Background: The present study was done to examine the prevalence and antimicrobial susceptibility pattern of NFGNB. 

Introduction: Non Fermenter Gram Negative Bacilli were previously considered as Non-pathogenic or contaminants but in past few years they have become a serious threat to the society as the frequency of their isolation and resistance towards antimicrobial agents is increasing rapidly. They have developed resistance towards commonly used antimicrobial agents as well as towards higher class also.

Material & Methods: This study was done on all clinical samples received for culture and sensitivity over a period of 6 months in department of Microbiology, NIMS Medical College, Jaipur. Samples were received and processed according to standard procedures and Antimicrobial susceptibility testing was done by using Kirby Bauer’s disc diffusion method.

Result: From 674 bacterial isolates, 122 isolates (18.10%) were identified as NFGNB. Male population was highly affected by NFGNB as compared to female population. Pseudomonas species was commonly isolated followed by Acinetobacter species and Proteus species. Meropenem was most sensitive drug followed by Imipenem. Cephalosporins showed high resistance.

Conclusion: Higher isolation rate of NFGNB seen in our study with high resistance towards first line antibiotics. Resistance towards Cephalosporins and Carbapenems indicates Beta-lactamases production by these organisms. So this study will be helpful in initiating proper empirical therapy of such patients, thus reducing the morbidity rate.

Keywords: NFGNB, Pseudomonas species, Acinetobacter species, Proteus species, Kirby-Bauer’s disc diffusion method, Carbapenem, Cephalosporins.

1. Koneman EW, Alen SD, Janda WM, Schreckenbeiger PC, Winn WC. The Non fermenting gram Negative Bacilli. In color Atlas and text book of diagnostic microbiology 6th edition, Philadelphia. J. B. Lippincott, 2006;305-91.
2. Siou Cing S et al. Identification of non-fermenting Gram-negative bacteria of clinical importance by an oligonucleotide array. Journal of Medical Microbiology (2009),58,596-605.
3. Meharwal S K, Taneja N, Sharma S K, Sharma M. Complicated nosocomial UTI caused by non fermenters. Indian J Urol 2002;18:123-8.
4. Juyal D, Prakash R, Shanakarnarayan SA, Sharma M, Negi V, Sharma N. Prevalence of non-fermenting gram negative bacilli and their in vitro susceptibility pattern in a tertiary care hospital of Uttarakhand: A study from foothills of Himalayas. Saudi J Health Sci 2013;2:108-12.
5. Baron EJ, Peterson LR, Finegold SM. Non-fermentative gram negative bacilli and coccobacilli. In: Shanahan JF, Potts LM, Murphy C, editors. Bailey and Scott's Diagnostic Microbiology. 9th ed. St. Louis, Missouri: Mosby-Year Book; 1994:386-404.
6. Gaynes, R. and J. R. Edwards. 2005. Overview of nosocomial infections caused by gram negative bacilli. Clin. Infect. Dis. 41: 848-854.
7. Kollef, M.H., A. Shorr, Y.P. Tabak, V. Gupta, L. Z. Liu and R.S. Johannes. 2005. Epidemiology and outcomes of Health care associated pneumonia. American Journal of chest infections, New York. 128: 3854-3862.
8. Kiran Chawla, Shashidhar Vishwanath and Frenil C Munim. 2013. Non-fermenting Gram negative Bacilli other than Pseudomonas aeruginosa and Acineto-bacter spp. Causing Respiratory Tract Infections in a Tertiary Care Centre. J Glob Infect Dis. 5(4): 144–148.
9. Eltahawy AT, Khalaf RM. Antibiotic resistance among gram-negative non-fermentative bacteria at a teaching hospital in Saudi Arabia. J Chemotherapy. 2001;13:260-4.
10. Mehta M, Dutta P, Gupta V. Bacterial isolates from burn wound infections and their antibiogram: An eight year study. Indian Journal of Plastic surgery. 2007; 40(1): 25-28.
11. Forbes B, Sahm D, Weissfeld A. Baily and Scott’s Diagnostic Microbiology.10^th Edition, Mosby Inc,1998.
12. Clinical and laboratory standards institute (CLSI). 2017. Performance standards for antimicrobial Susceptibility testing, 27th Ed Wayne, USA.
13. Kharangate NV, Pinto MJ, Rodrigues S, Verenkar MP. Characterization of nonfermenters from clinical samples. J Assoc Physicians India 2001;49:324-6.
14. Kaur A, Gill AK, Singh S. Prevalence and antibiogram of nonfermenting gram negative bacilli isolates obtained from various clinical samples in a tertiary care hospital, Bathinda, Punjab, India. Int J Res Med Sci 2018;6:1228-34.
15. Vijaya D, Kamala, Bavani S, Veena M. 2000. Prevalence of non-fermenters in clinical specimens. Indian J. Med. Sci. 54: 87- 91.
16. Sidhu S, Arora U, Devi P. 2010. Prevalence of nonfermentative gram negative bacilli in seriously ill patients with bacteremia. JK Science. 12: 168-171.
17. Malini A, Deepak EK, Gokul BN, Prasad SR. 2009. Non-fermenting gram negative bacilli infections in a tertiary care hospital in Kolar Karnataka. J Lab Physicians. 1(2): 62-66.
18. Singh Savita, Saxena Naveen. Prevalence of Aerobic Nonfermenting gram Negative Bacilli and Their Changing Antibiotic Pattern in a Tertiary Care Hospital in Kota Rajasthan. Int Jour of Sc R 2017;vol 6;issue 7:60-61.
19. Patel PH, Pethani JD, Rathod, SD, Chauhan B, Shah PD. Prevalence of non-fermenting Gram negative bacilli infection in a tertiary care hospital in Ahmedabad, Gujarat. Ind Jo Basic App Med Res. 2013;22:608-13.
20. K. Gokale,S. C. Metgud. Characterization and antibiotic sensitivity pattern of nonfermentinggram negative bacilli from various clinical samples in a tertiary care hospital, belgaum. Journal of pharmaceutical and biomedical sciences. 2012; 17(14).
21. Benachinmardi KK, Padmavathy M, Malini J, Naveneeth BV. Prevalence of non-fermenting Gram-negative bacilli and their in vitro susceptibility pattern at a tertiary care teaching hospital. J Scientific Society. 2014;41:162-66.
22. Jitendranath, Ashish & Radhika, R & Bhargavi, L & Bhai, G &Bai, R. (2016). Current trend of nonfermenting gram negative bacilli in a tertiary care hospital in Trivandrum. 10. 425-429.
23. Nabamita Chaudhury, Retina Paul, R.N. Misra, Sankha Subhra Chaudhuri, Shazad Mirza and Sukanta Sen. 2019. Evaluating the Trends of Bloodstream Infections by Non fermenting Gram Negative Bacilli among the Patients in a Tertiary Care Hospital of Western Part of India and its Antibiogram. Int. J. Curr. Microbiol. App. Sci. 8(01): 1149-1162.

Dr Mohammad Suhaib

Assistant Professor, Department of Microbiology, National Institute of Medical Sciences & Research, NIMS University, Jaipur, Rajasthan, India