DOI: 10.5061/dryad.ghx3ffc1f
title: In-vitro efficacy of fluoroquinolones and carbapenems against biofilm-forming and non-forming non-fermenting gram-negative bacteria isolated from clinical specimens

description: Non-fermenting gram-negative bacteria (NFGNB) pose a public health threat
 due to their tendency to cause multidrug-resistant and/or
 biofilm-associated infections. This cross-sectional study analyzed
 antibiograms, biofilm formation, and minimum inhibitory concentrations
 (MICs) of quinolones and carbapenems in NF-GNB from clinical specimens in
 a tertiary care hospital. Clinical specimens were processed for bacterial
 isolation and identification. Quinolone- and
 carbapenem-resistant Acinetobacter
 calcoaceticus-baumannii (ACB) complex and Pseudomonas
 aeruginosa, confirmed by disc diffusion, were tested for MICs of
 quinolones and carbapenems using broth microdilution. Biofilm formation
 was assessed by the microtiter plate method. Statistical analyses were
 performed in SPSS 17.0. A total of 92 NFGNB were isolated from
 patients (median age: 24 years, 56.52% female), primarily with urinary
 tract infections (40.23%). Biofilm formation was detected in 23.94%
 (17/71) of the ACB complex and 57.14% (12/21) of P. aeruginosa.
 For P. aeruginosa, the MIC50 against norfloxacin was 8
 µg/ml in biofilm non-formers and ≥64 µg/ml in formers, while ≥0.5 µg/ml
 and ≥1 µg/ml against ofloxacin, respectively. The MIC50 against
 ciprofloxacin was ≥32 µg/ml for ACB complex (both groups) and ≥4 µg/ml
 (non-formers) vs. ≥16 µg/ml (formers) for P. aeruginosa. The
 MIC50 against levofloxacin was ≥16 µg/ml for ACB complex (both
 groups) and ≥0.5 µg/ml (non-formers) vs. ≥1 µg/ml (formers)
 for P. aeruginosa. For meropenem, MIC50 was ≥0.5 µg/ml
 (non-formers) vs. ≥8 µg/ml (formers) in ACB complex and ≥8 µg/ml vs. ≥16
 µg/ml in P. aeruginosa. The MIC50 against imipenem for
 ACB complex was ≥4 µg/ml (non-formers) vs. ≥8 µg/ml (formers). Biofilm
 non-forming and forming P. aeruginosa exhibited a
 similar MIC50 value of ≥0.5 µg/ml. Over three-fourths of the
 NFGNB infections were caused by the ACB complex, with nearly one-fourth
 involving biofilm-forming strains, necessitating the need for higher MICs
 of quinolones and carbapenems.
description: Patients' demographics and laboratory results, including
 microbiological analyses, were collected through patient information
 sheets. The sheet detailed for demographic information, such as age group
 and gender of the infected patients; clinical information, including
 clinical samples; microbiological findings comprising bacterial genera,
 antimicrobial resistance patterns, biofilm formers or non-formers,
 inhibitory concentrations of fluoroquinolones (norfloxacin, ciprofloxacin,
 ofloxacin, and levofloxacin) and carbapenems (imipenem and meropenem).
 Considering that the Patient identification number and Specimen number
 were human subject data and must be anonymized, these identifiers were
 removed from the dataset. Exact or direct age is removed and is
 categorized as an age group in order to anonymize the data. Any missing or
 unclear records were clarified by communicating with healthcare providers,
 patients, or families (using the phone numbers from the patient
 information sheet). The study variables were then recorded in Microsoft
 Excel, version 13.0. Data was then entered and analyzed
 using Statistical Package for Social Sciences (SPSS), version 17.0.
 Descriptive data were analyzed in terms of frequency and percentage.
