Bacteriological Profile of Non-Fermenting Gram Negative Bacilli and its Antibiogram in Tertiary Care Hospital, Calicut, India
1Department of Microbiology, MIMS college of Allied Health Sciences, Kerala University of Health Sciences, Malappuram, India 2Department of Microbiology, Aster MIMS Hospital, Calicut, India 3Department of Microbiology, MIMS college of Allied Health Sciences, Malappuram, India 4Department of Microbiology, MIMS college of Allied Health Sciences, Malappuram, India
*Corresponding author
Abstract:
Non-fermenting Gram-negative bacilli (NFGNB) have emerged as a major cause of healthcare-associated infections and are innately resistant to many antibiotics. High intrinsic resistance of NFGNB to antimicrobial compounds makes the treatment caused by them difficult and expensive. To identify and determine the antibiogram of Nonfermenting gram negative bacilli isolated in clinical samples and to compare the its pattern over a period of 2 years. This ambidirectional study was done at our Department of Microbiology Aster MIMS, Calicut. NFGNB were isolated from a variety of clinical specimens, plated on blood agar and MacConkey agar and incubated at 37°C for 18–24 h under aerobic conditions. Appropriate biochemical tests were done to identify the organisms isolated. Antibiotic susceptibility test was performed using the modified Kirby–Bauer disc diffusion method using commercially available discs on Mueller–Hinton agar. Blood culture was done by automated blood culture system, (BacT/Alert 3 D) and identification and antibiotic susceptibility of non-fermenting gram-negative bacilli was done by VITEK 2 Compact System. Out of 28162 clinical samples, 2148 (1109 in year 2023 and 1038 in year 2024) (7.6%) yielded NFGNB. Acinetobacter baumanni was the most common NFGNB, isolated in 965/2148 (44.9%) samples which were susceptibile to colistin (100%) and tigecycline (66.9%) , followed by Pseudomonas aeruginosa in 700/2148 (32.5%) susceptible to colistin (98.2%) and amikacin (75.7%) and a total of 965/2148 (44.9%) carbapenem-resistant Acinetobacter baumannii (CRAB) and 700/2148 (32.5%) carbapenem-resistant Pseudomonas aeruginosa (CRPA) was detected in the study. This study revealed a significantly high prevalence of non-fermenting Gram-negative bacilli (NFGNB), with Acinetobacter baumannii and Pseudomonas aeruginosa being the most frequently isolated species. The high rates of. multidrug-resistant A. baumannii and P. aeruginosa underscore a growing concern regarding the rapid emergence and spread of antimicrobial resistance in the region. These findings reflect the rising threat of multidrug resistance among NFGNB and emphasize the urgent need for enhanced antimicrobial stewardship, infection control, and routine resistance surveillance to contain their spread and preserve treatment efficacy.
Keywords: Non-fermenting Gram-negative bacilli, Antibiotic susceptibility, carbapenem-resistant
References:
- Procop GW, Church DL, Hall GS, Janda WM. Koneman’s color atlas and textbook of diagnostic microbiology. 7th ed. Sudbury, MA: Jones and Bartlett; 2020.
- Baruah FK, Hussain AN, Kausalya, Grover RK. Antibiotic resistance profile of non-fermenting Gram-negative bacilli isolated from the blood cultures of cancer patients. J Glob Infect Dis. 2015 Jan-Mar; 7 (1): 46–7. doi: 10.4103/0974-777X.150892.
- Malini A, Deepa E, Gokul B, Prasad S. Non-fermenting Gram-negative bacilli infections in a tertiary care hospital in Kolar, Karnataka. J Lab Physicians. 2009.
- Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2019. 2019 [accessed 2023 Apr 17]. Available from: https: //www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf.
- Infectious Diseases Society of America. IDSA Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections: Version 2.0. 2022 [accessed 2023 Apr 28]. Available from: https: //www.idsociety.org/practice-guideline/amr-guidance-2.0/.
