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Background: Achromobacter is a ubiquitous, non-fermenting, Gram-negative bacterium that lives in soil and aquatic environments. In recent years, many studies have shown its potential as opportunistic pathogen. It can colonize various items used in hospital and can survive various disinfectants. The infections get complicated due to its vast spectrum of intrinsic and extrinsic resistance to antimicrobial agents and disinfectants. Achromobacter spp. is an emerging pathogen and is becoming a reservoir for horizontal genetic transfer elements involved in spreading antibiotic resistance. This study was conducted to assess the extent of the Achromobacter related infection in our hospital setting and to set a baseline for future studies.Methods: This study was conducted over a period of one year (January to December 2018) in our tertiary care hospital. All specimens submitted for aerobic culture and sensitivity were analyzed and the bacterial identification and antibiotic sensitivity of the isolates was carried out using automated method (Vitek 2 Compact, bioMerieux).Results: Achromobacter species was reported from 0.46% (63/13831) specimens, 40% of them were isolated from suction tips. Achromobacter denitrificans amounted for 47/63 (74.6%) while Achromobacter xylosoxidans was identified in 16/63 (25.4%).Conclusions: Studying the organisms in order to observe their changing trends
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Objective To learn the species distrilbution and drug-resistance of Gram-negative bacilli among bloodstream infections (BSI) in Yunnan province of China during 2012 to 2014.Methods Bloodstream infected Gram-negative bacilli were collected from 28 general hospitals in Yunan province of China.Data from all hospitals were applied with the same method of bacteria culture,isolation,identification and antibiotic sensitivity tests.WHONET 5.6 was used to perform the statistical analysis.Results A total of 9042 clinical strains of non-repetitive gram-negative bacilli were collected.Enterobacteriaceae and Non-fermenter bacteria accounted for 82.4％ and 17.6％ respectively.Enterobacteriaceae were mainly composed of Escherichia coli and Klebsiella pneumoniae.Non-fermenter bacteria were mainly composed of Acinetobacter baumannii and Pseudomonas aerouginosa.Escherichia coli accounted for the majority 49.29％,other species were Klebsiella pneumoniae 13.17％,Acinetobacter baumannii 4.04％ and Pseudomonas aeroginosa 3.85％.The susceptible rate of Enterobacteriaceae strains to the first generation cephalosporin was lower than 60％.The susceptible rate of E coli and Klebsiella pneumoniae to impenem was close to 100％,to Amikacin was more than 85％,to piperacillin-tazobactam was more than 70％,to Cefepime was more than 70％.But the susceptible rate of Klebsiella pneumoniae to impnem and amikacin decreased year by year from 2012 to 2014.The susceptible rate of Enterobacter cloacae to Amikacin was 86.4％ ～ 93.6％,Ciprofloxacin 70.5 ～ 76％,Cefepime 72.1 ～ 82.8％.It was less than other Enterobacteriaceae.The susceptible rate of Non-fermenter bacteria to normal antibiotics was much lower than Enterobacteriaceae.The susceptible rates of Pseudomonas aeroginosa to Impnem was 58.9％,Tobramycin 85％,Ciprofloxacin 71.7％,Amikacin 82.9％,Piperacillintazobactam 75.3％,Piperacillin59.6％,Atreonam 46.5％,Ceftazidime 69.1％ and Cefepime 68.9％ respectively.Furthermore,Acinetobacter baumannii's durg-resistance was more severe.The susceptible rate of Acinetobacter baumannii was lower than 30％,to the third and fourth generation cephalosporin,the susceptible rate of Ampicillin/Sulbactam,Cefoperazone/Sulbactam,Carbapenems,Piperacillin/Tazuobatan,Quinolones and Carbapenems was less than 40％.Conclusion Gram-negative bacilli have low susceptibilities among BSI.E.coli is the most common pathegon among BSI.The resistant rate of Non-fermenter bacteria to normal antibiotics is severe in hospitals.
