Prevalence of Non Fermenting Gram Negative Bacilli with Their in vitro Antibiotic Sensitivity Profile in RIMS, Ranchi

ABSTRACT

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.