Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care Hospital
Introduction: The emergence and spread of Multi-Drug Resistant (MDR) Non-Fermenting Gram-Negative Bacilli (NFGNB) in Intensive Care Units (ICU) and their genetic potential to transmit diverse antibiotic resistance regardless of their ability to ferment glucose poses a major threat in hospitals....
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2017-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9317/24023_CE[Ra1]_F(DK)_PF1(P_RK)_PFA(DK)_PF2(NE_DK).pdf |
| _version_ | 1818537323759927296 |
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| author | Sonika Agarwal Barnali Kakati Sushant Khanduri Shalini Gupta |
| author_facet | Sonika Agarwal Barnali Kakati Sushant Khanduri Shalini Gupta |
| author_sort | Sonika Agarwal |
| collection | DOAJ |
| description | Introduction: The emergence and spread of Multi-Drug
Resistant (MDR) Non-Fermenting Gram-Negative Bacilli (NFGNB)
in Intensive Care Units (ICU) and their genetic potential to
transmit diverse antibiotic resistance regardless of their ability
to ferment glucose poses a major threat in hospitals. The
complex interplay of clonal spread, persistence, transmission
of resistance elements and cell-cell interaction leads to the
difficulty in controlling infections caused by these multi drugresistant strains. Among non-fermenting Gram-negative
rods, the most clinically significant species Pseudomonas
aeruginosa, Acinetobacter baumannii and Stenotrophomonas
maltophilia are increasingly acquiring resistant to carbapenems.
Carbapenems once considered as a backbone of treatment of
life threatening infections appears to be broken as the resistance
to carbapenems is on rise.
Aim: To document the prevalence of carbapenem resistance
in non-fermenting Gram-negative bacilli isolated from patients
with respiratory tract infections in the ICU of Himalayan Institute
of Medical Sciences, Dehradun.
Materials and Methods: This is a cross-sectional study
conducted in ICU patients between October 2015 to March 2016.
A total of 366 lower respiratory tract samples were collected
from 356 patients with clinical evidence of lower respiratory
tract infections in form of Endotracheal (ET) aspirate, Tracheal
Tube (TT) aspirate and Bronchoalveolar Lavage (BAL) specimen.
Organism identification and the susceptibility testing was done
by using an automated system VITEK 2.
Results: Out of 366 samples received 99 NFGNB were isolated
and most common sample was ET aspirate sample 256 (64.5%).
Acinetobacter baumannii was the most common NFGNB
isolated 63 (63.63%) followed by Pseudomonas aeruginosa 25
(25.25%), Elizabethkingia meningoseptica seven (7.07%) and
Strenotrophomonas maltophilia four (4.04%). We observed that
90.5% Acinetobacter baumannii were resistant to imipenem and
95.2% resistant to meropenem, Pseudomonas aeruginosa came out
to be 52% resistant to imipenem and 56% resistant to meropenem
while Stenotrophomonas maltophilia and Elizabethkingia meningoseptica were 100% resistant to carbapenems as they are intrinsically resistant to carbapenems.
Conclusion: The resistance rate of carbapenems for NFGNB
infections is very high in our study and variable in different
regions. Overall carbapenem resistance is on rise. So, the
infection control team and microbiologist needs to work
together to determine the risk carried by multi drug resistant
non-fermenting gram-negative infections and the resistance
surveillance programs are mandatory to control these bacteria
in ICU settings. |
| first_indexed | 2024-12-11T18:49:18Z |
| format | Article |
| id | doaj.art-1c5d755f2f784216b3da6fe80d6fba72 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-11T18:49:18Z |
| publishDate | 2017-01-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-1c5d755f2f784216b3da6fe80d6fba722022-12-22T00:54:20ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-01-01111DC04DC0710.7860/JCDR/2017/24023.9317Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care HospitalSonika Agarwal0Barnali Kakati1Sushant Khanduri2Shalini Gupta3Assistant Professor, Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, Srhu, Dehradun, Uttarakhand, India.Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India.Assistant Professor, Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India.Senior Resident, Department of Microbiology, Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India.Introduction: The emergence and spread of Multi-Drug Resistant (MDR) Non-Fermenting Gram-Negative Bacilli (NFGNB) in Intensive Care Units (ICU) and their genetic potential to transmit diverse antibiotic resistance regardless of their ability to ferment glucose poses a major threat in hospitals. The complex interplay of clonal spread, persistence, transmission of resistance elements and cell-cell interaction leads to the difficulty in controlling infections caused by these multi drugresistant strains. Among non-fermenting Gram-negative rods, the most clinically significant species Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia are increasingly acquiring resistant to carbapenems. Carbapenems once considered as a backbone of treatment of life threatening infections appears to be broken as the resistance to carbapenems is on rise. Aim: To document the prevalence of carbapenem resistance in non-fermenting Gram-negative bacilli isolated from patients with respiratory tract infections in the ICU of Himalayan Institute of Medical Sciences, Dehradun. Materials and Methods: This is a cross-sectional study conducted in ICU patients between October 2015 to March 2016. A total of 366 lower respiratory tract samples were collected from 356 patients with clinical evidence of lower respiratory tract infections in form of Endotracheal (ET) aspirate, Tracheal Tube (TT) aspirate and Bronchoalveolar Lavage (BAL) specimen. Organism identification and the susceptibility testing was done by using an automated system VITEK 2. Results: Out of 366 samples received 99 NFGNB were isolated and most common sample was ET aspirate sample 256 (64.5%). Acinetobacter baumannii was the most common NFGNB isolated 63 (63.63%) followed by Pseudomonas aeruginosa 25 (25.25%), Elizabethkingia meningoseptica seven (7.07%) and Strenotrophomonas maltophilia four (4.04%). We observed that 90.5% Acinetobacter baumannii were resistant to imipenem and 95.2% resistant to meropenem, Pseudomonas aeruginosa came out to be 52% resistant to imipenem and 56% resistant to meropenem while Stenotrophomonas maltophilia and Elizabethkingia meningoseptica were 100% resistant to carbapenems as they are intrinsically resistant to carbapenems. Conclusion: The resistance rate of carbapenems for NFGNB infections is very high in our study and variable in different regions. Overall carbapenem resistance is on rise. So, the infection control team and microbiologist needs to work together to determine the risk carried by multi drug resistant non-fermenting gram-negative infections and the resistance surveillance programs are mandatory to control these bacteria in ICU settings.https://jcdr.net/articles/PDF/9317/24023_CE[Ra1]_F(DK)_PF1(P_RK)_PFA(DK)_PF2(NE_DK).pdfacinetobacterimipenemmeropenemvitek 2 |
| spellingShingle | Sonika Agarwal Barnali Kakati Sushant Khanduri Shalini Gupta Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care Hospital Journal of Clinical and Diagnostic Research acinetobacter imipenem meropenem vitek 2 |
| title | Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care Hospital |
| title_full | Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care Hospital |
| title_fullStr | Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care Hospital |
| title_full_unstemmed | Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care Hospital |
| title_short | Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an Icu of a Tertiary Care Hospital |
| title_sort | emergence of carbapenem resistant non fermenting gram negative bacilli isolated in an icu of a tertiary care hospital |
| topic | acinetobacter imipenem meropenem vitek 2 |
| url | https://jcdr.net/articles/PDF/9317/24023_CE[Ra1]_F(DK)_PF1(P_RK)_PFA(DK)_PF2(NE_DK).pdf |
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