- Grewal US, Bakshi R, Walia G, Shah PR. Antibiotic susceptibility profiles of non-fermenting gram-negative Bacilli at a tertiary care hospital in Patiala, India. Niger Postgrad Med J. 2017; 24: 121–5. doi: 10.4103/npmj.npmj_76_17.
- Enoch DA, Birkett CI, Ludlam HA. Non-fermentative Gram-negative bacteria. Int J Antimicrob Agents. 2007; 29 (Suppl 1): S33–41. doi: 10.1016/S0924-8579 (07)72176-3.
- Ozenen GG, Bal ZS, Umit Z, et al., Nosocomial non-fermentative gram-negative bacteria bloodstream infections in children; Risk factors and clinical outcomes of carbapenem resistance. J Infect Chemother. 2021; 27 (5): 729–735. doi: 10.1016/j.jiac.2020.12.024.
- Bassetti M, et al., New antibiotics for the treatment of nonfermenting Gram-negative bacteria. Curr Opin Infect Dis. 2021; 34 (6): 701–709. doi: 10.1097/QCO.0000000000000757.
- Yadav SK, Bhujel R, Mishra SK, et al., Emergence of multidrug-resistant non-fermentative gram-negative bacterial infection in hospitalized patients in a tertiary care center of Nepal. BMC Res Notes. 2020.
- Mehta A, Diwakar MK. Characterization and antimicrobial susceptibility profile of non-lactose fermenting gram-negative bacterial isolates in a tertiary care teaching hospital of central India. AJPCR. 2021; 10 (14): 41–7.
- Benachinmardi KK, Padmavathy M, Malini J, Naveneeth BV. Prevalence of non-fermenting Gram-negative bacilli and their in vitro susceptibility pattern at a tertiary care teaching hospital. J Sci Soc. 2014; 41: 162–6.
- Sushitha TS, Kurian Pulikottil S, Beena VG. Bacteriological profile of non-fermenting gram-negative bacilli causing infections in immunocompromised patients. Int J Acad Med Pharm. 2024.
- Sarkar M, Jena J, Pattnaik D, Mallick. Prevalence of non-fermentative gram-negative bacilli and their antimicrobial susceptibility profiles in a tertiary care hospital of Eastern India. Int J Adv Med. 2018; 5: 366–70
- Kumar R, Hassan AA, Kumar A, Kumar A. Prevalence of non-fermentative gram-negative bacilli and their antimicrobial susceptibility profile at a tertiary care center in Eastern India. Int J Acad Med Pharm. 2023.
- Rit K, Nag F, Raj HJ, Maity PK. Prevalence and susceptibility profiles of non-fermentative gram-negative bacilli infection in a tertiary care hospital of Eastern India. Indian J Clin Pract. 2013; 24: 451–5.
- Soni M, Kapoor G, Perumal N, Chaurasia D. 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? Cureus. 2023.
- Kumar R, Patel R, Jain M, Mistry A. Prevalence of non-fermenting gram-negative bacilli from clinical isolates and their antibiogram profile. Int J Curr Microbiol Appl Sci. 2020.
- Mehta A, Diwakar MK. Characterization and antimicrobial susceptibility profile of non-lactose fermenting gram-negative bacterial isolates in a tertiary care teaching hospital of central India. AJPCR. 2021; 10 (14): 41–7.
- Benachinmardi KK, Padmavathy M, Malini J, Naveneeth BV. Prevalence of non-fermenting Gram-negative bacilli and their in vitro susceptibility pattern at a tertiary care teaching hospital. J Sci Soc. 2014; 41: 162–6.
- Sushitha TS, Kurian Pulikottil S, Beena VG. Bacteriological profile of non-fermenting gram-negative bacilli causing infections in immunocompromised patients. Int J Acad Med Pharm. 2024.
- Sarkar M, Jena J, Pattnaik D, Mallick. Prevalence of non-fermentative gram-negative bacilli and their antimicrobial susceptibility profiles in a tertiary care hospital of Eastern India. Int J Adv Med. 2018; 5: 366–70.
