scholarly journals Outbreak of KPC-3-producing ST15 and ST348Klebsiella pneumoniaein a Portuguese hospital

2016 ◽  
Vol 145 (3) ◽  
pp. 595-599 ◽  
Author(s):  
D. VUBIL ◽  
R. FIGUEIREDO ◽  
T. REIS ◽  
C. CANHA ◽  
L. BOAVENTURA ◽  
...  
Keyword(s):  
Gel Electrophoresis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Pulsed Field Gel Electrophoresis ◽  
Care Hospital ◽  
E Coli ◽  
Carbapenemase Gene ◽  
Sporadic Cases ◽  
First Time ◽  
Sequence Types

SUMMARYTo date, only a few sporadic cases of infections due toKlebsiella pneumoniaecarbapenemase (KPC) producers have been reported in Portugal. Here, we report for the first time an outbreak ofK. pneumoniaeKPC-3 producers in a tertiary-care hospital during 2013. Twenty-seven ertapenem-resistantK. pneumoniaewere identified in patients at a tertiary-care hospital during 2013 isolated predominantly from urine (48·1%) and blood (25·9%) cultures. All isolates were highly resistant toβ-lactam antibiotics and most showed intermediate resistance to imipenem. The more frequentβ-lactamases were TEM- (77·7%), CTX-M- (70·3%) and KPC-type (66·6%). KPC-3 was identified by sequencing. TheblaKPC−3gene was associated with an IncF plasmid, and efficiently transferred toE. coliJ53. Pulsed-field gel electrophoresis typing revealed three clusters of isolates which were further characterized by multi-locus sequence typing as ST11, ST15 and ST348. Ertapenem-resistant ST15 was already in circulation in the hospital, related to expression of OmpK36 modified porin, but the other two sequence types had not been previously found in the hospital. We conclude that the IncF plasmid mediated transfer of KPC-3 in the outbreak and that implementation of carbapenemase gene screening in isolates from patients on admission to hospital is advisable in order to control dissemination of these antimicrobial resistance elements.

scholarly journals Asymptomatic Bacteriuria among Pregnant Women Attending Tertiary Care Hospital in Lucknow, India

2021 ◽  
pp. 1-8
Author(s):  
Naimshree Sonkar ◽  
Malay Banerjee ◽  
Suman Gupta ◽  
Absar Ahmad
Keyword(s):  
Haemoglobin Level ◽  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.

scholarly journals Prevalence of ESBL Producing E. coli and Klebsiella Species in a Tertiary Care Hospital, Telangana

2020 ◽  
Vol 7 (38) ◽  
pp. 2116-2119
Author(s):  
Sofia Nawaz ◽  
Syeda Fahada Zia ◽  
Shashikala Reddy P,
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Klebsiella Species ◽  
E Coli

scholarly journals Multidrug-resistant urinary tract isolates of escherichia coli: Frequency and patient demographics in a Tertiary Care Hospital.

2020 ◽  
Vol 27 (02) ◽  
pp. 335-340
Author(s):  
Salman Azhar ◽  
Muhmmad Wasif Baig ◽  
Shahid Rasool ◽  
Rizwan Rasool Khan ◽  
Talha Munir ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
E Coli ◽  
Patient Demographics ◽  
Tract Infections

Urinary tract infections (UTIs) are a major burden to the health care as it is estimated that around 150 million UTIs occur yearly worldwide. Enterobacteriaceae are the most common agent causing serious urinary tract infections; and MDR cases are increasing day by day. Objectives: To determine the frequency and patient demographics of multidrug resistant urinary tract isolates of Escherichia Coli in a Tertiary Care Hospital. Study Design: Retrospective cross sectional study. Setting: Medicine Department of Madinah Teaching Hospital / The University of Faisalabad, Faisalabad. Period: From May 2016 to Sep 2018. Material & Methods: 187 patients of age 15 to 90 years with positive E. coli on urine culture and sensitivity were included in this Retrospective cross sectional study. All those patients with history of dysuria (pain during urination) or frequent urination (more than 7 times per day) were advised urine complete analysis and those with >5 WBCs or pus cells /HPF or having positive for leukocyte esterase and/or nitrite, were advised urine culture and sensitivity. Main outcome variable was the frequency of MDRE cases among the culture positive E. coli UTI patients. Results: Among all the cases of E. coli UTI, frequency of MDRE UTI was 66.8% (n=125) and rest 33.2% (n= 62) cases were not MDR UTI. 97.3% patients were resistant to lactam antibiotics, 95.7% were resistant to quinolones and 68.4% were resistant to aminoglycosides.

