Species Of Non-Fermentative Gram-Negative Bacilli Other Than Pseudomonas Aeruginosa Isolated From Surgical Wards In Regional Institute Of Gastroenterology And Hepatology Cluj Napoca, Romania

Purpose: Nonfermentative Gram – negative bacilli represent an important cause of morbidity and mortality in hospital environments with intrinsic resistance to multiple classes of antibiotics and their ability to gain new resistance factors. In this study we aimed to identify the etiology of nonfermentative Gram - negative bacilli in 2014 from surgical wards of Regional Institute of Gastroenterology and Hepatology “O. Fodor” Cluj - Napoca and to analyze their resistance profile. Methods & Materials: We analyzed 280 clinical specimens from hospitalized patients between January - December 2014. Their identification was achieved with automatic system Vitek® 2 Compact (bioMérieux, Marcy - l’ Étoile, France). Antibiotic susceptibility testing was performed both with automatic system VITEK® 2 Compact and with disc diffusion method. Antibiotic susceptibility for Stenotrophomonas maltophilia was done by disc diffusion method with Levofloxacin 5 μg., Minocycline 30 μg. and Sulphamethoxazol-Trimethoprim 1.25 / 23.75 μg. Interpretation sensitivity testing was done according to current CLSI. Results: 308 nonrepetitive strains of nonfermentative Gram - negative bacilli were isolated. The involved species are presented in the table that follows.Tabled 1Bacterial speciesn%Achromobacter denitrificans10.3%Achromobacter xylosoxidans10.3%Burkholderia pseudomallei10.3%Burkholderia cepacia10.3%Elizabethkingia meningoseptica82.6%Pseudomonas aeruginosa25984.1%Pseudomonas putida10.3%Rhizobium radiobacter10.3%Stenotrophomonas maltophilia3310.7%Sphingomonas paucimobilis20.7%Total308100%P. aeruginosa was the main pathogen isolated (84.1%), followed by S. maltophilia (10.7%) and E. meningoseptica (2.6%). Open table in a new tab P. aeruginosa was the main pathogen isolated (84.1%), followed by S. maltophilia (10.7%) and E. meningoseptica (2.6%). The antimicrobial resistance profile for S. maltophilia was: 3.9% to levofloxacin, 3.3% to minocycline, and 32.1% to sulphamethoxazol-trimethoprim (SXT). E. meningoseptica was resistant to all tested antibiotics, except, ciprofloxacin, minocycline and trimethoprim. B. cepacia was resistant to aminoglycosides. P. putida, R. radiobacter and S. paucimobilis were sensitive to all antibiotics. Achromobacter species were resistant toaminoglycosides, fluoroquinolones, colistin and SXT. Conclusion: These species require automated methods for identification, their diversity is a challenge for microbiological diagnosis. Although these species are rarely isolated, they are important due to the intrinsic resistance that limits therapeutic options.