Antimicrobial Susceptibility Pattern and Prevalence of the Emerging Nosocomial Pathogen Achromobacter xylosoxidans in a North Indian Tertiary Care Hospital

Abstract

Achromobacter xylosoxidans is an emerging nosocomial pathogen which is commonly found in the environment. In hospital settings, especially in ICU, it can be a cause of nosocomial infection. It is commonly found in the humidifiers in ICU settings and it is also commonly associated with the immunocompromised state of patient having comorbidities. The objective of the study was to study the prevalence of Achromobacter xylosoxidans and its antimicrobial sensitivity pattern. The Retrospective analysis was done of the culture reports positive for Achromobacter xylosoxidans by VITEK 2 method and its Antimicrobial sensitivity pattern was analysed from the period of September 2021 to February 2023.The maximum (54.54%) infection was seen in the age group >50 years. The maximum number (66.2%) of Achromobacter xylosoxidans were isolated from Suction tip, followed by blood (8%) and Tracheal Tip (5%). Surgical ICU contributed to the maximum number of infections i.e. 40.2%, followed by Respiratory ICU (22.1%). Maximum sensitivity was seen for Cotrimoxazole and Meropenem (around 80%), followed by Cefoperazone-Sulbactam (74%), Imipenem, Levofloxacin, Ceftazidime (around 65%). The sensitivity was minimal for Ceftriaxone (0%), Aztreonam (1.3%), and Gentamicin (5.2%). The most common risk factors/ comorbidities associated with Achromobacter infections was recent ICU admission (87.01%). The antibiotic sensitivity trends to all the antibiotics used, declined from 2021 to 2022. The antibiotic of choice to our conclusion is Cotrimoxazole, followed by Piperacillin-Tazobactam. Colistin should be kept as a reserve drug for the last resort treatment. The bacteria should not be ignored as it can lead to various opportunistic infections in immunocompromised patients, causing hindrance in the treatment.