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  Table of Contents  
CORRESPONDENCE
Year : 2017  |  Volume : 35  |  Issue : 2  |  Page : 318-319
 

Antibiotic susceptibility pattern of Burkholderia cepacia complex and Stenotrophomonas maltophilia: A 5-year analysis


Department of Laboratory Medicine – Microbiology, Manipal Hospital, Bengaluru, Karnataka, India

Date of Web Publication5-Jul-2017

Correspondence Address:
Malavalli Venkatesh Bhavana
Department of Laboratory Medicine – Microbiology, Manipal Hospital, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmm.IJMM_16_236

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How to cite this article:
Bhavana MV, Joshi S, Adhikary R, Beena HB. Antibiotic susceptibility pattern of Burkholderia cepacia complex and Stenotrophomonas maltophilia: A 5-year analysis. Indian J Med Microbiol 2017;35:318-9

How to cite this URL:
Bhavana MV, Joshi S, Adhikary R, Beena HB. Antibiotic susceptibility pattern of Burkholderia cepacia complex and Stenotrophomonas maltophilia: A 5-year analysis. Indian J Med Microbiol [serial online] 2017 [cited 2017 Sep 26];35:318-9. Available from: http://www.ijmm.org/text.asp?2017/35/2/318/209577


Dear Editor,

Non-fermenting Gram-negative bacilli have emerged as significant pathogens over the years, causing serious infections, especially in immunocompromised patients. These organisms are ubiquitous in nature, particularly in soil, water and also in the hospital environment.[1] Among these non-fermenters, Burkholderia cepacia complex (BCC) and Stenotrophomonas maltophilia have a different susceptibility pattern compared to that of Pseudomonas aeruginosa. There are not many studies from South India analysing the susceptibility pattern of these organisms.

This is a retrospective laboratory-based analysis from a tertiary care hospital in South India. We had a total of 88 BCC and 158 S. maltophilia isolates from 2011 to 2015. Clinical samples were processed by standard microbiological methods. VITEK 2 compact (BioMerieux, France) was used for the final identification of BCC and S. maltophilia. Antibiotic susceptibility was tested by Kirby–Bauer disk diffusion method for cotrimoxazole (1.25 μg/23.75 μg) and levofloxacin (5 μg) for S. maltophilia and for meropenem (10 μg), cotrimoxazole (1.25 μg/23.75 μg) and ceftazidime (30 μg) for BCC following the Clinical Laboratory Standards Institute guidelines.[2] Minimum inhibitory concentration testing was done using VITEK 2 for the same set of antibiotics. ATCC  Escherichia More Details coli 25922 was used for quality control.

The analysis of the year-wise susceptibility pattern is shown in [Figure 1] and [Figure 2].
Figure 1: Susceptibility pattern of Burkholderia cepacia from 2011 to 2015.

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Figure 2: Susceptibility pattern of Stenotrophomonas maltophilia from 2011 to 2015.

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Cotrimoxazole exhibited very good susceptibility against both the isolates. According to the SENTRY Antimicrobial Surveillance Program, which monitors the predominant community-acquired and nosocomial pathogens including their antimicrobial resistance globally, cotrimoxazole was found to have an excellent susceptibility against both these organisms.[3] In the Indian scenario, Gautam et al. from North India have reported susceptibility rates of 75%–80% among BCC isolates and 70%–90% among S. maltophilia isolates to cotrimoxazole.[4] As per a study conducted in a tertiary care centre of coastal Karnataka by Chawla et al., 86.7% susceptibility to cotrimoxazole for S. maltophilia was seen.[1]

We observed a decrease in the susceptibility to cotrimoxazole in 2013 for BCC and in 2011 for S. maltophilia. This may be just the tip of the iceberg; it indicates that there are mechanisms which lead to the resistance against this important drug, and a watchful eye over the same is a must.[5] Among the other antibiotics, ceftazidime has very good susceptibility for BCC whereas levofloxacin looks promising for S. maltophilia infections.

The limitation of this study is the lack of molecular procedures. However, our findings emphasise the importance of accurate identification of these non-fermenters and periodic analysis of their susceptibility profiles for a better patient outcome.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
 ~ References Top

1.
Chawla K, Vishwanath S, Munim FC. Nonfermenting Gram-negative Bacilli other than Pseudomonas aeruginosa and Acinetobacter Spp. Causing Respiratory Tract Infections in a Tertiary Care Center. J Glob Infect Dis 2013;5:144-8.  Back to cited text no. 1
[PUBMED]    
2.
Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; 24th Informational Supplement M100-S24. Wayne, USA: CLSI; 2015.  Back to cited text no. 2
    
3.
Sader HS, Jones RN. Antimicrobial susceptibility of uncommonly isolated non-enteric Gram-negative Bacilli. Int J Antimicrob Agents 2005;25:95-109.  Back to cited text no. 3
    
4.
Gautam V, Kumar S, Kaur P, Deepak T, Singhal L, Tewari R, et al. Antimicrobial susceptibility pattern of Burkholderia cepacia complex & Stenotrophomonas maltophilia over six years (2007-2012). Indian J Med Res 2015;142:492-4.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Tseng SP, Tsai WC, Liang CY, Lin YS, Huang JW, Chang CY, et al. The contribution of antibiotic resistance mechanisms in clinical Burkholderia cepacia complex isolates: An emphasis on efflux pump activity. PLoS One 2014;9:e104986.  Back to cited text no. 5
    


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