Antimicrobial susceptibility pattern of Burkholderia cepacia complex & Stenotrophomonas maltophilia over six years (2007-2012)
| Autor: | Rupinder Tewari, Lipika Singhal, Parvinder Kaur, T Deepak, Pallab Ray, Vikas Gautam, Sunil Kumar |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
biology
Burkholderia cepacia complex Stenotrophomonas maltophilia India Ceftazidime General Medicine Drug resistance Opportunistic Infections Antimicrobial biology.organism_classification Meropenem Trimethoprim General Biochemistry Genetics and Molecular Biology Microbiology Levofloxacin Correspondence Drug Resistance Bacterial Trimethoprim Sulfamethoxazole Drug Combination medicine Humans Gram-Negative Bacterial Infections medicine.drug |
| Zdroj: | The Indian Journal of Medical Research |
| ISSN: | 0971-5916 |
| Popis: | Sir, Non-fermenting Gram-negative bacteria (NFGNB) are a threat to the health care community because these cause opportunistic infections in critically ill or immunocompromised patients. Following Acinetobacter species and Pseudomonas aeruginosa, Burkholderia cepacia complex (Bcc) and Stenotrophomonas maltophilia are the third and fourth common NFGNB among the positive blood cultures at a tertiary care institute in north India1,2. The treatment of infections caused by these organisms is challenging because of high intrinsic and acquired resistance to all commonly used antibiotics including the antipseudomonal drugs3. The increasing incidence of infections by these organisms along with the rising drug resistance warrants a close monitoring of the antimicrobial susceptibility of these organisms. We present the analysis of the antimicrobial susceptibility profiles from March 2007 to December 2012 of 186 Bcc isolates (63 isolates from 2007 to 2009, 89 isolates from 2010 to 2011 and 34 isolates in 2012) and 125 S. maltophilia isolates (38 isolates from 2007 to 2009, 54 isolates from 2010 to 2011 and 33 isolates in 2012) obtained from various clinical specimens (blood, cerebrospinal fluid, sputum, endotracheal aspirate, bronchoalveolar lavage and pus) at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. All the NFGNB isolates were identified by conventional biochemical reactions. Gram-negative, motile, NFGNB were identified further by the use of oxidase test, triple sugar iron agar with lead acetate paper strip and decarboxylase tests4. Molecular identification and typing of Bcc were done by recA polymerase chain reaction-restriction fragment length polymorphism (recA PCR-RFLP)4. Drug susceptibility was tested by Kirby-Bauer disk diffusion test (DD)5 against co-trimoxazole (TMP-SMX, 1.25 µg/23.75 µg), ceftazidime (30 µg), tetracycline (30 µg)/minocycline (30 µg), levofloxacin (5 µg) for S. maltophilia and additionally against meropenem (10 µg) for Bcc following Clinical Laboratory Standards Institute (CLSI) guidelines6. The minimum inhibitory concentrations (MIC) of selected number of isolates were determined by agar dilution method as per CLSI guidelines6 against minocycline (sensitive, S≤4 and resistant R≥16 μg/ml), levofloxacin (S≤2 & R≥8 μg/ml), ceftazidime (S≤8 & R≥32 μg/ml), chloramphenicol (S≤8 & R≥32 μg/ml) for Bcc, and minocycline (S≤4 & R≥16 μg/ml), levofloxacin (S≤2 & R≥8 μg/ml), co-trimoxazole (S≤2/38 & R≥4/76 μg/ml), chloramphenicol (S≤8 & R≥32 μg/ml), ceftazidime (S≤8 & R≥32 μg/ml) for S. maltophilia. The proportional data were analyzed by Z-test for proportions. In 2012, by DD 100 per cent of the Bcc isolates were susceptible to minocycline, 71 per cent to co-trimoxazole, 71 per cent to meropenem and 59 per cent to ceftazidime. A significant decrease in susceptibility of Bcc for ceftazidime has been observed in 2012 (59%) when compared with previous years (83 and 85%, P |
| Databáze: | OpenAIRE |
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