Emergence of Multidrug-Resistant Non-Fermenting Gram-Negative Bacilli in a Tertiary Care Teaching Hospital of Central India: Is Colistin Resistance Still a Distant Threat?

被引:6
作者
Soni, Mitisha [1 ]
Kapoor, Garima [1 ]
Perumal, Nagaraj [2 ]
Chaurasia, Deepti [1 ]
机构
[1] Gandhi Med Coll, Dept Microbiol, Bhopal, India
[2] Gandhi Med Coll, Dept Microbiol, State Virol Lab, Bhopal, India
关键词
amr; multidrug-resistant acinetobacter; broth microdilution; mcr gene; colistin resistance; mdr non-fermenter; TREND;
D O I
10.7759/cureus.39243
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose Multidrug-resistant (MDR) organisms are being increasingly reported from India. This study aimed to determine the antibiotic susceptibility pattern of non-fermenting Gram-negative bacilli (NF-GNB) isolated from all the clinical samples to estimate the prevalence of MDR MDR NF-GNB and to screen for colistin-resistance genes among all colistin-resistant strains. Materials and methods This prospective study conducted from January 2021 to July 2022 at a tertiary care teaching hospital in central India identified MDR NF-GNB from clinical samples using standard procedures and antimicrobial susceptibility testing conducted as per Clinical Laboratory Standards Institute (CLSI) guidelines. Colistin-resistant strains identified by broth microdilution were further subjected to detection of plasmid-mediated colistin-resistant genes (mcr-1, mcr-2, mcr-3) by polymerase chain reaction (PCR). Results A total 2,106 NF-GNB were isolated from 21,019 culture positive clinical samples, of which 743 (35%) were MDR. Majority of MDR NF-GNB isolated were from pus (45.50%) followed by blood (20.50%). Out of 743 non-duplicate MDR non-fermenters, the most common were Pseudomonas aeruginosa (51.7%), Acinetobacter baumannii (23.4%), and others (24.9%). Around 5.2% Pseudomonas aeruginosa and 2.3% Acinetobacter baumannii were resistant to colistin, and 88.2% were resistant to ceftazidime. Burkholderia cepacia complex was 100% susceptible to minocycline and least susceptible to ceftazidime (28.6%). Out of 11, 10 (90.9%) Stenotrophomonas maltophilia were susceptible to colistin and least susceptible to ceftazidime and minocycline (27.3%). All 33 colistin-resistant strains (minimal inhibitory concentration >= 4 mu g/mL) were found to be negative for mcr-1, mcr-2, and mcr-3 genes. Conclusion Our study showed a significantly wide variety of NF-GNB, ranging from Pseudomonas aeruginosa (51.7%), Acinetobacter baumannii (23.4%), to Acinetobacter haemolyticus (4.6%), Pseudomonas putida (0.9%), Elizabethkingia meningoseptica (0.7%), Pseudomonas luteola (0.5%), and Ralstonia pickettii (0.4%), which have not been commonly reported in literature. Of all the non-fermenters isolated in the present study, 35.28% were MDR, raising the concern for rationalizing antibiotic use and improving infection control measures to avert or slow the emergence of antibiotic resistance.
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