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Chryseobacterium spp are widely distributed in nature but data of their isolation from clinical samples is scanty. Here, we report the first case of AmpC producing C. gleum causing pyonephrosis in a patient having bilateral nephrolithiasis on double J (DJ) stent. The present isolate was resistant to vancomycin, erythromycin, clindamycin, carbapenems and ciprofloxacin and susceptible to tetracycline and minocycline. The patient was treated with tetracycline and recovered without the need for removal of the DJ stent. The environmental surveillance carried out to trace the nosocomial origin of the isolate was negative. Since antimicrobial susceptibility of this isolate is different from previous reports, we emphasise that in vitro susceptibility testing should be sought to choose optimal antimicrobial agents for these Nonfermentative Gram-Negative Bacilli (NFGNBs) with different susceptibility patterns.
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Objective To investigate the resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2011.Methods Fifteen repre-sentative general hospitals were involved in this program. Bacterial susceptibility testing was carried out by means of a unified protocol using Kirby-Bauer method and MIC determi-nation.Results were analyzed according to CLSI 2011 break-points.Results Majority (93.3%) of the 1 889 clinical strains of S.maltophilia were isolated from inpatients.On-ly 6.7% of the isolates were from outpatients.About 62.9% of these S .maltophilia strains were isolated from old patients whose age was 60 years or older.Only 8.2% of the strains were from the patients younger than 18 years old.Sputum and re-spiratory tract secretion were the most common specimen source,accounting for 82.6%.Another 4.2% isolates were from blood,abdominal fluid and other sterile body fluids.The percentage of the S .maltophilia strain resistant to trimethoprim-sul-famethoxazole,levofloxacin and minocycline was 16.6%,10.0% and 1.8%,respectively.The strains resistant to cefopera-zone-sulbactam accounted for 19.0%.About 37.1% of the strains isolated from blood or sterile body fluids were resistant to trimethoprim-sulfamethoxazole,significantly higher than the strains from urine or wound specimens (P < 0.01).Conclusions S.maltophilia strains are mainly isolated from inpatients.The most common source is sputum and other respiratory speci-mens.Most of the patients with S.maltophilia isolate are 60 years of age or older.The S.maltophilia strains are constitu-tively resistant to several antibacterial agents,but showed relatively lower resistance to trimethoprim-sulfamethoxazole,levo-floxacin and minocycline.Cefoperazone-sulbactam is still active against these strains.The antimicrobial therapy targeting S. maltophilia infections should be selected cautiously according to the results of antimicrobial resistance surveillance.
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Objective To study the non-fermenter isolation rate and its drug resistance to more than 10 kinds of antibiotics at the First Affiliated Hospital to Xinxiang Medical University from the year of 2010 to 2012 in order to offer evidences for reasonable use of drugs by doctors and to prevent nonfermenters from becoming common pathogenic bacteria.Methods The infection and drug resistance of different Nonfermenters (Pseudomonas aeruginosa,Acinetobacter baumannii,Pseudomon as mahophilia,Los non Acinetobacter,Pseudomonas stutzeri,Achromobacter,Bacillus steady short,onions Bock cepacia,meningitis septicemia Elizabeth Kim bacteria)during present 3 years were analyzed by using WHONET 5.5 software.Results The infection rate from non-fermenters as pathogenic bacteria was gradually increased,with the rate from 18.2％ to 27.2％,until 31.2％ ; Acinetobacter Baumannii were isolated as higher infection rate and multiple drug resistance (7.1％ to 18.5％ until 28.7％) in pathogenic bacteria; the infection rate of other non-fermenter with infection rate of high and multiple drug resistance in pathogenic bacteria were gradually increased,such as infection rate or the precedence of Achromobacter xylosoxidans and Pseudomonas maltophilia,especially the precedence of Pseudomonas maltophilia ranged the third in non-fermenters,and Pseudomonas maltophiliai had a higher and multiple drug resistance to many antibiotics; infection rate of non-fermenters with low drug resistance gradually decreased,such as Pseudomonas fluorescens; the drug resistance rate of Acinetobacter Baumannii was higher than that of Pseudomonas aeruginosa and its drug resistance rate was over 50％ to common antibiotics used clinically,as well as Pseudomonas maltophiliai and Empedobacter brevis,especially the resistance rate of Pseudomonas maltophiliai to many commonly used antibiotics was more than 90.0％.Conclusions Non-fermenter isolation rate is becoming higher clinically and its drug resistance becomes more severe,so the sanitation administration department should pay more attention to the use of antibiotics in order to prevent and control drug resistance and higher infection rate caused by non-fermenters as a serious consequence.
