Prevalence of Non-Fermenter as Uro Pathogen in Tertiary Care Hospital in Chidambaram Tamil Nadu
Corresponding Author(s) : Vijay kumar J
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 2 No. 4 (2014): 2014 Volume 2- Issue -4
Abstract
Background and Objectives
Aerobic, nonfermenting gram-negative bacilli (non-fermenters) are now emerging as important uropathogens. This study was done to know the prevalence of non-fermenters in Urinary Tract Infections (UTI) along with their antibiotic sensitivity.
Method
1361 mid stream urine specimens received in 18 months period from December 2012 to July 2014 were subjected to Gram, staining ,semi-quantitative culture, biochemical tests and antibiotic sensitivity testing as per the standard procedures in the routine microbiology laboratory and the results were noted.
Results
Out of the 317 culture positive cases with significant bactereuria, 131 (9.7%) were caused by non-fermenters. Among the non-fermenters, Pseudomonas spp. was the most common (80.6%) followed by Acinetobacter spp. (19.3%). Majority of patients belonged to the age group of 15 to 50 years and most of them were females. Antibiotic sensitivity testing revealed that, among Pseudomonas spp., 77.4% isolates were sensitive to Piperacillin, 71.13% sensitive to Amikacin, 41.9% sensitive to Ciprofloxacin, 35.4% sensitive to Ceftazidime and 90% sensitive to Imipenem. In the case of Acinetobacter spp., 68% isolates were sensitive to Amikacin, 33.3% sensitive to Norfloxacin and all were sensitive to imipenem. Out of the 6 non-fermenter isolates which were resistant to commonly used antibiotics, 4 were from inpatients indicating the possibility of nosocomial infection. Conclusion: The non-fermenters are emerging as important cause of Urinary Tract Infections. In this study, Pseudomonas spp. was the most common non-fermenter isolated in significant numbers in MSU specimens. But, Acinetobacter spp. appeared to be more resistant to invitro antibiotics in general.
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REFERENCE
[1] Bryan CS. Reynolds KL. (1984) Community acquired bacteremic urinary tract infections: Epidemiology and outcome. J U rol: 132: 490.
[2] Baron EJ, Fine-old SM (1990) Nonfermentative gram-negative bacilli and coccobacilli. In: Bailey and Scott's Diagnostic microbiology, 8 th Edn. Mosby 386-407.
[3] Hall GS. (1995) Non fermentative gram-negative bacilli and miscellaneous gram negative rods. In: Textbook of diagnostic Microbiology. Conneie R Mahan. George Manuselis Jr. eds. Philadelphia: 513-538.
[4] Koneman EW. Allen SD, Rowell Jr VR et al. In (1988) Color atlas and textbook of diagnostic microbiology. 3' edn. Lippincott. Philadelphia: 157-208, 493-534.
[5] Pederson MB. Marso E, Pickett MJ. (1970) Nonfermentative bacilli associated with man; III. Pathogenicity and antibiotic susceptibility. Am J Clin Path : 54: 178-192
[6] Quinn PJ. (1998)Clinical problems posed by multidrug resistant nonfermenting gram-pathogens. CID: 27(suppl): sl 17-124
[7] Rambaugh KP, Griswold JA. Hamood AN.(1999) Pseudomonas aeruginosa: Strains obtained from patients with tracheal, urinary tract and wound infection; variation in virulence factors and virulence genes. J Hosp Infect: 43: 211-215.
[8] Stansfeld JM.(1966) Clinical observation relating to incidence and etiology of urinary tract infections in children. Br Med J : 1: 631-635
[9] Sussman M. (1998) Urinary tract infections. In: Topley and Wilson's Microbiology and Microbial infections. Hausler Jr, Sussman M eds. 9th edn. Arnold : 601-621
[10] Gupta V, Yadav A, Joshi RM. Antibiotic resistance pattern in uropathogens. Indian J Med Microbiol 2002;20:96-8.
[11] Jamal W et al, Role of tigecycline in the control of a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit. J Hosp Infect. 2009 Jul; 72(3):234-42. Epub 2009 Jun 3.
[12] Nenek A et al, Emergence of carbapenem resistance in Acinetobacter baumannii in the Czech Republic is associated with the spread of multidrug-resistant strains of European clone II. J Antimicrob Chemother. 2008 Sep; 62(3):484-9. Epub 2008 May 13.
