Non- Fermenters as Mysterious Pathogens or Contaminants- Continuing Dilemma
Journal Title: Saudi Journal of Pathology and Microbiology - Year 2018, Vol 3, Issue 9
Abstract
Non-fermenters (NFs) account for about 15% of all bacterial pathogens isolated from a clinical microbiology laboratory. Primarily regarded as contaminants, they have been implicated in causing various infections. They are innately resistant to many antibiotics and emerging as important nosocomial pathogens. To isolate non-fermenters from Urinary Tract Infections and assess their clinical significance and anti-microbial sensitivity pattern.Five thousand nine hundred and thirty four (5934) non-repetitive consecutive samples of urine from patients diagnosed of culture-proven UTI of a tertiary-care teaching hospital over a period of four-years (2014-2017) were selected. A urinary sample was subjected to presumptive screening followed by semi-quantitative culture on CLED (Himedia, Mumbai) agar. Identification and antibiogram was done by Vitek 2 compact (bioMérieux, France) automated systems. Clinical history and laboratory parameters were utilized for clinical correlation.Out of 5934 samples showing significant growth 6212 (15.6%) bacterial isolates were grown, Non fermenters being in 5.6%. P. aeruginosa (55.17%)and Burkholderia cepacia (17.42%) were predominant NFs. Post- operative UTI (23.3%) and history of Diabetes (17.5%) were the two most common risk factors associated. Pseudomonas spp., Burkholderia spp., Acinetobacter spp. and Sphingomonas spp. gave variable susceptibilities to normally recommended drugs compared to Myroides spp, Achromobacter spp.,and other NFs.Appropriate identification and susceptibility patterns of NFs is vital for management of infections, implementation of appropriate Infection Control interventions, and avoidance of irrelevant antibiotics use preventing emergence of drug resistance and thus morbid complications.
Authors and Affiliations
Dr. Anuradha Makkar, Dr. Pragyan Swagatika Panda, Lt Col Inam Danish Khan, Dr. Priyanka Banerjee, Mr. Sanjay Singh Kaira, Col K S Rajmohan
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