary care center of Nepal

Abstract

Objective: This study was designed for the characterization and establishment of antibiotic susceptibility profiles of non-fermentative gram negative bacteria isolated from hospitalized patients in a tertiary care hospital of Nepal. Results: A total of 402 non-fermentative gram negative bacteria was isolated in 1486 culture-positive cases from 6216 different clinical samples obtained from hospitalized patients. Among total non-fermentative gram negative bacterial isolates, the highest number was recovered from specimens collected from lower respiratory tract infections (n = 173, 43.0%) of hospitalized patients followed by pus/swab samples (n = 99, 24.6%) and urinary tract infections (n = 49, 12.2%). The most common non-fermentative gram negative bacteria identified were Acinetobacter baumannii (n = 177, 44.0%), Pseudomonas aeruginosa (n = 161, 40.1%) and Burkholderia cepacia complex (n = 33, 8.2%). These bacterial isolates exhibited a higher rate of insusceptibility to beta-lactam antibiotics, fluoroquinolones, and aminoglycosides. On the other hand, all the isolates of P. aeruginosa and A. baumannii were completely susceptible to colistin sulfate and polymyxin B. Among total isolates, 78.1% (n = 314) were multidrug-resistant with a high rate of multidrugresistant among A. baumannii (91.0%).

Synergistic Effect between Usnic Acid and Polymyxin B against Resistant Clinical Isolates of Pseudomonas aeruginosa

“…and P. aeruginosa isolates compared to the present study. The presence of different percentages of polymyxin-resistant strains in different parts of the world is related to the public health characteristics, number of inhabitants, sanitation, and economic development, those being considered determinant factors in the health-disease process [ 28 – 30 , 32 ].…”

“…In addition to that, all isolates of A. baumannii and P. aeruginosa demonstrated susceptibility to polymyxin B and colistin [31]. Studies conducted by Grewal et al [30] and Yadav et al [32] obtained different incidence results of polymyxin B-resistant Acinetobacter spp. and P. aeruginosa isolates compared to the present study.…”

“…and P. aeruginosa isolates compared to the present study. e presence of different percentages of polymyxinresistant strains in different parts of the world is related to the public health characteristics, number of inhabitants, sanitation, and economic development, those being considered determinant factors in the health-disease process [28][29][30]32]. Clinical isolates of P. aeruginosa which presented an intermediate susceptibility to polymyxin B were present in tracheal secretion samples, whereas resistant isolates were found in urine (3/5), catheter tip (1/5), and ulcer secretion (1/5).…”

High prevalence of multidrug-resistant non-fermentative Gram-negative bacilli harboring bla and bla metallo-beta-lactamase genes in Birjand, south-east Iran

“…The ever-increasing emergence of antibiotic resistance in P. aeruginosa, A. baumannii, and S. maltophilia strains has become a health concern worldwide. Currently, the choice of appropriate treatment options for patients with multidrug-resistant NFGNB infections is a serious challenge ( 4 , 5 ). The increasing incidence of resistance to beta-lactam antibiotics such as penicillins and cephalosporins among NFGNB represents a significant clinical problem nowadays.…”

“…Given the rising emergence of antibiotic resistance in MBL-producing NFGNB and the fact that clinical infections caused by these bacteria are often associated with a high rate of morbidity and mortality ( 5 , 6 ), this study aimed to investigate the antibiotic resistance profiles and molecular characteristics of MBL-producing NFGNB isolates in Birjand, South-East Iran.…”