PMID- 37342731
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230701
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 5
DP  - 2023 May
TI  - 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?
PG  - e39243
LID - 10.7759/cureus.39243 [doi]
LID - e39243
AB  - 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%).Around5.2% Pseudomonas aeruginosa and 2.3% Acinetobacter baumannii were 
      resistant to colistin, and 88.2% were resistant to ceftazidime. Burkholderia 
      cepacia complexwas 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 
      microg/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.
CI  - Copyright (c) 2023, Soni et al.
FAU - Soni, Mitisha
AU  - Soni M
AD  - Department of Microbiology, Gandhi Medical College, Bhopal, IND.
FAU - Kapoor, Garima
AU  - Kapoor G
AD  - Department of Microbiology, Gandhi Medical College, Bhopal, IND.
FAU - Perumal, Nagaraj
AU  - Perumal N
AD  - State Virology Laboratory, Department of Microbiology, Gandhi Medical College, 
      Bhopal, IND.
FAU - Chaurasia, Deepti
AU  - Chaurasia D
AD  - Department of Microbiology, Gandhi Medical College, Bhopal, IND.
LA  - eng
PT  - Journal Article
DEP - 20230519
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10277209
OTO - NOTNLM
OT  - amr
OT  - broth microdilution
OT  - colistin resistance
OT  - mcr gene
OT  - mdr non-fermenter
OT  - multidrug-resistant acinetobacter
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/06/21 19:15
MHDA- 2023/06/21 19:16
PMCR- 2023/05/19
CRDT- 2023/06/21 12:07
PHST- 2023/05/18 00:00 [accepted]
PHST- 2023/06/21 19:16 [medline]
PHST- 2023/06/21 19:15 [pubmed]
PHST- 2023/06/21 12:07 [entrez]
PHST- 2023/05/19 00:00 [pmc-release]
AID - 10.7759/cureus.39243 [doi]
PST - epublish
SO  - Cureus. 2023 May 19;15(5):e39243. doi: 10.7759/cureus.39243. eCollection 2023 
      May.