Antibiogram pattern and seasonality of Salmonella serotypes in a North Indian tertiary care hospital

The antibiogram pattern and seasonal distribution of Salmonella serotypes were analysed retrospectively over a 6-year period from January 1999 to December 2004. Blood cultures received in the Bacteriology Laboratory were processed by standard procedures and the Salmonella spp. isolates were identified with specific antisera and standard biochemical tests. Antimicrobial susceptibility testing was carried out by a standard disc diffusion method and the minimum inhibitory concentration (MIC) of ciprofloxacin for 332 representative Salmonella isolates was determined by E test. Salmonella Typhi (75·7%) was the predominant serotype among 830 Salmonella spp. isolated during the study period followed by S. Paratyphi A (23·8%). The maximum number of enteric fever cases occurred during April–June (dry season) followed by July–September (monsoon season). There was a decrease in multidrug-resistant (MDR) S. Typhi, but MDR S. Paratyphi A isolates increased. There was also a dramatic increase in nalidixic acid-resistant isolates. All isolates were susceptible to third-generation cephalosporins and ciprofloxacin except one S. Typhi strain which demonstrated high-level ciprofloxacin resistance with a MIC of 16 μg/ml. A knowledge of the seasonal distribution and antibiotic resistance pattern of Salmonella in a particular geographical region is helpful in the delineation of appropriate control measures required for prevention of enteric fever.

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Metallo-Beta-Lactamase-Producing Acinetobacter spp. from Clinical Isolates at a Tertiary Care Hospital in Ghana

BioMed Research International ◽

10.1155/2020/3852419 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Michael A. Olu-Taiwo ◽

Japheth A. Opintan ◽

Francis Samuel Codjoe ◽

Akua Obeng Forson

Keyword(s):

Tertiary Care ◽

Multidrug Resistant ◽

Control Measures ◽

Clinical Isolates ◽

Diffusion Method ◽

Resistance Pattern ◽

Care Hospital ◽

Beta Lactamase ◽

Infection Control Measures ◽

Significant Difference

Metallo-beta-lactamase-producing Acinetobacter spp. is a major challenge for therapeutic treatment of nosocomial infections. This study is aimed at determining the prevalence of MBL-producing Acinetobacter spp. among 87 clinical isolates of Acinetobacter spp. from the Korle-Bu Teaching Hospital, Accra, between August 2014 and July 2015. Acinetobacter spp. was identified by standard bacteriological method, and resistance to different antibiotics was assessed with the Kirby–Bauer disc diffusion method. Meropenem-resistant Acinetobacter isolates were screened for enzyme activity using the modified Hodge test (MHT) and combined disc test (CDT). Additionally, multiplex PCR was used to determine MBL genes presence (blaVIM,blaIMP, and blaNDM). All Acinetobacter isolates showed high resistance to cefotaxime (90.8%), ceftazidime (75.9%), cotrimoxazole (70.1%), ciprofloxacin (64.4%), gentamicin (72.4%), levofloxacin (67.8%), and meropenem (59.8%). A total of 54 (62.1%) of Acinetobacter isolates were multidrug-resistant. Out of 52 (59.8%) meropenem-resistant Acinetobacter, 3 (5.8%) were carbapenemase producers by MHT, whilst, 23 (44.2%) were CDT positive. There was no significant difference between the resistance pattern of amikacin, ceftazidime, cotrimoxazole, ciprofloxacin, and meropenem amongst CDT-positive and CDT-negative isolates (p>0.05). A total of 7/87 (8.1%) CDT-positive Acinetobacter isolates harboured blaNDM; of these, 4 (57.1%) were from wound swabs, urine (n=2) (28.6%), and ear swab (n=1) (14.3%). The study revealed that less than 9% of Acinetobacter spp. contained blaNDM encoding genes. Strict antibiotics usage plan and infection control measures are required to prevent the spread of these resistance genes.