scholarly journals Antibiotic sensitivity pattern of pathogens in children with urinary tract infection in a tertiary care hospital in Kachchh, Gujarat, India

2017 ◽  
Vol 4 (6) ◽  
pp. 2103
Author(s):  
Rekha Thaddanee ◽  
Gurudas Khilnani ◽  
Nupur Shah ◽  
Ajeet Kumar Khilnani
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
E Coli ◽  
Sensitivity Pattern

Background: This prospective observational study was conducted in a tertiary care hospital in Kachchh, over a period of 6 months, to know the antibiotic sensitivity pattern of pathogens in children less than 18 years old with Urinary Tract Infection (UTI).Methods: Between December 2016 to June 2017, 186 children met the inclusion criterion. Urine samples were collected and processed for urine routine microscopy, culture and antibiotic sensitivity as per the standard laboratory guidelines. Urine culture was positive in 50 cases, which were further evaluated to find out any renal disease. All patients were given 10-14 days antibiotics course and follow-up urine reports were done. Patients were considered cured when the follow-up urine reports were normal.Results: E. coli was the commonest organism (34%) isolated, found mainly in 1-5 years age group (20%). Enterococci were isolated in 32% cases, most of which were less than 5 years of age (28%). Klebsiella (12%), Methicillin Resistant Staphylococcus Aureus (MRSA) (10%), Coagulase negative staphylococci (6%), Pseudomonas (2%) and Budding yeast cell (4%) were the less frequent organisms isolated. E. coli were found to be less sensitive to different Aminoglycosides (11.7% - 23.5%), Cephalosporins (11.7% - 52.9%), Fluoroquinolones (5.8% - 11.7%), Co-trimoxazole (17.6%) and Piperacillin (17.6%), but were more sensitive (70.6%) to Imipenems. Enterococci were also partially sensitive to Aminoglycosides (6.2-18.7%), Cephalosporins (25-37.5.7%), Fluoroquinolones (6.25-12.5%), Penicillin-G (50%), Piperacillin (31.25%) and Co-trimoxazole (43.75%), but had good sensitivity for Imipenems (68.7%), Linezolid (75%) and Vancomycin (81.2%). Similarly, MRSA was 100% sensitive to Linezolid and Imipenem but partially sensitive (20-60%) to other antibiotics. Klebsiella showed 16.65-33.3% sensitivity to all antibiotics except Imipenem (83.3%) and was 100% resistant to Co-trimoxazole. Coagulase negative Staphylococci (CONS) remained 100% sensitive to all antibiotics and Pseudomonas was resistant to all antibiotics.Conclusions: The study concludes that pathogens for UTI in children have developed resistance, even to the newer generation antibiotics, probably due to the irrational use of antibiotics. In view of emergence of multi drug resistant pathogens, which carry considerable morbidity and mortality, every effort must be taken to use antibiotics judiciously.

scholarly journals Beta-lactamase Profile and Biofilm Production of Pseudomonas aeruginosa Isolated from a Tertiary Care Hospital in Kolkata, India

2020 ◽  
Author(s):  
Soma Sarkar ◽  
Shanta Dutta ◽  
Anjum Namhata ◽  
Chayanika Banerjee ◽  
Mallika Sengupta ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Health Concern ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Automated Method ◽  
Biofilm Production ◽  
Carbapenemase Gene