- Kumar R, Hassan AA, Kumar A, Kumar A. Prevalence of non-fermentative gram-negative bacilli and their antimicrobial susceptibility profile at a tertiary care center in Eastern India. Int J Acad Med Pharm. 2023.
- Rit K, Nag F, Raj HJ, Maity PK. Prevalence and susceptibility profiles of non-fermentative gram-negative bacilli infection in a tertiary care hospital of Eastern India. Indian J Clin Pract. 2013; 24: 451–5.
- Manjunath V, Revanappa SB, Bullappa A, Lakshminarayana JV. Prevalence of multidrug-resistant non-fermenters in a tertiary care centre. Asian J Med Sci. 2022; 13 (10): 176–182. doi: 10.3126/ajms.v13i10.46366.
- Kaur A, Gill AK, Singh S. Prevalence and antibiogram of non-fermenting gram-negative bacilli isolates obtained from various clinical samples in a tertiary care hospital, Bathinda, Punjab, India. Int J Res Med Sci. 2018.
- Berwal A, Shobha KL, Gupta R, et al., Non-fermenting gram-negative bacteria as uropathogens in causing urinary tract infection and its antimicrobial susceptibility pattern at a tertiary care centre of South India. J Pure Appl Microbiol. 2020.
- Juyal D, Prakash R, Shanakarnarayan SA, et al., Prevalence of non-fermenting gram-negative bacilli and their in vitro susceptibility pattern in a tertiary care hospital of Uttarakhand: a study from foothills of Himalayas. Saudi J Health Sci. 2013; 2: 108–12.
- Jayapriya S, Lata S, Sumathi G. Non-fermentative gram-negative bacilli - characterization and antibiotic resistant pattern study from a tertiary care hospital. Ind J Basic Appl Med Res. 2014; 3 (4): 227–32.
- Samanta P, Gautam V, Thapar R, Ray P. Emerging resistance of non-fermenting gram-negative bacilli in a tertiary care centre. Indian J Pathol Microbiol. 2011; 54: 666–7.
- Hafiz TA, Essa EA, Alharbi SR, et al., Epidemiological, microbiological, and clinical characteristics of multi-resistant Pseudomonas aeruginosa isolates in King Fahad Medical City, Riyadh, Saudi Arabia. Trop Med Infect Dis. 2023; 8 (4): 205. doi: 10.3390/tropicalmed8040205.
- Lee YL, Liu CE, Ko WC, Hsueh PR. In vitro susceptibilities of Stenotrophomonas maltophilia isolates to antimicrobial agents commonly used for related infections: Results from the Antimicrobial Testing Leadership and Surveillance (ATLAS) program, 2004–2020. Int J Antimicrob Agents. 2023; 62 (2): 106878. doi: 10.1016/j.ijantimicag.2023.106878
- Alhuthil RT, Hijazi RM, Alyabes OA, et al., Epidemiology, clinical profiles, and antimicrobial susceptibility of Elizabethkingia meningoseptica infections: Insights from a tertiary care hospital in Saudi Arabia. Saudi Med J. 2024.
- Chang J, Kim S, Kwak YG, et al., Clinical and microbiological characteristics of Chryseobacterium indologenes bacteremia: A 20-year experience in a single university hospital. Infect Chemother. 2023; 55 (3): 322–327. doi: 10.3947/ic.2022.0133.
- Laupland KB, Paterson DL, Stewart AG, et al., Sphingomonas paucimobilis bloodstream infection is a predominantly community-onset disease with significant lethality. Int J Infect Dis. 2022
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Gayathri Meyana, Reshmi Gopalakrishnan, Savitha M., Swathy Viswanath, Anjali M. P., Athulya M. M., Irfana and Vismaya P. P. 2025. Bacteriological Profile of Non-Fermenting Gram Negative Bacilli and Its Antibiogram in Tertiary Care Hospital, Calicut.
Int.J.Curr.Microbiol.App.Sci. 14(10): 106-125. doi:
https://doi.org/10.20546/ijcmas.2025.1410.010
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