Chawla Kiran, Vishwanath Shashidhar, Munim Frenil C
Department of Microbiology, Kasturba Medical College, Manipal, Manipal University, Karnataka, India.
J Glob Infect Dis. 2013 Oct;5(4):144-8. doi: 10.4103/0974-777X.121996.
Nonfermenting gram-negative bacilli have emerged as important healthcare-associated pathogens. It is important to correctly identify all clinically significant nonfermenting gram-negative bacilli considering the intrinsic multidrug resistance exhibited by these bacteria.
A retrospective study was undertaken to identify the various nonfermenting gram-negative bacilli other than Pseudomonas aeruginosa and Acinetobacter spp. isolated from respiratory samples (n = 9363), to understand their clinical relevance and to analyze their antibiotic susceptibility pattern.
Nonfermenting gram-negative bacilli were isolated from 830 (16.4%) samples showing significant growth. Thirty-three (4%) isolates constituted nonfermenting gram-negative bacilli other than P. aeruginosa and Acinetobacter spp. Stenotrophomonas maltophilia (15, 45.5%) was the most common isolate followed by Burkholderia cepacia (4, 12.1%), Sphingomonas paucimobilis (3, 9.1%), and Achromobacter xylosoxidans (3, 9.1%). On the basis of clinicomicrobiological correlation, pathogenicity was observed in 69.7% (n = 23) isolates. Timely and correct treatment resulted in clinical improvement in 87.9% cases.
Any nonfermenting gram-negative bacilli isolated from respiratory tract infection should not be ignored as mere contaminant, but correlated clinically for its pathogenic potential and identified using standard methods so as to institute appropriate and timely antibiotic coverage.
非发酵革兰氏阴性杆菌已成为重要的医疗保健相关病原体。鉴于这些细菌表现出的固有多重耐药性，正确识别所有具有临床意义的非发酵革兰氏阴性杆菌非常重要。
进行了一项回顾性研究，以识别从呼吸道样本（n = 9363）中分离出的除铜绿假单胞菌和不动杆菌属之外的各种非发酵革兰氏阴性杆菌，了解它们的临床相关性，并分析它们的抗生素敏感性模式。
从830份（16.4%）显示有显著生长的样本中分离出非发酵革兰氏阴性杆菌。33份（4%）分离株为除铜绿假单胞菌和不动杆菌属之外的非发酵革兰氏阴性杆菌。嗜麦芽窄食单胞菌（15份，45.5%）是最常见的分离株，其次是洋葱伯克霍尔德菌（4份，12.1%）、少动鞘氨醇单胞菌（3份，9.1%）和木糖氧化无色杆菌（3份，9.1%）。根据临床微生物学相关性，在69.7%（n = 23）的分离株中观察到致病性。及时且正确的治疗使87.9%的病例临床症状得到改善。
从呼吸道感染中分离出的任何非发酵革兰氏阴性杆菌都不应被视为单纯的污染物而被忽视，而应根据其致病潜力进行临床关联，并使用标准方法进行鉴定，以便及时给予适当的抗生素覆盖。