Introduction: Nosocomial infections caused by Multidrug Resistant (MDR) Pseudomonas aeruginosa (P. aeruginosa) have become a major clinical and public health concern. Moreover, the biofilm production protects the bacteria from antibiotics and thereby makes the drugs ineffective. Aim: To find out the β-lactamases profile of antimicrobial resistance and biofilm production of P. aeruginosa isolated from different clinical specimens of patients attending a tertiary care hospital of Kolkata, West Bengal, India. Materials and Methods: A total of 394 consecutive, non-duplicate isolates of P. aeruginosa were identified from 3559 Gram negative bacilli over a period of two years from July 2016 to June 2018. Identification of the isolates and antibiotic sensitivity testing was performed by using automated method and interpreted. Extended Spectrum β-Lactamases (ESBLs), Amp-C β-lactamase (AmpC) and Metallo-β-Lactamases (MBLs) were phenotypically detected by disk synergy test and MBL-encoding genes were detected by multiplex Polymerase Chain Reaction (PCR). Biofilm production was done by tissue culture plate assay. Laboratory data and test results were statistically analysed in counts and percentages using MS Excel 2010 version. Results: Out of 394 strains of P. aeruginosa 288 (73.10%) were isolated from male patients whereas 106 (26.90%) were isolated from female patients. Maximum number of cases (67.26%) were from adult populations. The resistance pattern showed 72.33% resistance to ticarcillin-clavulanic acid followed by ciprofloxacin (53.80%), levofloxacin (50.25%), gentamicin (51.52%), ceftazidime (CAZ) (45.93%), cefoperazone-sulbactam (40.1%), aztreonam (34.77%), imipenem (33.5%), piperacillin/tazobactum (30.96%) and Meropenem (MRP) (29.18%). Out of 394 Pseudomonas spp. isolates, 204 (51.77%) were MDR. Overall, ESBLs, AmpC and carbapenemase (MBL) production was detected in 145 (36.80%), 51 (12.94%) and 49 (12.43%) isolates by phenotypic methods. By genotypic method 53.34% were carbapenemase producing and blaNDM-1 (68.75%) was the most prevalent carbapenemase gene detected followed by blaVIM (18.75%) and co-production of blaNDM-1+ blaVIM was 12.5%. Biofilm production was observed in 158 (40.10%) isolates. Conclusion: Early detection of these β-lactamases production is crucial not only for epidemiological study and effective infection control practices to limit the spread of infection but also for planning appropriate therapy according to the resistance mechanisms of the MDR strains.

scholarly journals Antibacterial effect of green tea extract against multi drug resistant Escherichia coli isolated from urine sample of patients visiting tertiary care hospital of Eastern Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 45-51
Author(s):  
Kabita Giri ◽  
Bijay Kumar Shrestha ◽  
Jenish Shakya ◽  
Shiv Nandan Sah ◽  
Hemanta Khanal
Keyword(s):  
Escherichia Coli ◽  
Green Tea ◽  
Antibacterial Effect ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Green Tea Extract ◽  
Care Hospital ◽  
Drug Resistant ◽  
E Coli ◽  
Tea Extract

Urinary tract infections (UTIs) caused by drug resistant (DR) Uropathogenic Escherichia coli have become a significant worldwide public health problem. Green tea (Camellia sinensis), has been reported to have antimicrobial activities against various pathogenic bacteria. The main aim of our study was to estimate the antibacterial effect of green tea extract against drug resistant Uropathogenic E. coli isolated from urine samples of patients visiting in tertiary care hospital from eastern Nepal. During the study 360 urine samples were collected from UTI suspected patients visiting a tertiary care hospital of Biratnagar. Urine samples were cultured by using semi-quantitative culture technique and bacteria was identified by standard microbiological procedure. Antibiotic susceptibility testing was done by Kirby-Bauer Disk Diffusion method according to NCCLS (2011) guidelines. The antibacterial effect of green tea extract was performed by preparing the 95% ethanol extract in Soxhlet apparatus which was dispensed in DMSO solution and sterilized by membrane filtration. Antibacterial activity of Green Tea Extract against MDR Uropathogenic Escherichia coli was performed by making different concentration of green tea. The overall prevalence of E. coli was 27.22% in study population whereas the prevalence of MDR E. coli was 21.08%. All the isolated E. coli exhibited 100% sensitivity towards Nitrofurantoin and it was still a drug of choice for the treatment of Urinary tract infection caused by E. coli. The green tea extracts exhibited effective antibacterial activity against MDR E. coli. The MIC of Green Tea Extract was found to be 600µg/ml for 24 MDR isolates and 1000µg/ml for remaining 11 isolates. Based on the present study it is concluded that Green Tea extracts have great potential as an antimicrobial agent against E. coli. Int. J. Appl. Sci. Biotechnol. Vol 8(1): 45-51

