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

The present study evaluates the prevalence and trends of Achromobacter xylosoxidans in clinical specimens and the trend in its sensitivity pattern. Achromobacter xylosoxidans is an emerging nosocomial pathogen that is commonly found in the environment. It may lead to nosocomial infections in hospital settings, particularly in the intensive care unit. It is frequently identified in humidifiers in intensive care units and is also frequently linked to patients who have several comorbidities and are immunocompromised. 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 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 the Suction tip, followed by blood (8%) and the 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 variation in antibiotic sensitivity or resistance can be due to the various factors like antibiotics used in patients in primary treatment, the immune status of the patients from which the sample was collected, overuse or misuse of antibiotics, availability of antibiotics, etc. The antibiotic of choice in our conclusion is Cotrimoxazole, followed by Piperacillin-Tazobactam. Colistin should be kept as a reserve drug for the last resort treatment.