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Weeksella virosa was previously included in group II f of CDC. We here present the Microbiological characteristics of the isolate from a case of neonatal sepsis at our center. The organism is a non-fermenter growing only on blood agar and not on Mac Conkey agar, oxidase and catalase positive, and negative for several other bio-chemical tests, except for indole with Ehrlich’s reagent. The isolate in the present case study was sensitive to aminoglycosides and β- lactams, and resistant to quinolones and carbapenems.
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Burkholderia cepacia complex (BCC) is an important nosocomial pathogen in hospitalised patients, particularly those with prior broad-spectrum antibacterial therapy. BCC causes infections that include bacteraemia, urinary tract infection, septic arthritis, peritonitis and respiratory tract infection. Due to high intrinsic resistance and being one of the most antimicrobial-resistant organisms encountered in the clinical laboratory, these infections can prove very difficult to treat and, in some cases, result in death. Patients with cystic fibrosis (CF) and those with chronic granulomatous disease are predisposed to infection by BCC bacteria. BCC survives and multiplies in aqueous hospital environments, including disinfectant agents and intravenous fluids, where it may persist for long periods. Outbreaks and pseudo-outbreaks of BCC septicaemia have been documented in intensive care units, oncology units and renal failure patients. BCC is phenotypically unremarkable, and the complex exhibits an extensive diversity of genotypes. BCC is of increasing importance for agriculture and bioremediation because of their antinematodal and antifungal properties as well as their capability to degrade a wide range of toxic compounds. It has always been a tedious task for a routine microbiological laboratory to identify the nonfermenting gram-negative bacilli, and poor laboratory proficiency in identification of this nonfermenter worldwide still prevails. In India, there are no precise reports of the prevalence of BCC infection, and in most cases, these bacteria have been ambiguously reported as nonfermenting gram-negative bacilli or simply Pseudomonas spp. The International Burkholderia cepacia Working Group is open to clinicians and scientists interested in advancing knowledge of BCC infection/colonisation in persons with CF through the collegial exchange of information and promotion of coordinated approaches to research.
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Present study was an attempt to study the prevalence of nonfermenter and its antibiotic susceptibility pattern at CSM Medical University, Lucknow. All the isolates and samples were selected from clinical specimens received in Bacteriology section, P.G. Depart of Microbiology, for culture. The observation were made on the nonfermenter isolates that can be isolated from clinical specimen using simple Laboratory media e.g. Blood Agar & Mac Conkey agar. All relevant history & information were recorded from the subjects. A total of 8340 specimen were screened for a period of one year. The prevalence of nonfermenters came to be 19.09% among all isolates. Most of spp. belongs to oxidase+ve group (77%). P. aeruginosa was found to be most common isolate (53%). Overall sensitivity profile for ciprofloxacin was 60%, P/T 58% & Amikacin 56%. Sensitivity of imepenem was 60% for multi-resistant isolates. The most resistant isolate was Sachrolytic Acinetobacter spp. The knowledge of synergism between drugs in context to different isolates may aid in effective therapy for these isolates.