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Prevalence and antibiogram of nonfermenting gram negative bacilli isolates obtained from various clinical samples in a tertiary care hospital, Bathinda, Punjab, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181273 ◽

2018 ◽

Vol 6 (4) ◽

pp. 1228

Author(s):

Amandeep Kaur ◽

Amarjit Kaur Gill ◽

Satnam Singh

Keyword(s):

Clinical Laboratory ◽

Tertiary Care ◽

Empiric Therapy ◽

Species Level ◽

Diffusion Method ◽

Clinical Samples ◽

Resistance Pattern ◽

Care Hospital ◽

Biochemical Tests ◽

Gram Negative

Background: Non-fermenting gram-negative bacilli (NFGNB) have emerged as important healthcare associated pathogens in recent years. Infections caused by these bacteria are almost always secondary to some predisposing factors in patients such as burns, prolonged antimicrobial therapy, immunosuppression etc. The Objectives of the study was to be carried out with an objective to identify NFGNB upto genus and species level and study their antimicrobial sensitivity/ resistance pattern so that empiric therapy could be selected accordingly.Methods: A total of 2261 clinical samples were collected from patients admitted in ICU and different wards of the hospital. All samples were processed according to standard microbiological procedures. Identification of NFGNB upto genus and species level was done by various biochemical tests. Antimicrobial susceptibility testing was done by Kirby Bauer disc diffusion method results were interpreted in accordance with clinical laboratory standards institute guidelines.Results: In this study, 365 NFGNB were obtained accounting for their prevalence of 16.1%. P. aeruginosa was the commonest NFGNB isolated in this study accounting for 52.6%, A. baumannii was the second common NFGNB isolated (31.7%). Other NFGNB isolates were obtained with a lesser frequency. P. aeruginosa isolates were highly sensitive to polymyxin B and colistin followed by imipenem. Most of the A. baumannii isolates were multidrug resistant.Conclusions: This study gives an alarming sign towards high prevalence of multi drug resistant NFGNB in our hospital. Therefore, improved antibiotic stewardship and strict protocols for hand washing need to be implemented to prevent emergence and spread of multidrug resistant NFGNB in health care settings.

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MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i6.17717 ◽

2017 ◽

Vol 10 (6) ◽

pp. 78

Author(s):

Bhuvaneshwari Gunasekar

Keyword(s):

Antibiotic Resistance ◽

Tertiary Care ◽

Multidrug Resistant ◽

Diffusion Method ◽

Care Hospital ◽

Multiple Antibiotic Resistance ◽

Antibiotic Resistant ◽

Gram Negative ◽

Mar Index ◽

Surgery Department

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

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Antibiotic Susceptibility Pattern of Nosocomial Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.190 ◽

2009 ◽

Vol 48 (175) ◽

Cited By ~ 1

Author(s):

Bidya Shrestha ◽

B M Pokhrel ◽

T M Mohapatra

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Tertiary Care ◽

Test Method ◽

University Teaching ◽

Clinical Samples ◽

Resistance Pattern ◽

Care Hospital ◽

Biochemical Tests ◽

Methicillin Resistant

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), the most common cause ofnosocomial infection has been a major cause of morbidity and mortality around the world. They arenormally resistant to most of the antibiotics used in clinical practice. This study has been carried outto fi nd out the resistance pattern among S. aureus.Methods: During November 2007 to June 2008, clinical samples from patients with nosocomialinfection were processed for culture and sensitivity following standard methodology in microbiologylaboratory, Tribhuvan University teaching hospital, Kathmandu, Nepal.Results: Among 149 Staphylococcus aureus isolates, highest resistance was observed against Penicillin(91.94%) followed by Fluoroquinolone (61.74%), Erythromycin (52.94%), Gentamicin (46.98%),Cotrimoxazole (42.95%), Tetracycline (40.94%) and others, whereas susceptibility was observedmaximum against Chloramphenicol (94.85%) followed by Rifampicin (92.61%), Tetracycline(59.06%), Cotrimoxazole (57.04%), and others. None of the isolates were resistant to Vancomycinand Teicoplanin. Of these isolates 44.96 % of the isolates were Methicillin resistant S. aureus (MRSA).Resistance to Penicillin, Fluoroquinolone, Erythromycin, Gentamicin, Co-trimoxazole and Tetracyclinewere associated signifi cantly with MRSA isolates (X2= 8.779, p<0.05, X2= 74.233, p<0.05, X2= 84.2842,p<0.05, X2= 108.2032, p<0.05, X2= 88.1512, p<0.05 and X2= 79.1876, p<0.05 respectively). Althoughmost of the Methicillin sensitive S. aureus (MSSA) isolates were susceptible to both Rifampicinand Chloramphenicol, only Rifampicin susceptibility was signifi cantly associated with them (X2=10.1299, p<0.05). Among three Biochemical tests for the detection of β lactamase detection namelychromogenic, iodometric and acidimetric test, chromogenic test method had highest sensitivity andspecifi city.Conclusions: Since MRSA comprised a greater part of S. aureus isolates and were multi-resistant,patients infected by such strains should be identifi ed and kept in isolation for hospital infectioncontrol and treated with second line of drug like vancomycin.Key Words: β lactamase, methicillin resistant Staphylococcus aureus,methicillin sensitive Staphylococcus aureus, resistance pattern

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Nasal Carriage of Methicillin Resistant Staphylococcus aureus Among Health Care Workers At Tertiary Care Hospital In Dhaka.