 Quantitative data were reported as mean, median, and interquartile range
 (IQR). Except for values of inhibitory concentrations, the data were
 qualitative and were calculated as frequency (percentage) in SPSS version
 17.0. Quantitative variables were calculated as median (interquartile
 range), also referred to as MIC50/MIC90. Qualitative variables were
 analyzed using the Chi-square test, while quantitative variables were
 analyzed using the independent student t-test, with statistical
 significance determined at a p-value of &lt;0.05 within a 95%
 confidence interval (CI).
description: # In-vitro efficacy of fluoroquinolones and carbapenems against
 biofilm-forming and non-forming non-fermenting gram-negative bacteria
 isolated from clinical specimens Dataset DOI:
 [10.5061/dryad.ghx3ffc1f](10.5061/dryad.ghx3ffc1f) ## Description of the
 data and file structure Comparative In-Vitro Efficacy of Fluoroquinolones
 and Carbapenems among Biofilm-Forming and Non-Forming Non-Fermenters
 Isolated from Clinical Specimens The dataset is of hospital-visiting
 individuals with infection due to non-fermenter bacteria, i.e.,
 *Acinetobacter calcoaceticus-baumanii* complex and *Pseudomonas
 aeruginosa*. The dataset comprises of single sheet. The sheet details for
 demographic information, such as age group and gender of the infected
 patients; clinical information, including clinical samples;
 microbiological findings comprising bacterial genera, antimicrobial
 resistance patterns, biofilm formers or non-formers, inhibitory
 concentrations of fluoroquinolones (norfloxacin, ciprofloxacin, ofloxacin,
 and levofloxacin) and carbapenems (imipenem and meropenem). Considering
 that the Patient identification number and Specimen number are human
 subject data and must be anonymized, these identifiers were removed from
 the dataset. Exact or direct age is removed and is categorized as an age
 group to anonymize the data. Not available (n/a) is noted for
 antimicrobial susceptibility testing results where certain antibiotics
 were not tested against the bacterium, whether due to the guidelines of
 the Clinical and Laboratory Standards Institute (31st edition) or other
 reasons for omitting antibiotic testing. Data were anonymized with the
 code. Patients with non-fermenting infections were coded with an
 alphanumeric number with the initial No. (N1, N23, etc.). Units of the
 study variables were standard and as follows: (a) Age group: Years (b)
 Inhibitory concentrations: μg/mL (microgram per milliliter) Significant
 bacterial growth on culture plates was processed for identification using
 standard microbiological protocols, including cultural characteristics,
 Gram staining, cell morphology, and biochemical characteristics [1]. Disc
 diffusion or antimicrobial susceptibility testing was done with the
 Kirby-Bauer Disc Diffusion method [2]. The inhibitory concentrations were
 determined by the gold standard broth microdilution technique. Biofilm
 formers were detected by the gold standard microtiter plate method. In the
 patient information sheet, outcome variables (bacterial pathogens) and
 predictor variables [patient demographics, time frame, specimen type, type
 of bacterial isolate(s), and antimicrobial susceptibility patterns] were
 collected from the hospital records. The data were anonymized to ensure
 patient confidentiality. Data was entered and managed using Microsoft
 Excel, version 13.0, and analyzed using Statistical Package for Social
 Sciences (SPSS), version 17.0. Descriptive data were analyzed in terms of
 frequency and percentage. Quantitative data were reported as mean, median,
 and interquartile range (IQR). Except for values of inhibitory
 concentrations, the data were qualitative and were calculated as frequency
 (percentage) in SPSS version 17.0. Quantitative variables were calculated
 as median (interquartile range), also referred to as MIC50/MIC90 or
 MBIC50/MBIC90. Qualitative variables were analyzed using the Chi-square
 test, while quantitative variables were analyzed using the independent
 student t-test, with statistical significance determined at a p-value of
 &lt;0.05 within a 95% confidence interval (CI). n/a represents not
 available, 0 represents female, 1 represents male, AST represents
 antimicrobial susceptibility testing, MIC represents minimum inhibitory
 concentration, OD = optical density. Readers may access the data from the
 Dryad repository or with a request email to the corresponding author,
 Aakash Parajuli
 ([paraj.aakash52@gmail.com](mailto:paraj.aakash52@gmail.com)), of the
 article. References \[1] Procop GW, Church DL, Hall GS, Janda WM.
 Koneman's color atlas and textbook of diagnostic microbiology. Jones
 & Bartlett Publishers; 2020 Jun 29. \[2] Clinical and Laboratory
 Standards Institute. CLSI document M100S. Performance Standards for
 Antimicrobial Susceptibility Testing. 26th ed. Wayne, PA. 2016. ## Human
 subjects data We received consent from the study participants to publish
 the de-identified data in the public domain. Considering that Patient
 identification number (e.g., P1, P18, P128, etc.) and Specimen number (S5,
 S17, S6, etc.) were human subject data and must be anonymized, these
 identifiers were removed from the dataset. Exact or direct age is removed
 and is categorized as an age group in order to anonymize the data.