non lactose fermenting gram negative rods treatment

Among the Pseudomonas species, a high level of resistance was recorded for ceftazidime (50%), aztreonam (50%), and doripenem (50%). baumannii isolates were resistant to aminoglycosides and colistin, respectively, while all the isolates were susceptible to meropenem. cepacia isolates from cancer patients may be slightly different, with increased susceptibility to some antibiotics, especially piperacillin, piperacillin-tazobactam, and cefepime. However, according to literature, the antibiogram of B. cepacia isolates are susceptible are meropenem, ceftazidime, ceftibuten, chloramphenicol, and trimethoprim. The 2010 Sanford Guide recommends co-trimoxazole as the treatment of choice for these infections. The in vitro anti-microbial susceptibility of Burkholderia cepacia isolates revealed 92% resistance to meropenem, while the susceptibility to co-trimoxazole was 100%. Prabash et al., in 2010, analyzed the blood cultures of cancer patients (neutropenic and non-neutropenic) and found that non-fermenters comprised a majority of the Gram-negative bacilli isolated (62.24%), with Pseudomonas (30.37%) and Acinetobacter sp. Out of the total Gram-negative bacilli, the NFGNB in our study were 63.5% (40/63), and B. In this study, NFGNB were isolated from 4.9% of the total blood samples received for the culture. A high level of resistance against the first- and second-line antibiotics was noted. The antibiotic susceptibility results are given in Table 1, which shows the percentage of resistant isolates. Acinetobacter baumannii (20%), Pseudomonas aeruginosa (12.5%), Pseudomonas stutzeri (2.5%), Alcaligenes faecalis (2.5%), and Sphingomonas paucimobilis (2.5%) were the other NFGNB isolated from the blood stream infections. Forty, out of 63 (63.5%) Gram-negative organisms were NFGNB, out of which Burkholderia cepacia (60%) was the predominant isolate. Sixty-three (36.6%) were Gram-negative and 108 (62.7%) were Gram-positive organisms, while one isolate was fungus ( Candida sp.). However, only 172 yielded pathogenic bacteria on subculture. The antibiotic susceptibility results were expressed as susceptible, intermediate or resistant, according to the criteria of the Clinical Laboratory Standards Institute (CLSI) M100-S23 (2013).Īmong 815 total samples received for blood culture, 249 bottles were flagged as positive in the BacT Alert 3D. The VITEK ®2 Compact (C) system (bioMerieux, North Carolina, USA) was used to identify NFGNB up to the species level, using the Gram-negative Identification (GN-ID) 21341 card, and antibiotic susceptibility testing (AST) was done using the AST 281 card. From the positive bottles, the subcultures were performed on MacConkey agar and blood agar. Blood culture was performed in BacT/Alert blood culture bottles (bioMerieux, Durham, North Carolina, USA). In an attempt to recognize the antibiotic resistance and prevalence pattern among NFGNB associated with BSIs in cancer patients, a prospective study was conducted over a period of one year from July 2013 to June 2014, at a tertiary care cancer institute in North India.

NFGNB have a varied isolation rate, ranging from 2.18 to 45.9%, as observed from various clinical samples. High intrinsic resistance of NFGNB to antimicrobial compounds makes the treatment of BSIs caused by them difficult and expensive. Blood stream infections (BSI) caused by NFGNB are a major cause of morbidity and mortality worldwide.

NFGNB can cause a significant number of infections, ranging from superficial to deep-seated and disseminated infections in immunocompromised hosts, neutropenic patients, patients with cystic fibrosis, patients on mechanical ventilation and indwelling catheters, and patients undergoing invasive diagnostic and therapeutic procedures. Non-fermenting Gram-negative bacilli (NFGNB) are a group of organisms that either do not utilize glucose as a source of energy or utilize it oxidatively.

Non lactose fermenting gram negative rods treatment