RESUMEN
Background and Aim: The emergence of nonfermenter bacteria that are resistant to multidrug resistant ESBL are nowadays a principal problem for hospitalized patients. The present study aimed at surveying the emergence of nonfermenter bacteria resistant to multi-drug ESBL producing isolated from patients blood samples using BACTEC 9240 automatic system in Shiraz
Materials and Methods: In this cross-sectional study, 4825 blood specimens were collected from hospitalized patients in Shiraz [Iran], and positive samples were detected by means of BACTEC 9240 automatic system. The isolates containing nonfermenter bacteria were identified based on biochemical tests embedded in the API-20E system. Antibiotic sensitivity test was performed and identification of ESBL producing strains were done using phenotypic detection of extended spectrum beta-lactamase producing isolates [DDST] according to CLSI [2013]guidelines
Results: Out of 4825 blood samples, 1145 [24%] specimen were gram-positive using BACTEC system
Among all isolated microorganisms, 206 isolates were non-fermenting gram- negative bacteria
The most common non-fermenter isolates were Pseudomonas spp. [48%], Acinetobacter spp. [41.7%] ,and Stenotrophomonas spp. [8.2%]. Seventy of them [81.4%] were Acinetobacter spp. which were ESBL positive. Among beta-lactam antibiotics, Pseudomonas spp. showed the best sensitivity to piperacillintazobactam [46.5%]
Conclusion: It was found that ?-lactam antibiotics are not effective against more than 40% of Pseudomonas spp. infections and 78% Acinetobacter infections. Emergence of multi-drug resistant strains that are resistant to most antibiotic classes is a major public health problem in Iran. To resolve this problem using of practical guidelines is critical