National Academy of Agricultural Sciences (NAAS)
|
PRINT ISSN : 2319-7692
Online ISSN : 2319-7706 Issues : 12 per year Publisher : Excellent Publishers Email : editorijcmas@gmail.com submit@ijcmas.com Editor-in-chief: Dr.M.Prakash Index Copernicus ICV 2018: 95.39 NAAS RATING 2020: 5.38 |
Multidrug-resistant (MDR) and extensively drug-resistant (XDR) gram-negative bacilli (GNB) are a leading cause of healthcare associated infections worldwide and pose a growing threat to antimicrobial therapy in Indian tertiary care hospitals. To determine the prevalence and resistance pattern of MDR/XDR gram-negative bacilli isolated from inpatients and outpatients at a tertiary care hospital in Telangana over a one year period. This retrospective, descriptive study analyzed 146 multidrug-resistant gram negative clinical bacterial isolates recorded in the hospital’s antimicrobial resistance surveillance registry between June 2025 and May 2026. Organism identification and antimicrobial susceptibility testing were performed by standard microbiological methods as per CLSI guidelines 2025edition; isolates were categorized as MDR, XDR or pandrug-resistant (PDR) using the Magiorakos et al., international consensus definitions. Of 591 total gram negative bacilli 146 (24.7%) gram-negative bacilli were MDROs. Of which Klebsiellapneumoniae (56, 38.4%) and Escherichia coli (50, 34.2%) were the predominant organisms, followed by Pseudomonas aeruginosa (19, 13.0%) and Acinetobacterbaumannii (10, 6.8%). Among GNB isolates, 117 (80.1%) were XDR and 29 (19.9%) were MDR (non-XDR); XDR rates were highest for A. baumannii (100%), P. aeruginosa (89.5%) and K. pneumoniae (89.3%). Inpatients contributed 99 (67.8%) of GNB isolates. Urine (37.0%) and blood (13.7%) were the leading specimen types, and Nephrology, Internal Medicine and Plastic Surgery were the leading contributing departments. Gram-negative bacilli, particularly K. pneumoniae and E. coli, constitute the predominant reservoir of multidrug resistance in this tertiary care setting, with a strikingly high XDR burden. These findings underscore the urgent need for robust antimicrobial stewardship, infection-control measures, and judicious, susceptibility-guided use of novel beta-lactam/beta-lactamase-inhibitor combinations.
Ahmad S, Singh AK, Sinha S, et al., (2025) Phenotypic and molecular characterization of ESBL-producing Escherichia coli in urinary tract infections at a tertiary care centre in India. Int J Med Pharm Res, 6(4), pp.1367–1380.
Banerjee T, et al., (2018) High prevalence and endemicity of multidrug resistant Acinetobacter spp. in intensive care unit of a tertiary care hospital, Varanasi, India. J Pathog, 2018, 9129083.
Chaudhary R, Bhatta S, Pant C, Phuyal N, Shrestha L. (2024) Multidrug resistance gram-negative bacteria in intensive care unit of tertiary care hospital: a descriptive cross-sectional study. JNMA J Nepal Med Assoc, 62(277), pp.582–586.
Cheemala SS, Vara A, Lakshmi MS, Pradhan S, Kalyani K. (2023) Phenotypic detection of carbapenemase production in gram negative bacilli from clinical isolates in a tertiary care hospital in Telangana. J Pure ApplMicrobiol, 17(4), pp.2111–2118.
Clinical and Laboratory Standards Institute. (2025) M100: Performance Standards for Antimicrobial Susceptibility Testing. 35th ed. Wayne, PA: CLSI.
D’Souza A, Shetty R, Pai KB A. (2024) A study on ceftazidime/avibactam and aztreonam synergy among aztreonam-resistant metallo-β-lactamase producing Enterobacterales in a tertiary care hospital. Mediterr J Infect Microbes Antimicrob, 13, p.2.
Gupta N, Boodman C, Prayag P, Manesh A, Kumar TP. (2024) Ceftazidime-avibactam and aztreonam combination for carbapenem-resistant Enterobacterales bloodstream infections with presumed metallo-β-lactamase production: a systematic review and meta-analysis. Expert Rev Anti Infect Ther, 22(4), pp.203–209.
Indian Council of Medical Research. (2022) Guidance on Diagnosis & Management of Carbapenem Resistant Organisms. New Delhi: ICMR.
Joseph JN, Boloor R. (2023) Prevalence and pattern of multidrug resistant gram-negative bacilli isolated from patients in the intensive care unit of a tertiary care hospital in Coastal Karnataka. IP Int J Med Microbiol Trop Dis, 9(2), pp.92–97.
Kavya V, Mahale RP, Deepashree R, Jamal AN. (2024) Burden of multidrug-resistant gram-negative bacterial infections in a tertiary care hospital. J Pure ApplMicrobiol, 18(3), pp.1729–1740.
Khattab S, Askar AM, Abdellatif HAA, Othman AAA, Rayan AH, Azab H. (2025) Synergistic combination of ceftazidime and avibactam with aztreonam against MDR Klebsiellapneumoniae in ICU patients. Sci Rep, 15, p.5102.
Magiorakos AP, Srinivasan A, Carey RB, et al., (2012) Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. ClinMicrobiol Infect, 18(3), pp.268–281.
Murray CJL, Ikuta KS, Sharara F, et al., (2022) Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet, 399(10325), pp.629–655.
Padmaja GV, Jabeen U, Fatima SN. (2024) Prospective study on multidrug resistant organisms in clinical isolates and correlation with epidemiological isolates at a tertiary care hospital in Hyderabad. Int J Med Pharm Res, 6(6), pp.1480–1486.
Puttegowda D, Jayaram L, Rajshekar D, et al., (2026) Prevalence and antimicrobial resistance of Acinetobacterbaumannii isolated from endotracheal aspirates in a tertiary-care intensive care unit from South India. Front Microbiol, 17, p.1784001.
Shbaita S, Abatli S, Sweileh MW, et al., (2023) Antibiotic resistance profiles and associated factors of Pseudomonas infections among patients admitted to a large tertiary care hospital from a developing country. Antimicrob Resist Infect Control, 12(1), p.149.
World Health Organization. (2024) WHO Bacterial Priority Pathogens List, 2024: Bacterial Pathogens of Public Health Importance to Guide Research, Development and Strategies to Prevent and Control Antimicrobial Resistance. Geneva: World Health organization.|
|
|