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Background: Non fermenting Gram Negative Bacilli arediverse and complex group of bacteria that possess very fewdefined characteristics. They are aerobic, non-fermentingGram negative bacilli which were initially considered ascontaminants but have come up with life threatening infectionsin hospitals as multidrug resistant organisms posing a threatbecause of their inherent and acquired drug resistance nature.Aims: Isolation and identification of NFGNB in clinical samplesand determination of their antibiotic sensitivity profile.Materials and Methods: The study was conducted in theDepartment of Microbiology, RIMS, Ranchi from February2017-July 2017. Various clinical samples reaching theBacteriology section of the Department of Microbiology wereprocessed and NFGNB were isolated and identified usingstandard procedure and their antibiotic susceptibility wasperformed.Results: A total of 3581 samples were received out of which2246 were culture positive and 217 were identified as NFGNB.The isolation rate of NFGNB was 9.6%. Number of malesaffected by NFGNB was 121 and that of females was 96.Analysed by specimen NFGNB were isolated from 91 urine, 74pus, 11 ear swab, 6 sputum, 8 body fluid, 21 blood culture and6 catheter tip samples. Urine was most common specimenaccounting for 42% followed by pus (34%), blood (9%), earswab (5%), body fluid (4%), sputum and catheter tip (3%each).The clinical samples from indoor patients yielded highestpercentage of NFGNB (38%) followed by ICU patients (36%)and outdoor patients (26%). Among the NFGNB isolatedPseudomonaas aeruginosa (51%) was the most commonfollowed by Acinetobacter baumanii (22%), Pseudomonas spp(19%), Acinetobacter spp, Stenotrophomonas maltophila,Burkholderia cepacia (2% each), Ralstonia spp &Sphingobacterium spp (1%). Non fermenters were highlysensitive to Imipenem accounting for 91.5% followed byPiperacillin-tazobactam (71.5%), cefoperazone sulbactam(67.7%) & Amikacin (55.6%) on an average.Conclusion: NFGNB considered being contaminants in thepast have now emerged as important health care associatedinfections. In our setting Imipenem can be used for thepreliminary treatment of infections caused by nonfermenters.As these organisms are important opportunistic andnosocomial pathogens causing infections inimmunocompromised patients, better infection control policiesin our settings and its implementation is a must.
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ObjectiveTo explore the influencing factors of mechanical ventilation time in esophageal cancer patients with lung infection after operation.Methods55 esophageal cancer patients with lung infection after operation requiring endotracheal intubation or tracheostomy and mechanical ventilation were included.According to duration of mechanical ventilation time, ＜ 7 days for early weaned from ventilator group, ＞ 7 days for late weaning group.60 esophageal cancer patients with lung infection after operation without mechanical ventilation served as controls.Various factors on the impact of mechanical ventilation were compared.ResultsEarly and late weaning patients were older than control group(P ＜ 0.05), particularly in late weaning patients(P ＜ 0.01).Compared with the control, FEV1 and MVV decreased significantly in early weaning patients(P ＜ 0.05).NFGNB infection in late weaning patients significantly increased than in early weaning patients and the control(all P ＜ 0.01).Logistic multivariate analysis showed that FEV1 was independent factors affecting early weaning (P ＜ 0.01), age (P ＜ 0.05) and NFGNB infection (P ＜0.01) affecting late weaning.ConclusionThe influencing factors of mechanical ventilation time in esophageal cancer patiens with lung infection after operation were FEV1 decreasing,age and NFGNB infection.
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OBJECTIVE To study the isolation status and antimicrobial resistance of nonfermenting Gram-negative bacilli collected from intensive care unit(ICU) of our hospital so as to instruct the rational clinical application of antibiotics.METHODS The antimicrobial resistance of nonfermenting Gram-negative bacilli isolates collected from patients in ICU from Jan 2003 to Dec 2007 was analyzed.Antimicrobial susceptibility of clinical isolates were tested by Kirby-Bauer method.RESULTS Total 384 nonfermenting Gram-negative bacilli isolates were collected in 5 years.The most common species were Acinetobacter baumannii(219),Pseudomonas aeruginosa(117) and Stenotrophomonas maltophilla(36).The antimicrobial resistance rate of nonfermenting Gram-negative bacterial to most antibiotics were much higher.The antimicrobial resistance rate of Acinetobacter spp to imipenem,cefoperazone/sulbactam and piperacillin/tazobactam was 3.7%,28.3% and 42.9%.But the resistance rate of Acinetobacter spp to imipenem was increased in recent 2 years(58.0%).The antimicrobial resistance rate of P.aeruginosa to cefoperazone/sulbactam was the lowest.That of imipenem-resistant P.aeruginosa to cefoperazone/sulbactam was 34.0%.S.maltophilla was relatively susceptible to ceftazidime,cefoperazone/sulbactam and piperacillin/tazobactam.CONCLUSIONS Nonfermenters Gram-negative bacilli are the important pathogens in ICU.Surveillance of their prevalence and drug resistance may provide evidences for rational antibiotic choices.
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OBJECTIVE To study the drug-resistant diversity of Gram-negative bacilli isolated from inpatients during recent five years.METHODS A total of 1 464 Gram-negative bacilli isolated were detected and retrospectively analyzed from 1999 to 2003.Antimicrobial susceptibility testing was performed using Kirby-Bauer method.RESULTS The resistance of Pseudomonas aeruginosa to piperacillin rised from 17.6% of 1999 to 79.2% of 2003,and that to ciprofloxacin rised from 4.3% of 1999 to 36.0% of 2003.The resistance of Escherichia coli to quinolones was above 50%,while to third-generation cephalosporins was 30-40%;the resistance of E.coli to piperacillin rised from 42.9% of 1999 to 68.9% of 2003,and that to ciprofloxacin rised from 40.0% of 1999 to 73.5% of 2003.The resistance of Acinetobacter to piperacillin rised from 31.2% of 1999 to 67.5% of 2003,and that to ceftriaxone rised from 36.0% of 1999 to 74.1% of 2003.The resistance of Serratia to ceftazidime,ceftriaxone,gentamicin,amikacin and piperacillin rised sharply.Imipenem was the most active antibiotic tested against Gram-negative bacilli.Cefoperazone/sulbactam and piperacillin/tazobactam also showed excellent activity against Gram-negative bacilli.CONCLUSIONS During recent five years,the resistance of the most common Gram-negative bacilli has increased rapidly.How to delay the resistance development of common strains become a global problem.