Antimicrobial use and antimicrobial resistance in nosocomial pathogens at a tertiary care hospital in Pune

The rapid emergence of antimicrobial resistance in major uropathogens has created a global threat especially in the developing countries. In Bangladesh, prescribers of different regions generally diagnose microbial infection on clinical judgment and select antimicrobial on empirical basis, which unfavorably affects the sensitivity pattern of microbes. The present study was designed to determine the prevalence of antimicrobial resistance of Escherichia coli and Klebsiella species isolated from patients with UTI in a tertiary care hospital. This was a cross sectional study conducted at Sylhet MAG Osmani Medical College Hospital, Sylhet from 1st January to 31st December 2016. A total of 200 clinically suspected urinary tract infection patients aged 16-85 years were included in this study. The isolated Escherichia coli and Klebsiella species were tested for antimicrobial susceptibility according to the guideline of Clinical and Laboratory Standards Institute (CLSI) 2011 using the modified Kirby- Bauer disc diffusion technique. Out of 107 pus cell positive ( 05/HPF) urine samples, 75 (70.1%) yielded significant bacteriuria of which 49 (65.3%) were Escherichia coli and 9 (12%) were Klebsiella species. The isolated Escherichia coli showed absolutely high resistance to ampicillin and cefuroxime (100%), moderately high resistance to ceftazidime (81.6%), ciprofloxacin (77.6%), cotrimoxazole (75.5%), cefotaxime (67.4%) and ceftriaxone (59.2%), moderate rate of resistance to amikacin 48.9% and imipenem 46.9% and least rate of resistance to gentamicin (22.5%), nitrofurantion (22.5%) and netilmicin (6.1%). In addition, Klebsiella species revealed completely resistance to ampicillin, cotrimoxazole, cefuroxime, cefotaxime, ceftriaxone, ceftazidime (100%), moderately high resistance to imipenem (88.9%), nitrofurantoin (77.8%), moderate resistance to ciprofloxacin (44.4%), amikacin (33.3%) and gentamicin (33.3%) and least resistance to netilmicin (11.1%). Hence very high resistance rates of 1st line drugs found in uropathigenic Escherichia coli & Klebsiella species, it is necessary to diagnose clinically followed by culture and sensitivity testing. Regular antibiotic surveillance of a particular geographical area is required to establish reliable information regarding susceptibility pattern of uropathogens in order to preserve the continued usefulness of most antimicrobial agents.Medicine Today 2018 Vol.30(2): 61-66

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Shifting trends in bacteriology and antimicrobial resistance among gastrointestinal fistula patients in China: an eight-year review in a tertiary-care hospital

BMC Infectious Diseases ◽

10.1186/s12879-017-2744-7 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 4

Author(s):

Qinjie Liu ◽

Jianan Ren ◽

Xiuwen Wu ◽

Gefei Wang ◽

Zhiwei Wang ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Gastrointestinal Fistula

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High Prevalence of Antimicrobial Resistance Among Gram-Negative Isolated Bacilli in Intensive Care Units at a Tertiary-Care Hospital in Yucatán Mexico

Medicina ◽

10.3390/medicina55090588 ◽

2019 ◽

Vol 55 (9) ◽

pp. 588 ◽

Cited By ~ 2

Author(s):

Andrés H. Uc-Cachón ◽

Carlos Gracida-Osorno ◽

Iván G. Luna-Chi ◽

Jonathan G. Jiménez-Guillermo ◽

Gloria M. Molina-Salinas

Keyword(s):

Escherichia Coli ◽

Intensive Care ◽

Antimicrobial Resistance ◽

Intensive Care Units ◽

High Resistance ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Gram Negative ◽

Resistance Rates

Background and Objectives: Antimicrobial resistance (AMR) is increasing worldwide and imposes significant life-threatening risks to several different populations, especially to those in intensive care units (ICU). The most commonly isolated organisms in ICU comprise gram-negative bacilli (GNB), and these represent a leading cause of serious infections. This study was conducted to describe the prevalence of resistance in GNB isolated from patients in adults, pediatric, and neonatal ICU in a tertiary-care hospital in Mérida, Mexico. Materials and Methods: A retrospective study was done on samples collected in Neonatal (NICU), Pediatric (PICU) and Adult (AICU) ICU of Unidad Médica de Alta Especialidad, Instituto Mexicano del Seguro Social in Mérida, México. The identification of isolates and antimicrobial susceptibility testing were performed using an automated system. Results: A total of 517 GNB strains were isolated. The most common positive culture was bronchial secretions. Pseudomonas aeruginosa was the prevalent pathogen in NICU and PICU, whereas Escherichia coli was common in the AICU. Overall, GNB exhibited a high resistance rates for Ampicillin (95.85%), Cefuroxime (84.17%), Piperacillin (82.93%), Cefotaxime (78.07%), Ceftriaxone (77.41%), Aztreonam (75.23%), Cefazolin (75.00%), and Ceftazidime (73.19%). There are significant differences in the resistance rates of GNB from different ICUs for penicillins, cephalosporins, carbapenems and fluoroquinolones drugs. Escherichia coli (multidrug-resistant [MDR] = 91.57%, highly resistant microorganisms [HRMO] = 90.36%) and Acinetobacter baumannii (MDR = 86.79%, HRMO = 83.02%) exhibited the highest percentage of MDR and HRMO profiles. The prevalence of the extended-spectrum beta-lactamases (ESBL)-producing isolates was 83.13% in E. coli, 78.84% in Klebsiella pneumoniae, and 66.67% in Proteus mirabilis, respectively. Conclusions: The high resistance rates to drugs were exhibited by our GNB isolates. Continuous surveillance and control of the use of antimicrobials are urgently needed to reduce the emergence and spreading of MDR, HRMO, and/or ESBL-producing bacilli.

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