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

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.

scholarly journals Bloodstream infections and trends of antimicrobial sensitivity patterns at Port Blair

2018 ◽  
Vol 10 (03) ◽  
pp. 332-337 ◽  
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.

scholarly journals A study on the bacterial isolates from blood cultures of a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 171-174
Author(s):  
KMS Mohamed Ali ◽  
K Girija
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Tertiary Care Centre ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Blood Samples

Blood stream infections are the most important and common cause of morbidity and mortality in tertiary care hospitals. Since the results are usually not available promptly a knowledge of epidemiologic and antimicrobial susceptibility pattern of blood pathogens is life saving and very useful for early treatment and recovery of patients. The aim of this study is to describe the epidemiological, bacterial profile and antimicrobial resistance pattern of bloodstream infections in a tertiary care centre.A prospective cross-sectional study was done on seven hundred and eight blood samples collected over a period of six months in the Microbiology laboratory. Blood samples collected under aseptic conditions were cultured by aerobic culture method. Identification of bacterial isolates were done using standard bacteriologic and biochemical testing methods and antibiotic sensitivity testing done by Kirby - Bauer disc diffusion method.Bacteria was isolated in 201 (28.3%) samples with highest rates among newborns 84(41.8%). The most frequent isolates were 111 (55.2%) followed by 49 (24.4%). Results showed high susceptibilities of CoNS 111 (100%) to Vancomycin, Linezolid and 51 (98%) to Meropenem. This study highlights the common prevalent bacteriological agents in bacteremia, their antibiotic susceptibility & resistance patterns. and multi drug resistant were the leading causes of septicaemia in our hospital with Vancomycin, Linezolid and Carbapenems the effective antibiotics against these pathogens respectively.

scholarly journals MOLECULAR EPIDEMIOLOGY OF METALLO BETA LACTAMASES IN ACINETOBACTER BAUMANNII AT A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Sulaiman A Mohammed ◽  
Dr. Suman P Singh
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Beta Lactamases ◽  
Carbapenem Resistant ◽  
Significant Difference ◽  
Vitek 2

Background: Carbapenem resistance mediated by metallo beta lactamases (MBL) in Acinetobacter baumannii is a global challenge due to its rapid spread and limited therapeutic options. Objective: To determine the prevalence of MBL in A. baumannii isolates in hospitalized patients by both phenotypic and genotypic methods. Materials and Methods: The clinical samples were collected from inpatients and subcultured on routine culture media for growth. Identification of bacteria along with antimicrobial sensitivity testing was done by VITEK -2 Compact (bioMerieux). Antibiotics that were not tested by VITEK-2 were tested manually by Kirby-Bauer disk diffusion method according to CLSI 2017 and EUCAST 2016 guidelines. The isolates which were resistant to carbapenem (imipenem and/ or meropenem) were tested by phenotypic (imipenem-EDTA combined disk method) and genotypic method for presence of common metallo beta lactamases genes (blaIMP, blaNDM, blaGIM, blaVIM, blaSPM and blaSIM). Results: 84 non duplicate A.baumannii were isolated out of 947 pathogenic gram negative isolates. Majority (47.6%) of isolates were obtained from tracheostomy/endotracheal/bronchoalveolar lavage (TT/ET/BAL) followed by sputum (21.4%). None of the isolates were found to be resistant to colistin and tigecycline. 73 (86.9%) isolates were found to be carbapenem resistant, among these 60 (82.2%) were found to be MBL positive by phenotypic and 32 (43.2%) by genotypic method. MBL genes detected were blaNDM (39.7%), blaGIM (2.7%) and blaVIM (1.4%). None of the isolates were positive for blaIMP, blaSPM and blaSIM. Conclusion:  The prevalence of MBL in carbapenem resistant isolates of A.baumannii was 87.7%.  blaNDM was the most common gene detected. No significant difference was found in the ability of phenotypic and genotypic methods for MBL detection. The resistance rate of the A.baumannii is high for most antibiotics except for polymyxins (E&B) and tigecycline. Key words: Metallo beta Lactamases, Acinetobacter baumannii, Carbapenem.

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

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.

Evaluation of in vitro susceptibility of Gram-positive pathogens from a tertiary care hospital in Singapore to a novel oxazolidinone, tedizolid, by a gradient diffusion method and broth microdilution

2018 ◽  
Vol 72 (2) ◽  
pp. 181-184
Author(s):  
Saugata Choudhury ◽  
Lee Kar Mun ◽  
Esme Ng Chu Xuan ◽  
Lee Shin Jia ◽  
Shawn Vasoo ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Care Hospital ◽  
Broth Microdilution ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
In Vitro Susceptibility ◽  
Gradient Diffusion