[13] Katsumi Shigemura et al, Complicated urinary tract infection caused by Pseudomonas aeruginosa in a single institution (1999-2003), International J Urology 2006, 13 (5); 538-542.
[14] Jombo G.T.A, et al, Multidrug resistant Pseudomonas aeruginosa in a contemporary Medical Practice: Findings from urinary isolates at a Nigerian University Teaching Hospital, Nigerian J Physiological Sciences 2008, 23 (1-2); 105-109.
[15] K. Takeyama et al, Multidrug-resistant Pseudomonas aeruginosa isolated from the urine of patients with urinary tract infection, J of Infection and Chemotherapy 2008, 8(1); 59-63.
[16] Marcus N et al, Community-acquired Pseudomonas aeruginosa urinary tract infections in children hospitalized in a tertiary center: relative frequency, risk factors, antimicrobial resistance and treatment 2008 Oct; 36(5):421-6. Epub 2008 Sep 15.
References
[1] Bryan CS. Reynolds KL. (1984) Community acquired bacteremic urinary tract infections: Epidemiology and outcome. J U rol: 132: 490.
[2] Baron EJ, Fine-old SM (1990) Nonfermentative gram-negative bacilli and coccobacilli. In: Bailey and Scott's Diagnostic microbiology, 8 th Edn. Mosby 386-407.
[3] Hall GS. (1995) Non fermentative gram-negative bacilli and miscellaneous gram negative rods. In: Textbook of diagnostic Microbiology. Conneie R Mahan. George Manuselis Jr. eds. Philadelphia: 513-538.
[4] Koneman EW. Allen SD, Rowell Jr VR et al. In (1988) Color atlas and textbook of diagnostic microbiology. 3' edn. Lippincott. Philadelphia: 157-208, 493-534.
[5] Pederson MB. Marso E, Pickett MJ. (1970) Nonfermentative bacilli associated with man; III. Pathogenicity and antibiotic susceptibility. Am J Clin Path : 54: 178-192
[6] Quinn PJ. (1998)Clinical problems posed by multidrug resistant nonfermenting gram-pathogens. CID: 27(suppl): sl 17-124
[7] Rambaugh KP, Griswold JA. Hamood AN.(1999) Pseudomonas aeruginosa: Strains obtained from patients with tracheal, urinary tract and wound infection; variation in virulence factors and virulence genes. J Hosp Infect: 43: 211-215.
[8] Stansfeld JM.(1966) Clinical observation relating to incidence and etiology of urinary tract infections in children. Br Med J : 1: 631-635
[9] Sussman M. (1998) Urinary tract infections. In: Topley and Wilson's Microbiology and Microbial infections. Hausler Jr, Sussman M eds. 9th edn. Arnold : 601-621
[10] Gupta V, Yadav A, Joshi RM. Antibiotic resistance pattern in uropathogens. Indian J Med Microbiol 2002;20:96-8.
[11] Jamal W et al, Role of tigecycline in the control of a carbapenem-resistant Acinetobacter baumannii outbreak in an intensive care unit. J Hosp Infect. 2009 Jul; 72(3):234-42. Epub 2009 Jun 3.
[12] Nenek A et al, Emergence of carbapenem resistance in Acinetobacter baumannii in the Czech Republic is associated with the spread of multidrug-resistant strains of European clone II. J Antimicrob Chemother. 2008 Sep; 62(3):484-9. Epub 2008 May 13.
[13] Katsumi Shigemura et al, Complicated urinary tract infection caused by Pseudomonas aeruginosa in a single institution (1999-2003), International J Urology 2006, 13 (5); 538-542.
[14] Jombo G.T.A, et al, Multidrug resistant Pseudomonas aeruginosa in a contemporary Medical Practice: Findings from urinary isolates at a Nigerian University Teaching Hospital, Nigerian J Physiological Sciences 2008, 23 (1-2); 105-109.
[15] K. Takeyama et al, Multidrug-resistant Pseudomonas aeruginosa isolated from the urine of patients with urinary tract infection, J of Infection and Chemotherapy 2008, 8(1); 59-63.
[16] Marcus N et al, Community-acquired Pseudomonas aeruginosa urinary tract infections in children hospitalized in a tertiary center: relative frequency, risk factors, antimicrobial resistance and treatment 2008 Oct; 36(5):421-6. Epub 2008 Sep 15.