الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Non-fermenting gram-negative bacilli (NFGNB) are one of the major causes of hospital-acquired infections (HAIs) with high levels of antibiotic resistance and a significant cause of morbidity and mortality especially in neurosurgical patients. Aim of the work: We aimed to detect the prevalence of NFGNB-causing HAIs in neurosurgical patients and to assess the resistance pattern among the causative isolates. Methods: An analytical study was carried out in the neurosurgical department and neurosurgical intensive care unit (NSICU) of Fayoum University Hospital. The demographic characteristics and risk factors of infection among 120 inpatients with HAIs (according to Centers for Disease Control and Prevention 2022 criteria) were collected from April 2022 till December 2022. Clinical samples from the patients were cultured on different culture media. NFGNB were identified using standard microbiological methods and VITEK2. Antimicrobial susceptibility testing was performed using the disc diffusion method. The molecular pattern of the resistant isolates was detected by conventional PCR. Results: Among 131 clinical samples isolated from 120 inpatients, 146 isolates were isolated, and 63(43.1%) samples yielded NFGNB. Pseudomonas aeurginosa (66.7%) and Acinetobacter baumannii (33.3%) were the most commonly isolated NFGNB. Among NFGNB the highest level of antibiotic resistance was detected for gentamicin and amikacin. armA gene was the most detected aminoglycoside resistance gene (97.7%). For Pseudomonas aeurginosa armA (100%) and acc(3')IIa (70.4%) had the highest prevalence. For Acinetobacter baumannii, armA (94.1%) and accC1 (52.9%) showed the highest prevalence. Conclusions: There is a high prevalence of NFGNB (43.1%) causing HAIs among our neurosurgical patients with high levels of antibiotic resistance for gentamicin and amikacin among isolates. This makes a major challenge to implement antimicrobial stewardship program in our hospital to lower the prevalence and the incidence of HAIs. Key words: Non-fermenting gram-negative bacilli, Hospital-acquired infections, Neurosurgical patients. |