We compared the in vitro antimicrobial activities of tedizolid and linezolid on the Sensititre broth microdilution system for Gram-positive cocci isolates (n=146) from skin and skin structure infections and bloodstream infections, bronchoalveolar lavage and sputum. These pathogens included 40 methicillin-resistant Staphylococcus aureus, 38 coagulase-negative staphylococci, 20 Enterococcus faecalis and 48 beta-haemolytic Streptococcus spp. Susceptibility was simultaneously determined for 48 vanA vancomycin-resistant enterococci isolates 2013–2016 from rectal swabs (23 E. faecalis and 25 E. faecium, of which 4 were linezolid-non-susceptible). MIC90s for tedizolid were fourfold to eightfold lower than linezolid on the Sensititre and ranged from 0.12 to 0.5 µg/mL for the different pathogen groups. All isolates were susceptible to tedizolid except two vanA E. faecium strains (MICs of 1 and 2 µg/mL, respectively). Categorical and essential agreement for tedizolid were 99.48% and 92%, respectively, between Liofilchem gradient diffusion and Sensititre methods. Overall, the drug exhibited excellent activity against the surveyed Gram-positive pathogens.

scholarly journals Frequency and Sensitivity Patterns of Staphylococcus Aureus in a Tertiary Care Setting

2021 ◽  
pp. 121-126
Author(s):  
Aneela Khawaja ◽  
Asma Ejaz ◽  
. Abeer ◽  
Faiqa Arshad ◽  
Zaheer Saleem ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Care Setting ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Infection Prevention And Control ◽  
Multiple Infections ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Tertiary Care Setting

Background: Staphylococcus aureus (SA) is a major etiological pathogen causing multiple infections and broadly known as a serious public health challenge faced due to antibiotic resistance. It is the need of time that infection prevention and control strategies; and antibiotic stewardship policies have to be employed conjointly to minimize the extended rise of antibiotic resistance. Objectives: To determine the frequency and sensitivity patterns of Staphylococcus aureus in tertiary care setting. Study Design: Descriptive study Place & Duration of Study: Pathology Laboratory of tertiary care center from 1st March’ 2020 till 28th February’ 2021. Materials & Methods: A total 643 Staph. aureus isolated from various clinical specimens received in a tertiary care hospital; were processed and identified by culture, staining and bench tests. Sensitivity testing was done by Disc Diffusion method. Resistance to cefoxitin(30µg) was labelled as Methicillin Resistant Staphylococcus aureus (MRSA). Constitutive and Inducible Clindamycin resistance was also evaluated. (CLSI, 2020-21). Results: During the study period 125 (19.44%) MRSA were recovered. Statistically, gender distribution regarding MRSA was significant, most of SA was recovered from blood (53.68%), while 46.31% from pus and wound swabs. The frequency of MRSA from Surgical and allied wards was higher (52.63%) than Medicine and allied wards (47.36%). Sensitivity to vancomycin, linezolid and tigecycline was noted 100% by all the isolates. Sensitivity to clindamycin and Doxycycline was 68.42% and 64.81% respectively; while resistance to erythromycin, ciprofloxacin and trimethoprim/sulfamethoxazole was 73.68%, 60% and 57.89%, respectively. Conclusion: The hazardous infections due to Staphylococcus aureus are worrisome in the present therapeutic scenario. A levelheaded prescription of sensitive antibiotics has to be ensured to minimize the rising frequency of resistant strains of SA.

scholarly journals Prevalence of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Susil Pyakurel ◽  
Mehraj Ansari ◽  
Smriti Kattel ◽  
Ganesh Rai ◽  
Prasha Shrestha ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Growth Media ◽  
Care Hospital ◽  
Drug Resistant ◽  
Biochemical Tests

Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal.  Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better understanding of antibiotic resistance threat and enables physicians to select the most appropriate antibiotics.

scholarly journals Salmonella isolates’ serotypes and susceptibility to commonly used drugs at a tertiary care hospital in Riyadh, Saudi Arabia

2011 ◽  
Vol 6 (06) ◽  
pp. 478-482 ◽  
Author(s):  
Ali Mohammed Somily ◽  
Samina Bashir Sayyed ◽  
Hanan Ahmed Habib ◽  
Abdulaziz Saleh Al-Khattaf ◽  
Fawzia Eida Al Otabi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Nalidixic Acid ◽  
Tertiary Care ◽  
University Hospital ◽  
Diffusion Method ◽  
Care Hospital ◽  
Disk Diffusion Method ◽  
Salmonella Infections ◽  
Overall Resistance ◽  
Resistance Rates

