Prevalence of multidrug-resistant gram-negative bacilli (MDR-GNB) in hospital-acquired and ventilator-associated pneumonia: A comparative study from a tertiary care center, Gujarat

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Original Article

Author Details : Himani Bhardwaj Pandya*, Amit Pravin Chauhan, Rachana Bhavin Patel, Nidhi Mihirkumar Bhalodia, Sucheta Jitendra Lakhani

Volume : 11, Issue : 4, Year : 2024

Article Page : 248-253

https://doi.org/10.18231/j.ijmr.2024.044

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Abstract

Background: Antibiotic resistance poses a formidable challenge to global healthcare, with Gram-negative bacteria emerging as a primary concern. Multidrug-resistant Gram-negative bacilli (MDR-GNB) have become a significant cause of nosocomial infections, particularly pneumonia, complicate therapy, and have a detrimental impact on patients’ outcomes.
Aim and Objectives: This study aims to investigate the etiology, risk factors, and antibiotic resistance patterns associated with Gram-negative bacilli (GNB) isolated from nosocomial pneumonia cases.
Materials and Methods: This prospective cross-sectional study was conducted at the Microbiology laboratory of a tertiary care Hospital in Gujarat. Patients hospitalized for >48 hours with new lung infiltrates and at least two of the following clinical features: fever, leukocytosis/leukopenia, purulent secretions, or decreased oxygenation were included. The study was initiated after the ethical approval. Patient demographic and clinical details were noted in the preformed questionnaire. A total of 64 specimens [Sputum (n= 28) and Endotracheal aspirate (ET, n=36)] were cultured on MacConkey’s agar and Blood agar and further species identification with Antimicrobial Susceptibility Pattern was done by automated Vitek-2 compact system.
Result: Ventilator-associated Pneumonia (VAP) was found in 14.6% of infected patients, with male predominance and common in the 30-50 years age group. Out of them, 72% were mainly associated with late-onset. Overall, the major isolates were Pseudomonas aeruginosa (20/64, 31%), followed by
Acinetobacter baumannii (19/64, 29.6%) and Klebsiella pneumoniae (17/64, 26.5%) both as solitary and mixed infections.76% strains of Klebsiella and 85% of E. coli strains were resistant to carbapenems and 93.3% of Acinetobacter baumannii were resistant to cephalosporins and carbapenems. Enterobacter cloaca strains were 100% resistant to carbapenems.
Conclusion: The study recommends effective Infection control practices and strong antibiotic stewardship programs to reduce the morbidity and mortality of nosocomial pneumonia.

Keywords: Carbapenem resistance, Critical care units, Hospital-acquired pneumonia, Multidrug resistance (MDR), Ventilator- associated pneumonia

How to cite : Pandya H B, Chauhan A P, Patel R B, Bhalodia N M, Lakhani S J, Prevalence of multidrug-resistant gram-negative bacilli (MDR-GNB) in hospital-acquired and ventilator-associated pneumonia: A comparative study from a tertiary care center, Gujarat. Indian J Microbiol Res 2024;11(4):248-253

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