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OBJECTIVE To investigate the distribution and antibiotic resistance of nonfermenting gram-negative bacilli isolated from lower respiratory tract infection patients from 2003 to 2007 for rational antimicrobial therapy in practice.METHODS The data of distribution and antibiotic resistance of nonfermenting gram-negative bacilli isolated from sputum samples of lower respiratory tract infection in our hospital from 2003 to 2007 were retrospectively analysed.RESULTS The most predominant nonfermenting gram-negative bacilli isolates were Pseudomonas aeruginosa,Acinetobacter baumannii,Acinetobacter lwoffii and Stenotrophomonas maltophilia.From 2003 to 2007,the resistance rates of these isolates to 15 antibiotics increased,especially P.aeruginosa to ceftazidime.The resistance changed from 30.2% in 2003 to 55.4% in 2005,54.8% in 2006,and reduced to 41.5% in 2007.The resistance to gentamicin,imipenem,netilmicin,ticarcillin and tobramycin varied in the similar way.The resistance of A.baumannii to imipenem increased from 21.1% to 59.7% within the five years.The resistance rate of A.lwoffi was still relatively low.S.maltophilis isolates were highly multi-resistant to antimicrobial agents tested with a rate ranging from 61.9%-100.0% except ceftazidime,ticarcillin and trimethoprim-sulfamethoxazole.CONCLUSIONS P.aeruginosa,A.baumanii and S.maltophilia are the main nonfermentive pathogens of lower respiratory tract infections and not susceptive to many antibiotics.The tendency of susceptibility and distribution changes of those bacteria should be considered in practice for proper antimicrobial therapy.
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OBJECTIVE To investigate the nonfermenter distribution and drug-resistance in the clinical specimens,and instruct clinical application of antibiotics reasonably. METHODS Bacteria were cultured,isolated and identified with ATB Expression microbe identification system.Drug-resistance was detected with ATB PSE and statistically analyzed. RESULTS A total of 1 106 strains of bacteria were isolated from 7 395 specimens,the isolation rate was 14.9%.The isolation rate of Pseudomonas aeruginosa was the highest.The isolation rate of nonfermenter was the highest from sputum specimens.Nonfermenter was the most sensitive to imipenem except for Stenotrophomonas maltophilia and Chryseobacterium meningosepticum,after imipenem was cefoperazone/sulbactam. CONCLUSIONS The nonfermenter isolated from different clinical specimens and its drug-resistance are variant.To reduce the production of drug-resistance and control the nosocomical infection,the specimens must be collected and detected timely,the antibiotics are selected according to the results of susceptibility test.
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OBJECTIVE To study the distribution of the nonfermenter(NF) and the change in its resistance between 2002 and 2005 in our hospital ICU,and instruct clinical application of antibiotics reasonably.METHODS The(identification) of bacteria, antibiotic susceptibility and the detection by VITEK-32 of GNI~+、GNS-142 were used.Etest was applied for detection of metallo-?-lactamase.RESULTS The detective rate of the NF was 57.3%,(58.3%),67.5% and 69.8%,(respectively) from 2002 to 2005.Pseudomonas aeruginosa(PAE),Acinetobacter baumannii and (Stenotrophomonas) maltophilia accounted for 34.3%,11.1% and 4.0%,respectively.The highest distribution of the NF was in the sputum.The resistance rate of PAE to imipenem was lower,(however),it had rose from 0.0% to 17.8% in 2005.The resistance rate of S.maltophilia to sulfamethoxazole/(trimethoprim) was lower than the others,and rose from 0.0% in 2002 to 13.8% in 2005.The incidence rates of(metallo)-?-lactamase of PAE was 0.8% and of A.baumannii was 4.8%,respectively;the incidence rates of metallo-?-lactamase of A.baumannii and PAE were 0.8% and 4.8%,respectively.CONCLUSIONS The(detective) rates of PAE, and A.(baumannii) are gradually increased during the last four years.The incidence of(metallo)-?-lactamase of PAE and A.baumannii is also lower,and the other resistance is existed.