Antimicrobial resistance patterns of WHO priority pathogens isolated in children from a tertiary care hospital in Southern India: A descriptive and time trend analysis

2020 ◽  
Author(s):  
Vijayalaxmi V Mogasale ◽  
Prakash Saldanha ◽  
Vidya Pai ◽  
Rekha PD ◽  
Vittal Mogasale
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Trend Analysis ◽  
Time Trend ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
E Coli ◽  
Resistance Patterns

Abstract Background There is global consensus that Antimicrobial Resistance (AMR) poses an unprecedented challenge to modern medicine as we know it today; and the lack of new antibiotics in the pipeline is compounding the threat to contain emerging drug-resistant infections. In 2017, the World Health Organization (WHO) has articulated a priority pathogens list (PPL) to provide strategic direction to research and development of new anti-microbials. Anti-microbial resistance patterns of selected ‘drug-bug’ combinations based on the WHO-PPL in one tertiary health care facility in India are explored in this paper. Methods Culture reports of laboratory specimens, collected between 1st January 2014 and 31st October 2019 from paediatric patients in a tertiary care hospital in India, were retrospectively extracted. The antimicrobial susceptibility patterns for selected antimicrobials based on the WHO-PPL are analysed and reported. Results Of 12,256 culture specimens screened, 2,335 (19%) showed culture positivity; of which 1,556 were organisms from the WHO-PPL. E. coli was the most common organism isolated (37%) followed by Staphylococcus aureus (16%). Total 72% of E. coli were extended-spectrum beta-lactamases producers, 55% of Enterobacteriaceae were resistant to 3rd generation cephalosporins, and 53% of Staphylococcus aureus were Methicillin resistant. Time-trend analysis of the data showed continued high resistance to carbapenem in E coli, Klebsiella pneumoniae and Enterobacter cloacae. Conclusions The AMR trends and prevalence patterns are likely to be different, across various local settings, than as defined at the national level or the WHO-PPL. This difference needs to be recognised in decision and policy making. It is critical, that the evidence used at national and global levels, have reasonable geographical and population representation through standardised and more granular AMR surveillance, in order to improve the effectiveness of the overall national AMR response.

Determination of ESBL Production & Antibiotic Resistance Profile of Escherichia Coli Isolated from Patients with Urinary Tract Infections: A Study from Tertiary Care Hospital

2020 ◽  
Vol 7 (1) ◽  
pp. 23-29
Author(s):  
Gunjal P. N. ◽  
Gunjal S. P.
Keyword(s):  
Urinary Tract ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Esbl Production ◽  
Sensitivity Testing ◽  
E Coli ◽  
Tract Infections

Urinary tract infection (UTI), is defined as a disease caused by invasion of urinary tract by microorganisms. Majority of UTI cases are due to bacterial infection constitute about 95% of total UTI cases. About 80% of UTI cases are caused by E.coli producing extended spectrum ?-lactamase (ESBL) producing isolates. In recent years limitations in treating infections caused by multidrug resistant organisms has increased. This study aims to determine ESBL production of E. coli cases from a tertiary care hospital. Methodology: A total 358 midstream urine samples were collected by random sampling method during March 2015 to June 2018. Identification, antibiotic sensitivity testing, performed according to standard protocol following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. Screening for ESBL producing E.coli isolates performed using ceftazidime further confirmation done by phenotypic disc diffusion test using combined disc method using ceftazidime (30µg) & ceftazidime/ clavulanic acid (30/10 µg) as per CLSI guidelines. Results: Total 358 specimens processed for urine culture. Gram negative bacilli isolated from 123(34.35 %), out of which 68 (55.28%) were E.coli, 19 (15.44%) K. pneumoniae, 15 (12.19%), Pseudomonas spp. 08 (6.50%), Citrobacter spp and Acinetobacter spp, 03 (2.43%), Proteus mirabilis, 01 (0.81%) Proteus vulgaris and Enterobacter respectively. Out of 68 isolates of E.coli, 65 (95.58%) were MDR, ESBL was detected in 31 (47.69%) out of these 65 isolates. Out of these 31 cases 19 (61.29%) were female and 12 (38.70%) were male cases. Conclusion: This study concludes 47.69% ESBL producing MDR E. coli were isolated from UTI cases with female predominance.

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