Non-fermenter Gram-negative bacilli at a tertiary hospital, South Africa.

IF 1.4 Q4 INFECTIOUS DISEASES

Southern African Journal of Infectious Diseases Pub Date : 2023-11-20 eCollection Date: 2023-01-01 DOI:10.4102/sajid.v38i1.538

Sinenhlanhla Ndzabandzaba, Lesego Mothibi, Nina von Knorring

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引用次数: 0

Abstract

Background: Non-fermenting Gram-negative bacilli (NFGNB) are a significant cause of healthcare-associated infections and are often implicated in nosocomial outbreaks. Non- fermenting Gram-negative bacilli tend to have variable susceptibility patterns that make the choice of empiric therapy difficult and thus treatment must be based on in vitro susceptibility testing of each antimicrobial agent.

Objectives: To describe the epidemiology of the NFGNB isolated from adult patients at Chris Hani Baragwanath Hospital (CHBAH) and to assess their antimicrobial susceptibility patterns in order to guide empiric therapy and inform infection prevention and control practices.

Method: Organisms isolated from sterile sites of adult in-patients between 01 January 2016 to 31 December 2018 were retrospectively analysed.

Results: A total of 2005 NFGNB isolated. Blood cultures were the most common specimen type (91.4%). Acinetobacter species were the most commonly isolated organisms (65.1%), followed by Pseudomonas species (26.5%). The majority of NFGNB were isolated from patients in surgical wards (38.9%) followed by medical wards (35.2%). Most (60%) of the Acinetobacter species were extremely drug resistant. Pseudomonas species were more susceptible than the Acinetobacter species with an overall susceptibility rate of 86% for Pseudomonas species.

Conclusion: The rates of antimicrobial resistance demonstrated among Acinetobacter and Pseudomonas species were high, which illustrates the threat of antimicrobial resistance also seen worldwide. An emergence of NFGNB with intrinsic multidrug resistance (Stenotrophomonas maltophilia and Burkholderia cepacia) was noted. We suggest empiric therapy with a carbapenem sparing regimen of piperacillin-tazobactam in combination with amikacin and that empiric therapy be reviewed annually when cumulative antibiograms are done.

Contribution: Understanding of the distribution and antimicrobial susceptibility patterns of NFGNB at CHBAH.

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南非一家三级医院的非发酵革兰氏阴性杆菌。

背景:非发酵革兰氏阴性杆菌(NFGNB)是卫生保健相关感染的重要原因，经常与医院暴发有关。非发酵革兰氏阴性杆菌往往具有可变的药敏模式，这使得选择经验性治疗变得困难，因此治疗必须基于每种抗菌药物的体外药敏试验。目的:描述Chris Hani Baragwanath医院(CHBAH)成年患者分离的NFGNB的流行病学，并评估其抗菌药物敏感性模式，以指导经验性治疗并为感染预防和控制实践提供信息。方法:回顾性分析2016年1月1日至2018年12月31日成人住院患者无菌部位分离的微生物。结果:共分离NFGNB 2005例。血培养是最常见的标本类型(91.4%)。最常见的分离菌种是不动杆菌(65.1%)，其次是假单胞菌(26.5%)。NFGNB主要来自外科病房(38.9%)，其次是内科病房(35.2%)。大多数(60%)不动杆菌具有极强的耐药性。假单胞菌比不动杆菌更敏感，对假单胞菌的总敏感率为86%。结论:不动杆菌和假单胞菌对抗生素的耐药率较高，表明抗生素耐药性的威胁在世界范围内也存在。NFGNB出现了内在的多药耐药(嗜麦芽窄养单胞菌和洋葱伯克霍尔德菌)。我们建议经验性治疗为保留碳青霉烯的哌拉西林-他唑巴坦联合阿米卡星方案，并建议经验性治疗在累积抗生素图完成后每年进行回顾。贡献:了解NFGNB在CHBAH的分布和抗菌敏感性模式。

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来源期刊

Southern African Journal of Infectious Diseases INFECTIOUS DISEASES-

自引率

11.10%

发文量

审稿时长

52 weeks