Document Type : New and original researches in the field of Microbiology.
Authors
1
1Professor of Medical Microbiology and Immunology and head of Clinical Microbiology and Immunology department, National Liver Institute, Menoufia University, Shebin El-kom 32511, Egypt
2
Professor of Medical Microbiology and Immunology, Clinical Microbiology and Immunology department, National Liver Institute, Menoufia University, Shebin El-kom 32511, Egypt,
3
Infection control specialist, Infection control department, Directorate of Health Affairs, Ministry of Health Shebin El-kom , Egypt
4
Microbiology nd Immunology, National Liver Institute, Menoufia University, Shebin El-kom, Egypt
Abstract
Background: Bacilli infections is a leading cause of mortality and morbidity for patients with cirrhosis especially with ICU hospitalization and overuse of antibiotics all complicate patient's prognosis. NFGNB are heterogenous group of gram -negative bacilli that emerged as hospital acquired pathogens. Objectives: To characterize non -fermenter gram negative bacilli isolated from different clinical specimen of the ICU admitted hepatic patients and assess if hospital environment and workers share in its spread. Methodology: This is a cross sectional observational study done on liver disease patients admitted to The National Liver Institute, Menoufia University, included ICU environmental samples and HCWs samples, where samples for bacteriological cultures were collected and cultivated by ordinary methods and Organisms were identified by biochemical and confirmed by VITEK 2 system. Antibiotic Resistance pattern was confirmed by automated system, E-test. Results were tabulated and analyzed. Results: NFGNB infection was prevalent among ICU hospitalized end stage liver disease patients representing (27.4%), environmental samples group which represent (12.5.5%) and HCWs group which represent (7.5%). Of which pseudomonas aeruginosa, Acinetobacter baumannii in patient samples were significantly higher than other groups. Higher percentage of MDR-NFGN and XDR-NFGN were predominant among isolates from all groups, but all are Colistin sensitive. Higher incidence of ESBLs producer NFGNB include Achromobacter xylosoxidans and Aeromonas hydrophila isolate as they represent (100%) followed by Burkholderia cepacia which represent (66.7%) while the highest incidence of MBL positive test were among Achromobacter xylosoxidans and Aeromonas hydrophila isolates followed by pseudomonas. E-test remains the golden test in detection of ESBL and MBL-NFGN. Conclusion: Resistant NFGNB is an emerging bacterium that threats hepatic patients 'outcome, especially pseudomonas aeruginosa, Acinetobacter baumannii at the front position for more studies regarding different patterns of antibiotic resistance in ICU.
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