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v11i2.51678 ◽

2017 ◽

Vol 11 (2) ◽

pp. 17-19

Author(s):

Rahima Akter ◽

Shikha Paul ◽

Akhtarun Naher ◽

Moshiur Rahman ◽

Sharmin Sultana ◽

...

Keyword(s):

Tertiary Care ◽

Nasal Carriage ◽

Healthcare Personnel ◽

Diffusion Method ◽

Resistance Pattern ◽

Dilution Method ◽

Care Hospital ◽

Disc Diffusion ◽

Disc Diffusion Method ◽

Mannitol Salt Agar

Nasal carriage of MRSA among hospital stuff act as a source of endogenous infection and becomes a source for hospital and community acquired infection. The study was conducted to determine the rate antibiotic resistance pattern of nasal carriage of MRSA among the hospital stuff of Sir Salimullah Medical College and Mitford Hospital, Dhaka. Pre moistened nasal swabs from hospital stuff (doctor, nurses, lab technicians and other helping stuff were obtained. These swabs were inoculated into Blood agar and Mannitol salt agar media. Antibiogram was done by modified Kirby Bauer disc diffusion method. MRSA were detected by oxacillin and cefoxitin disc diffusion method. The resistance was confirmed by MIC of oxacillin agar dilution method. Out of 142 samples 34 strains of Staphylococcus were isolated among them 07 (4.93%) were MRSA and 27 (19.01%) were MSSA. The carriage rate of MRSA was higher among nurse than other healthcare provider. Nasal carriage of MRSA is responsible for spreading infection from healthcare personnel to normal individual. So, regular screening of carrier is required from prevention of hospital acquired infection. Bangladesh J Med Microbiol 2017; 11 (2): 17-19

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Phenotypic Pattern of Vibrio choleraeIsolates from a Tertiary Care Hospital in Vadodara, Gujarat, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44130.13947 ◽

2020 ◽

Author(s):

Sonia Sandeep Barve ◽

Srujana Prabhala ◽

Tanuja Bakul Javadekar ◽

Sandeep Om Nanda

Keyword(s):

Vibrio Cholerae ◽

Monsoon Season ◽

Descriptive Analysis ◽

Phage Type ◽

Tertiary Care ◽

Diarrhoeal Disease ◽

Phage Typing ◽

Resistance Pattern ◽

Care Hospital ◽

El Tor

Introduction: Cholera is an acute diarrhoeal disease caused by Vibrio cholerae (V.cholerae). Based on antigenic differences of O antigen, O1 serogroup can be divided into three serotypes. In addition, by performing various biochemical reactions, O1 Serogroup can be differentiated into two biotypes. Outbreaks of Cholera occur seasonally. It is associated with monsoon season, warm temperature, heavy rainfall and increased plankton population. Aim: The aim was to determine the trends in resistance pattern and phenotypic Pattern of Vibrio cholerae. Materials and Methods: A retrospective study was conducted during the period from June 2019-December 2019. Culture of Stool specimens were done on different agar media. Biotyping was done by conventional methods. Serotyping and phage typing was also done along with the Antibiotic susceptibility testing. Descriptive analysis was used and presented in terms of percentage. Results:V.cholerae was isolated in 72 patients and they belonged to serogroup O1 and biotype El Tor. The most common serotype was Ogawa. The predominant phage type were T2 by old scheme and T27 by new scheme of phage typing. The maximum number of V. cholerae isolates was seen in the month of November, 2019 followed by October, 2019. Conclusion: The phenotypic pattern and fluctuating seasonal trend of V. cholerae and antimicrobial resistance encourage the continued epidemiological and microbiological surveillance of the disease.