Introduction: Resistance of Salmonella to therapeutic agents currently being used for treatment of Salmonella infections is emerging as a global problem. This study aimed to assess the prevalence of Salmonella serotypes and their susceptibility patterns to commonly used drugs for treatment of Salmonella infections including quinolones. Correlation between nalidixic acid susceptibility of these isolates and their ciprofloxacin minimum inhibitory concentrations was also sought. Methodology; Salmonella isolates (n=213) were collected between January 2007 and May 2009 at King Khalid University Hospital in Riyadh, Saudi Arabia. The isolates were serotyped and their susceptibilities to commonly used first-line anti-Salmonella drugs (ampicillin, ceftriaxone, trimethoprim/sulfamethoxazole, nalidixic acid and ciprofloxacin) were determined using the automated Microscan system, the Kirby-Bauer disk diffusion method, and E-test. Results: The most frequently detected serotype was D1 (37%) followed by the serotypes, B (24%) and C1 (11%). Non-typable Salmonella isolates detected using available conventional Salmonella anti-sera were (11%). Overall resistance rates to nalidixic acid, ampicillin, trimethoprim/sulfamethoxazole and ceftriaxone were 99/213 (46%), 43/213 (20%), 34/213 (16%) and 7/213 (3%), respectively. Of the total isolates, 117 (55%) had a ciprofloxacin MIC of < 0.125 µg/ml and among these 105 (90%) were susceptible to nalidixic acid. The remaining 96 (45%) isolates had a ciprofloxacin MIC of ≥ 0.125 µg/ml and among them, 83 (86.5%) were resistant to nalidixic acid. Conclusions: The majority of Salmonella isolates in this study were non-typhi serotypes. Significantly higher proportions of Salmonellae were resistant to nalidixic acid and ciprofloxacin and a vast majority of nalidixic acid resistant organisms exhibited decreased susceptibility to ciprofloxacin.

Antibiogram of Urinary Enterococcus isolates from a tertiary care hospital

2020 ◽  
Vol 20 ◽  
Author(s):  
Nanditha Rajaram Bhat ◽  
Shruthi Bhat Kodur Shivashankar ◽  
Biranthabail Dhanashree
Keyword(s):  
Tertiary Care ◽  
Clinical Problem ◽  
Diffusion Method ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Serious Infections ◽  
Enterococcus Spp ◽  
Agar Dilution ◽  
Vancomycin Resistant ◽  
High Level

Purpose: Urinary tract infection (UTI) is one of the serious infections caused by enterococci. VancomycinResistant Enterococci (VRE), is a persevering clinical problem globally. This study aims to detect high-level aminoglycoside and vancomycin resistance in uropathogenic Enterococcus spp. Methodology: A total of 75 clinically relevant Enterococcus spp. grown from urine samples, were collected following convenience non-random sampling method. Identified by standard biochemical tests and susceptibility to antibiotics was studied by Kirby Bauer’s disc diffusion method. The MIC of vancomycin was detected by agar dilution test. Van A, and Van B genes in VREs were detected by PCR. Results: Among the 75 Enterococcal isolates, 43 (57.3%) were E.faecalis, 12 (16%) were E.faecium, six (8%) each were E.pseudoavium and E.casseliflavus, five (6.66%) were E.dispar and three (4%) were E.durans. E.faecalis (n=19) and E.faecium (n=3) were resistant to High Level Streptomycin (HLS). E.faecalis (n=21) and E.faecium (n=6) were resistant to High Level Gentamicin (HLG). Four (9.3%) E.faecalis were vancomycin-resistant, of which three were of Van A, and one was both Van A and Van B genotype. Conclusion: Isolation of high level aminoglycoside resistant (HLAR) Enterococci is a challenge for the treating physician because aminoglycoside cannot be used in combination with glycopeptide or ampicillin for such isolates. The occurrence of HLAR, Van A and Van B VRE genotypes is a cause of concern as they may transfer drug resistance genes to other bacterial isolates, thus leading to limited therapeutic options.

Molecular Typing of Imipenem-ResistantAcinetobacter baumannii-calcoaceticusComplex in a Singapore Hospital Where Carbapenem Resistance Is Endemic

2007 ◽  
Vol 28 (8) ◽  
pp. 941-944 ◽  
Author(s):  
Thean Yen Tan ◽  
Karen Poh ◽  
Siew Yong Ng
Keyword(s):  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Typing Method ◽  
Disk Diffusion Method ◽  
Carbapenem Resistant ◽  
High Prevalence ◽  
Resistant Strains

Objective.To investigate the molecular epidemiology of carbapenem-resistantAcinetobacter baumannii-calcoaceticuscomplex isolates in a tertiary care hospital where the prevalence of carbapenem resistance among these organisms is high.Design.The study was a prospective, observational study performed during an 8-month period (May 1 through December 31, 2004).A. baumanniiisolates recovered from all clinical samples during the study period were included in the study. Antibiotic susceptibility testing was performed using the disk diffusion method, and all carbapenem-resistant strains were typed by a polymerase chain reaction-based typing method.Setting.An 800-bed hospital in Singapore.Results.More than half of recovered isolates were clonally unrelated, with the remaining isolates grouped into 4 genotypes.Conclusions.The results of the study suggest that the high prevalence of carbapenem resistance amongAcinetobacterorganisms in this institution is not caused by the spread of a predominant clone and that other factors may need to be investigated.

Sign in / Sign up

Export Citation Format

Share Document