Abstract

  The Non Fermenting Gram Negative Bacilli were previously thought to be saprophytes existing solely as commensals or contaminants. But recent findings have established a clinical significance subject to their frequent isolation from clinical samples and pathological association with blood stream infections, immunocompromised hosts and patients with hematological malignancies. This study aims at providing a comprehensive view of this scenario through a span of one year in a tertiary hospital. Acinetobacter species was found to be the most common isolate comprising of 54.4% of all NFGNB, followed by Pseudomonas species (29.67%), Burkholderia species (2.75%) and Sphingomonas paucimobilis (0.55%). Analysis of antimicrobial susceptibility testing showed multidrug resistant pattern with majority of the isolates being resistant to three or more drugs

Keywords: NFGNB; Antimicrobial Susceptibility; Drug Resistance; Commensal; Septicaemia

References

1. Rahbar M., et al. “Prevalence of drug resistance in nonfermenter gram-negative bacilli”. Iranian Journal of Pathology 5 (2010): 90-96. 
2. Mcgrowan JE., et al. “Resistance in nonfermenting gram negative bacteria”. American Journal of Infection Control 34 (2006): 29-37.
3. McGowan JE. “Resistance in nonfermenting gramnegative bacteria: multidrug resistance to the maximum”. The American Journal of Medicine 119.6-1 (2006): S29-S36. 
4. Quinn JP. “Clinical problems posed by multiresistant nonfermenting gram negative pathogens”. Clinical Infectious Diseases 27 (1998): 117-124.
5. Buck AC and Cooke EM. “The fate of ingested Pseudomonas aeruginosa in normal persons”. Journal of Medical Microbiology 2 (1969): 521-525.
6. Johanson WG., et al. “Bacterial adherence to epithelial cells in bacillary colonization of the respiratory tract”. The American Review of Respiratory Disease 121 (1980): 55-63.
7. Rebecca Reik., et al. “Distribution of Burkholderia cepacia Complex Species among Isolates Recovered from Persons with or without Cystic Fibrosis”. Journal of Clinical Microbiology 43.6 (2005): 2926-2928.
8. Richet H., et al. “Epidemic Pseudomonas aeruginosa serotype 016 bacteremia in hematology-oncology patients”. Journal of Clinical Microbiology 27 (1989): 1992-1996.
9. Winn W., et al. “Nonfermenting Gram negative bacilli”. In: Koneman’s Color Atlas and textbook of Diagnostic Microbiology, 6th ed. USA: Lippincott Williams and Wilkins Company (2006):  305-391.
10. Mellmann A., et al. “High interlaboratory reproducibility of matrix-assisted laser desorption ionization-time of flight mass spectrometry-based species identification of nonfermenting bacteria”. Journal of Clinical Microbiology 47.11 (2009): 3732-3734.
11. Kharangate NV., et al. “Characterization of nonfermenters from clinical samples”. The Journal of the Association of Physicians of India 49 (2001): 324-326.
12. Malini A., et al. “Nonfermenting Gram-negative bacilli infections in a tertiary care hospital in Kolar, Karnataka”. Journal of Lab Physicians 1.2 (2009): 62-66.
13. Samanta P., et al. “Emerging resistance of non-fermenting gram negative bacilli in a tertiary care centre”. Indian Journal of Pathology and Microbiology 54 (2011): 666-667.
14. Vidal F., et al. “Bacteraemia in adults due to glucose nonfermentative gram negative bacilli other than Pseudomonas aeruginosa”. Quarterly Journal of Medicine 96 (2003): 227-234.
15. Rao PS and Shivananda PG. “Bacteraemia due to non fermenting gram negative bacilli in immunocompromised patients”. Indian Journal of Medical Sciences 11 (1993): 95-99.
16. Seetha KS., et al. “Bacteraemia in highrisk patients”. Indian Journal of Medical Sciences 56 (2002): 391-396.
17. Yashodara P and Shyamala S. “Identification and characterization of nonfermenters from clinical specimens”. Indian Journal of Medical Microbiology 15 (1997): 195-197.
18. Wroblewska MM., et al. “Multidrug resistant bacteria isolated from patients hospitalized in intensive care units”. International Journal of Antimicrobial Agents 27 (2006): 285-289.
19. Veenu Sikka R and Arora DR. “Isolation and susceptibility pattern of nonfermenting gram negative bacilli from clinical samples”. Indian Journal of Medical Microbiology 17 (1998): 14-18.
20. Grewal US., et al. “Antibiotic susceptibility profiles of non-fermenting gram-negative Bacilli at a Tertiary Care Hospital in Patiala, India”. Nigerian Postgraduate Medical Journal 24 (2017): 121-125.
21. Juyal D., et al. “Prevalence of non fermenting gram negative bacilli and their in vitro susceptibility pattern in a tertiary care hospital of Uttarakhand: A study from foothills of Himalayas”. Saudi Journal for Health Sciences 2 (2013): 108-112.
22. Gladstone P., et al. “Incidence of carbapenem resistant nonfermenting gram negative bacilli from patients with respiratory infections in the intensive care units”. Indian Journal of Medical Microbiology 23 (2005): 189-191.
23. Agarwal S., et al. “Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an ICU of a Tertiary Care Hospital”. Journal of Clinical and Diagnostic Research 11.1 (2017): DC04-DC07. 
24. Kim YJ., et al. “Risk factors for mortality in patients with carbapenem-resistant Acinetobacter baumannii bacteremia: Impact of appropriate antimicrobial therapy”. Journal of Korean Medical Science 27.5 (2012): 471-475.
25. Papp-Wallace KM., et al. “Carbapenems: past, present, and future”. Antimicrobial Agents and Chemotherapy 55.11 (2011): 4943-4960. 

Citation

Citation: Debosmita Paul and Amrit Kumar Borah. “Emergence of Non-Fermenting Gram Negative Bacilli as Multi-Drug Resistant Septicaemic Pathogen in A Tertiary Hospital". Acta Scientific Microbiology 3.2 (2020): 02-06.

Copyright

Copyright: © 2020 Debosmita Paul and Amrit Kumar Borah. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.