Siddiqui Tasneem, Sahu Chinmoy, Patel Sangram Singh, Ghoshal Ujjala
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
J Lab Physicians. 2022 Feb 9;14(3):312-316. doi: 10.1055/s-0042-1742634. eCollection 2022 Sep.
complex (BCC) is an emerging pathogen causing nosocomial bloodstream infections (BSIs), and its treatment is challenging due to its multidrug resistance. In India, there is a dearth of data on BSIs caused by BCC, therefore, an updated study is required to know the clinical and microbiological profile of these patients. We aimed to study the clinical epidemiology and antibiotic susceptibility pattern of BCC isolated from blood samples in our hospital. This observational study was conducted from January 2019 to December 2020 at a tertiary care center in northern India. All the blood cultures were done on an automated blood culture system. All BCC isolates of BSI were identified depending on their morphological properties and biochemical reactions, and underwent the matrix-assisted laser desorption ionization time-of-flight mass spectrometry system to confirm diagnosis. Antibiotic susceptibility testing was done as per Clinical Laboratory and Standards Institute guidelines. BCC was isolated from 30 BSI patients over a 2-year period. Sixty-six percent (20/30) of patients had cancer and a majority of them were undergoing chemotherapy. The most common predisposing factors were the use of steroids, immunosuppressive drugs, and chemotherapy (93.3%), central lines (83.3%), use of higher antibiotics (60%), and diabetes mellitus type 2 (60%). The most common species isolated were (64%) and (30%). Isolates showed highest sensitivity to minocycline (100%), ceftazidime (73.3%), and meropenem (70%) and the least to ticarcillin-clavulanate. BCC is an emerging pathogen causing BSIs, especially in malignancy patients. Minocycline can be a good choice for these bacteria.
洋葱伯克霍尔德菌复合体(BCC)是一种引发医院血流感染(BSIs)的新出现病原体,因其多重耐药性,其治疗颇具挑战性。在印度,关于BCC所致血流感染的数据匮乏,因此,需要开展一项更新研究以了解这些患者的临床和微生物学特征。我们旨在研究从我院血样中分离出的BCC的临床流行病学及抗生素敏感性模式。
这项观察性研究于2019年1月至2020年12月在印度北部的一家三级医疗中心进行。所有血培养均在自动血培养系统上进行。所有血流感染的BCC分离株均根据其形态学特性和生化反应进行鉴定,并采用基质辅助激光解吸电离飞行时间质谱系统进行确诊。抗生素敏感性试验按照临床实验室和标准研究所的指南进行。
在两年期间,从30例血流感染患者中分离出了BCC。66%(20/30)的患者患有癌症,且大多数患者正在接受化疗。最常见的易感因素是使用类固醇、免疫抑制药物和化疗(93.3%)、中心静脉导管(83.3%)、使用高级抗生素(60%)和2型糖尿病(60%)。分离出的最常见菌种是洋葱伯克霍尔德菌(64%)和唐菖蒲伯克霍尔德菌(30%)。分离株对米诺环素(100%)、头孢他啶(73.3%)和美罗培南(70%)敏感性最高,对替卡西林 - 克拉维酸敏感性最低。
BCC是一种引发血流感染的新出现病原体,尤其是在恶性肿瘤患者中。米诺环素可能是针对这些细菌的一个不错选择。