ABSTRACT
We report for the first time 2 cases of multidrug-resistant Burkholderia cenocepacia J2315 isolated from blood samples of patients without cystic fibrosis from a pediatric unit in a hospital in India. The first patient presented with community-acquired bacteremia, and the second patient was immunocompromised and developed hospital-acquired infection approximately 17 days after admission. The isolates from both patients were multidrug-resistant and strong biofilm producers. Surveillance cultures identified the secondary sources of the infections, but not the primary sources.
Subject(s)
Burkholderia Infections/diagnosis , Burkholderia cenocepacia/isolation & purification , Lung Diseases/complications , Lung Diseases/microbiology , Anti-Bacterial Agents/pharmacology , Bacteremia/diagnosis , Bacteremia/microbiology , Biofilms/growth & development , Burkholderia Infections/microbiology , Burkholderia cenocepacia/drug effects , Burkholderia cenocepacia/growth & development , Burkholderia cenocepacia/physiology , Child , Child, Preschool , Community-Acquired Infections/diagnosis , Community-Acquired Infections/microbiology , Cross Infection/diagnosis , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial , Humans , Immunocompromised Host , India , MaleABSTRACT
Acinetobacter baumannii is considered as an emerging nosocomial pathogen and is renowned for its multi-drug resistance. We report a case of community-acquired pan-resistant A. baumannii caused fulminating septicemia. The treatment failure led to death. The A. baumannii strain isolated from blood, pus, urine and tracheal aspirate was confirmed by 16S r-RNA sequence homology and found positive for metallo-ß-lactamase IMP-1, and was found to be a strong biofilm producer. The isolate was only susceptible (moderately) to colistin.
Subject(s)
Acinetobacter Infections/diagnosis , Acinetobacter baumannii/drug effects , Community-Acquired Infections/diagnosis , Drug Resistance, Multiple, Bacterial , Sepsis/microbiology , beta-Lactamases/biosynthesis , Acinetobacter Infections/microbiology , Acinetobacter baumannii/isolation & purification , Anti-Bacterial Agents/pharmacology , Blood/microbiology , Community-Acquired Infections/microbiology , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Fatal Outcome , Female , Humans , Microbial Sensitivity Tests , Middle Aged , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNA , Suppuration/microbiology , Trachea/microbiology , Urine/microbiologyABSTRACT
BACKGROUND: Recently, Acinetobacter emerged as an important pathogen and the prevalence of isolation has increased since the last two decades worldwide. AIMS: To determine Acinetobacter incidence, their clinical demography, antibiotyping and speciation. SETTINGS AND DESIGN: A study of the clinical samples submitted to microbiology laboratory of a teaching hospital over a period of 3 years (December 1994 through November 1997). MATERIALS AND METHODS: Identification, speciation and antibiotyping were performed for the isolates of Acinetobacter recovered from infective samples. Clinical demographic characteristics were studied retrospectively. RESULTS: Total 510 of 5391 (9.6%) of isolates were Acinetobacter, responsible for 71.2% (363 of 510) monomicrobial and 28.8% (147 of 510) polymicrobial infections. The organism was responsible for 156 (30.6%) cases of urinary tract infection and 140 (27.5%) cases of wound infection and was most prevalent in the intensive care unit (30.8%, 140 of 455). The crude mortality rate due to multi-drug resistant Acinetobacter septicemia was 7.9% (36 of 455). The isolates could be classified into 7 species, with A. baumannii being most predominant. No peculiar pattern during antibiotyping was observed, but most of them were multi-drug resistant. CONCLUSION: Multi-drug resistant Acinetobacter nosocomial infection has emerged as an increasing problem in intensive care units of the hospital, responsible for 7.9% deaths. The analysis of risk factors and susceptibility pattern will be useful in understanding epidemiology of this organism in a hospital setup.
