الفهرس 
*Infections caused by Burkholderia cepacia complexOnly 14 pages are availabe for public view
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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.