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Phenotypic and genotypic characterization of multidrug-resistant isolates from patients with catheter-associated urinary tract infection in a tertiary care hospital

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_22_19 ◽

2019 ◽

Vol 11 (03) ◽

pp. 206-211

Author(s):

Jaison Jayakaran ◽

Nirupa Soundararajan ◽

Priyadarshini Shanmugam

Keyword(s):

Urinary Tract ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Diffusion Method ◽

Care Hospital ◽

Disk Diffusion Method ◽

Carbapenem Resistant ◽

Tract Infections

Abstract INTRODUCTION: Urinary tract infections (UTIs) remain as the most common infection. Catheter-associated (CA) UTI can lead to bacteremia and thereby is the leading cause of morbidity and mortality in hospitalized patients in our country. AIMS AND OBJECTIVES: This study aims to check the prevalence of CAUTI and study the phenotypic and genotypic characters of the multidrug-resistant organisms in a tertiary care hospital, with special reference to NDM-1 and OXA-23. MATERIALS AND METHODS: A total of 231 urine samples from patients with CA-UTI in different wards in a tertiary care hospital over a period of 3 months between June and August 2018 were collected and processed following the standard protocol. Antibiotic susceptibility tests were performed by disk-diffusion method. Modified Hodge test (MHT) was done to isolate carbapenem-resistant isolates, and polymerase chain reaction was done to detect NDM-1 and OXA-23. RESULTS: Out of 231 samples, 101 samples yielded significant growth. These 38 samples were Gram-negative bacilli which were resistant to carbapenems. Out of the 38 which showed carbapenem resistance, 23 were MHT positive. Out of the 23 MHT-positive isolates, 8 (21.05%) were positive for NDM-1 gene and only 1 (2.6%) was positive for the OXA-23 gene. CONCLUSION: This study has shown that carbapenem-resistant isolates from all the CA urinary tract-infected patients were 52.77% and most of them were Klebsiella. About 21% of them harbored the NDM-1 gene whereas only 2% had the OXA-23 gene. There has been an alarming increase in the spread of carbapenem resistance.

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Ecology of Bloodstream Infections and Temporal Trends of Their Antibiograms with Respect to Source and Duration of Incubation: A 5-Year Retrospective Observational Analysis

Journal of Laboratory Physicians ◽

10.1055/s-0040-1714199 ◽

2020 ◽

Vol 12 (01) ◽

pp. 56-67

Author(s):

Amit Banik ◽

Valarie W. Lyngdoh ◽

Elantamilan Durairaj ◽

Anil C. Phukan ◽

Raghavendra Kotal

Keyword(s):

Tertiary Care ◽

Temporal Trends ◽

Bloodstream Infections ◽

Diffusion Method ◽

Blood Collection ◽

Care Hospital ◽

Biochemical Tests ◽

Sensitivity Testing ◽

Disk Diffusion Method ◽

Significant Difference

Abstract Purpose Blood is one of the most important connective tissues of human body. Bloodstream infection can range from inapparent bacteremia till fulminant septic shock with high mortality. Presence of microbes in blood whether continuously, intermittently, or transiently is a grave risk to every organ of body. Culture of blood is a vital tool to diagnose such infections. Drug susceptibility patterns help in rationalizing therapy. Objective The aim of the study is to perform bacteriological analysis and assess drug sensitivity patterns of blood culture isolates and compare in light of other associated variables. Design Retrospective observational study was conducted from January 2009 to December 2013 at a tertiary care hospital at Shillong, India. Blood samples were collected with aseptic guidelines and cultured for 7 days. Growths were identified by standard biochemical tests and subjected to sensitivity testing according to Modified Kirby Bauer disk diffusion method. Data for source of blood collection and duration of incubation were noted and compared. Results A total of 658 (11.2%) pathogens were isolated from 5,867 bacteremia-suspected patient blood specimens. Contamination was observed at the rate of 1.21%. Gram-negative organisms were the predominant pathogens recovered, Klebsiella pneumoniae being the most common. No significant difference was observed between the number of organisms isolated within or beyond 48 hours. Acinetobacter baumannii and K. pneumoniae have significantly higher chances (p < 0.05) of isolation from central line catheters compared with peripheral venipuncture. Conclusion Successful treatment of sepsis depends on early diagnosis and proper antimicrobial therapy. Local knowledge of bacteriological profile and antimicrobial sensitivity patterns helps rationalize empiric treatment strategies.

