ABSTRACT
OBJECTIVE：To provide reference for clinical empirical treatme nt of non-fermentative Gram-negative bacilli （NFGNB）infection. METHODS ：All kinds of clinical specimens were collected from Jan. 2010 to Dec. 2019 in a tertiary hospital from Hanzhong city of Shaanxi province ；the distribution and drug resistance of NFGNB were analyzed retrospectively. RESULTS ： A total of 26 386 strains of pathogenic bacteria were detected in the hospital during 2010-2019，including 4 077 strains of NFGNB （15.45％），mainly from patients ≥60 years old （1 836 strains，45.05％）. During the 10 years，the detection rate of NFGNB decreased from 20.14％ in 2010 to 15.36％ in 2019 （P＜0.001）. Acinetobacter baumannii （1 359 strains），Pseudomonas aeruginosa （1 269 strains），Stenotrophomonas maltophilia （447 strains） and Burkholderia cepacia （351 strains） were main pathogens. The detected NFGNB mainly came from hospitalized patients （4 001 strains），and most of them were found in ICU （17.05％），neurosurgery department （14.52％），respiratory department （12.41％），and respiratory tract （66.69％），secretion （7.80％）specimens. The detection rates of A. baumannii and P. aeruginosa in oncology department ，blood specimens and urine specimens showed an overall upward trend ，while the detection rates in ICU of the hospital showed a downward trend （P＜0.05）； the detection rate of P. aeruginosa in neurosurgery department showed an upward trend （P＜0.05），and that of A. baumannii in respiratory department showed an upward trend （P＜0.05）. The resistance rate of A. baumannii to carbapenems increased from about 10％ in 2010 to about 75％ in 2019，and the guyh3201@163.com resistance rate to cephalosporins exceeded 78％. The resistance rates of P. aeruginosa to imipenem and me ropenem were lower than 35％ and 30％ respectively，and the trend of drug resistance did not change significantly （P＞0.05）；the resistance rates to 12 kinds of clinically commonly used antibiotics as piperacillin and aztreonam were lower than 40％. The resistance rate of S. maltophilia to compound sulfamethoxazole showed a decreasing trend （P＜0.001），and the resistance rate to ceftazidime was high （54.70％-74.10％）. The resistance rates of B. cepacia to compound sulfamethoxazole，meropenem and ceftazidime showed a downward trend （P＜0.01），and were lower than 15％ after 2014. CONCLUSIONS：Although the detection rate of NFGNB in our hospital showed a downward trend ，the multi-drug resistance and pan-drug resistance of A. baumannii are serious ，and the resistance rate to carbapenems is increased. Sensitive drugs such as cefoperazone/sulbactam，amikacin，levofloxacin and ceftazidime should be selected for NFGNB infection according to the results of drug sensitivity tests.
ABSTRACT
Aim: To isolate, identify and characterize the prevalence of non- fermenting gram negative bacteria (NFGNB) along with their antimicrobial resistance pattern among the patients attending a tertiary care Hospital in Meerut. Materials and Methods: The isolates of NFGNB obtained from various samples were identified by standard bacteriological technique and VITEK® 2 system (Biomerieux , France) . Antimicrobial susceptibility test was carried out to assess the resistance profile both by Kirby Baeur disk diffusion method and VITEK® 2 system (Biomerieux , France) . Result: Atotal of 16,296 clinical samples from the indoor and outdoor patients were processed in the bacteriology laboratory. Isolation rate of nonfermenters was 7.82% (1274/16296). Pseudomonas spp. was the predominant isolate (66.56%) followed by Acinetobacter spp. (27.16%). Other isolated non-fermenters were Burkholderia cepacia complex (BCC)(1.57%), Stenotrophomonas maltophila (0.86%), Sphingomona spaucimobilis (0.71%), Achromobacter xylosoxidans (0.16%), Ochrobactrum anthropic (0.16%). Conclusion: NFGNB are emerging as important opportunistic pathogens and are mostly resistant to commonly used antimicrobials. Therefore early diagnosis and initiation of appropriate antibiotic therapy would help in efficient management of patients and result in reduction of morbidity and mortality caused by these multi drug resistant organisms.
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OBJECTIVE:To provide reference for rational selection of antibiotics against non-fermentative Gram-negative bacilli in clinic. METHODS:Etiological data of clinical isolated Pseudomonas aeruginosa(PA),Acinetobacter baumanii(AB) and Stenotrophomonas maltophilia(SM)were collected from the Affiliated Hospital of Qingdao University(called"our hospital"for short)during Jan. 2004-Dec. 2016. Drug resistance of them to commonly used antibiotics was analyzed retrospectively. RESULTS:Totally 15 587 strains of PA,7 446 strains of AB and 2 950 strains of SM were detected. Resistance rates of PA to commonly used antibiotics fluctuated but were in a decreasing tendency. Except for imipenem,resistance rates of PA to commonly used antibiotics decreased significantly,and resistance rates of PA to amikacin and gentamicin decreased to 4.60% and 7.48%, respectively. Resistance rates of AB to most commonly used antibiotics were more than 40%,but it was sensitive to tigecycline (drug resistance of 0-4.03%). Resistance rates of SM to cefoperazone sodium and sulbactam sodium increased from 3.03% in 2004 to 39.01% in 2016,but it was sensitive to sulfamethoxazole,minocycline and levofloxacin. CONCLUSIONS:Non-fermentative Gram- negative bacilli detected in our hospital are mainly PA. Resistance rate of PA to most of the antibiotics is declining;drug resistance of AB is severe;resistance rates of SM to cefoperazone sodium and sulbactam sodium show increasing tendency.Above 3 non-fermentative Gram-negative bacilli are sensitive to amikacin,tegocycline and minocycline. Clinical selection should be based on the results of drug sensitivity test.
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OBJECTIVE To investigate the antimicrobial activity in vitro of cefoperazine/sulbactam for non-fermentative Gram-negative bacilli and analyze its antimicrobial capacity in vitro in comparison with imipenem and other antimicrobial drugs.METHODS The 362 clinical strains of non-fermentative Gram-negative bacilli were collected from Jun 1,2008 to Jun 1,2009.The drug resistance of the strains to 9 antibiotics was detected.RESULTS The primary non-fermentative Gram-negative bacilli were Pseudomonas aeruginosa,Acinetobacter baumannii,Stenotrophomonas maltophilia and Burkholderia cepacia in our hosipal.The resistant rates to cefoperazine/sulbactam were 29.2%,20.8%,25.0% and 27.3%,respectively.Cefoperazine/sulbactam was better than imipenem and meropenem and far better than piperacillin/tazobactam.CONCLUSIONS The resistant rate of non-fermentative Gram-negative bacilli is very high,and it shows multi-drug resistance.The results show cefoperazine/sulbactams is useful for non-fermentative Gram-negative bacilli infection with multi-drug resistance.