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Bloodstream infections and trends of antimicrobial sensitivity patterns at Port Blair

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_50_18 ◽

2018 ◽

Vol 10 (03) ◽

pp. 332-337 ◽

Cited By ~ 1

Author(s):

Amit Banik ◽

Sanjeev H. Bhat ◽

Abhay Kumar ◽

Agnijeet Palit ◽

Kandregula Snehaa

Keyword(s):

Tertiary Care ◽

Bloodstream Infections ◽

The Body ◽

Diffusion Method ◽

Blood Collection ◽

Care Hospital ◽

Biochemical Tests ◽

Sensitivity Testing ◽

Disk Diffusion Method ◽

Antimicrobial Sensitivity

ABSTRACT PURPOSE: Bloodstream infection can range from inapparent bacteremia until fulminant septic shock with high mortality. Microorganisms present in circulating blood whether continuously, intermittently, or transiently are a threat to every organ in the body. Culture of blood is a vital tool to diagnose such infections. Drug susceptibility patterns help in rationalizing therapy. OBJECTIVE: The objective of this study was to perform bacteriological analysis and assess drug sensitivity patterns of isolates from blood stream infections. DESIGN: Retrospective observational study was conducted from May 2015 to February 2017 at a tertiary care hospital, Port Blair, India. Blood samples were collected with aseptic guidelines and cultured for 7 days. Growths were identified using standard biochemical tests and subjected to sensitivity testing according to Modified Kirby–Bauer’s disk diffusion method. Data for the source of blood collection and duration of incubation were noted and compared. RESULTS: A total of 270 (14.24%) pathogens were isolated from 1895 bacteremia suspect patient blood specimens. Contamination was observed at a rate of 1.63%. Gram-positive cocci (60.37%) were predominant organisms recovered followed by Gram-negative Bacilli (36.29%) and Yeasts (3.33%). Staphylococcus aureus, CoNS, and Acinetobacter spp. were the primary pathogens isolated. Aminoglycosides, carbapenems, and glycopeptides were the most effective drugs for treating bacteremia. CONCLUSIONS: Successful treatment of sepsis depends on early diagnosis and proper antimicrobial therapy. Local knowledge of bacteriological profile and antimicrobial sensitivity patterns helps rationalize empiric treatment strategies.

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Drug Resistance and Biofilm Production among Pseudomonas aeruginosa Clinical Isolates in a Tertiary Care Hospital of Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v21i2.25109 ◽

2019 ◽

Vol 21 (2) ◽

pp. 110-116

Author(s):

Rajani Shrestha ◽

N. Nayak ◽

D.R. Bhatta ◽

D. Hamal ◽

S.H. Subramanya ◽

...

Keyword(s):

Pseudomonas Aeruginosa ◽

Drug Resistance ◽

Biofilm Formation ◽

Tertiary Care ◽

Clinical Problem ◽

Multidrug Resistant ◽

Clinical Isolates ◽

Diffusion Method ◽

Care Hospital ◽

Microbiological Methods

Clinical isolates of Pseudomonas aeruginosa often exhibit multidrug resistance due to their inherent ability to form biofilms. Drug resistance in Ps. aeruginosa is a major clinical problem, especially in the management of patients with nosocomial infections and those admitted to ICUs with indwelling medical devices. To evaluate the biofilm forming abilities of the clinical isolates of Ps. aeruginosa and to correlate biofilm formation with antibiotic resistance. A total of 90 consecutive isolates of Ps. aeruginosa obtained from various specimens collected from patients visiting the Manipal Teaching Hospital, Pokhara, Nepal between January 2018 - October 2018 were studied. Isolates were identified by standard microbiological methods. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method. All the isolates were tested for their biofilm forming abilities by employing the tissue culture plate assay. Of the 90 Ps. aeruginosa isolates, maximum i.e 42 (46.6%) were from patients in the age group of > 50 years. Majority (30; 33.3%) of the isolates were obtained from sputum samples. However, percentage isolation from other specimens like urine, endotracheal tube (ETT), pus, eye specimens and blood were 18.9%, 16.7%, 16.7%, 7.8% and 6.7% respectively. All the isolates were sensitive to polymixin B and colistin, 91.1% of the organisms were sensitive to imipenem, and more than 80% to aminoglycosides (80% to gentamicin, 83.3% to amikacin). A total of 29 (32.2%) organisms were biofilm producers. Maximum numbers of biofilm producing strains were obtained from ETT (8 of 15; 53.3%), pus (8 of 15; 53.3%) and blood (2 of 6; 33.3%) i.e from all invasive sites. None of the isolates from noninvasive specimens such as conjunctival swabs were biofilm positive. Significantly higher numbers of biofilm producers (23 of 29; 79.3%) were found to be multidrug resistant as compared to non-biofilm (6 of 61; 9.8%) producers (p=0.000). Ps. aeruginosa colonization leading to biofilm formation in deep seated tissues and on indwelling devices is a therapeutic challenge as majority of the isolates would be recalcitrant to commonly used antipseudomonal drugs. Effective monitoring of drug resistance patterns in all Pseudomonas clinical isolates should be a prerequisite for successful patient management.

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