scholarly journals Nitrofurantoin Susceptibility Pattern in Gram-Negative Urinary Isolates: In Need of Increased Vigilance

2021 ◽  
Author(s):  
Garima Gautam ◽  
Sanjib Gogoi ◽  
Sonal Saxena ◽  
Ravinder Kaur ◽  
Megh Singh Dhakad
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Analysis Data ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
Tract Infections ◽  
Urinary Isolates

AbstractNitrofurantoin is the first-line drug in the treatment of uncomplicated urinary tract infections (UTIs) and its use has increased exponentially in recent years. Objectives This study aims to determine the susceptibility pattern of nitrofurantoin in gram-negative urinary isolates and to evaluate their bacteriological and epidemiological profile along with co-existing resistance to other important urinary antimicrobials. Material and Methods This was a retrospective study conducted in a tertiary care hospital in New Delhi in which 500 gram-negative bacterial urinary isolates were evaluated. Records of antimicrobial susceptibility were reviewed from July to September 2019. Antimicrobial susceptibility was performed using the Kirby–Bauer disk diffusion method on Mueller Hinton agar and interpreted using CLSI 2019. Test for extended spectrum β-lactamase (ESBL) producers was done using double disk approximation test. Statistical Analysis Data analysis was performed using the SPSS windows version 25.0 software. Results Out of total 500 isolates, 20.17% (94) isolates were resistant (R) to nitrofurantoin and 9.01% (42) were found to be intermediate (I). Highest resistance was seen in Klebsiella sp. (44.61%) and Escherichia coli (8.12%). About 28.82% of the I/R isolates were of the pediatrics age group and most of the isolates belonged to females (64.69%). High resistance was also seen against ampicillin (92.30%), cefazolin (88.46%), ceftazidime (73.0%), and fluoroquinolones (65.38%). Carbapenemase co-resistance was seen in 57.15% isolates whereas ESBL production was seen in 30.76% of E. coli and 12.06% of Klebsiella sp. Conclusion Increase in multidrug resistance uropathogens along with a near absence of novel oral antibiotics has led to increased consumption of nitrofurantoin since its resistance has increased.

AEROBIC BACTERIOLOGICAL PROFILE WITH ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF PUS SAMPLES AT A TERTIARY CARE HOSPITAL IN JAIPUR

2021 ◽  
pp. 65-67
Author(s):  
Hemendra K Sharma ◽  
Niketa Gupta ◽  
Mahesh Yadav ◽  
Aruna Vyas ◽  
Rajni Sharma
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Gram Negative ◽  
Inappropriate Use ◽  
Antimicrobial Susceptibility Pattern

Background: Pyogenic infections can be caused by various microorganisms and may co-exist as poly microbial infections which require antibiotic therapy. The inappropriate use of antibiotics has led to major problems of MDRO's contributing to morbidity and mortality. Even though the bacteriological prole of pus samples in many studies remain the same, antimicrobial susceptibility pattern of these isolates has shown a lot of variation. This study was conducted to assess bacteriological prole of pus samples and their antimicrobial susceptibility pattern Materials and Methods:Aretrospective study was carried out from April to June 2021. 540 pus culture aerobic bacterial isolates were included. The samples were cultured on Blood and MacConkey agar. After aerobic incubation at 37oC for 18-24 hrs, organisms were identied by conventional bacteriology methods as per laboratory protocol and antimicrobial susceptibility was tested by Kirby Bauer disc diffusion method as per CLSI 2020 guideline. Results: Out of 540 pus isolates , 452(83.7%)were gram negative bacili and 88(16.3%) were gram positive cocci Pseudomonas spp. 173(31.9%), was most common gram negative isolate while S.. aureus 66(12.19%) was most common Gram positive isolate. Most of gram negative isolates were susceptible to Imipenem and Polymyxin and gram positive isolates to vancomycin and linezolid . Conclusion: To combat resistance irrational use of antibiotics should be avoided. Also regular surveillance helps in implementing better therapeutic strategies to reduce morbidity and mortality

scholarly journals Antibiotic Susceptibility Pattern of Clinical Isolates of Escherichia coli at a Tertiary Care Hospital

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 681-686
Author(s):  
Md Shakhaowat Hossain ◽  
Rehana Khatun ◽  
Mohammed Solayman ◽  
Babul Aktar ◽  
Abdullah Akhtar Ahmed
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Penicillin G ◽  
Diffusion Method ◽  
Care Hospital ◽  
Isolation And Identification ◽  
Disk Diffusion Method ◽  
Tract Infections

Infections due to multidrug resistant E.coli range from uncomplicated urinary tract infections to life-threatening sepsis. A retrospective study was conducted to determine the patterns of antimicrobial susceptibility in 173 (12.84%) Escherichia coli strains isolated from 1347 clinical specimens of different types. Isolation and identification of E.coli were done as per routine laboratory protocol directed by Cheesbrough1. The isolation rate of E.coli was 48.57% in stool followed by 17.68% in urine, 25% in wound swabs, and 15.38% in tracheal aspirate etc. Among the 173 isolates 102 (59%) were from males and 71 (41%) were from females. Patients were classified into five age groups: 0-15, 16-30, 31-45, 46-60 and >60 years. E.coli was found highest number in females (13.9%) of age range 31-45 years and in males (22%) belonged to age group of over 60 years. Antimicrobial susceptibility testing by the disk diffusion method was conducted for 22 different antibiotics. The majority of isolated E.coli were highly sensitive to Imipenem (98.18%), Meropenem (97.37%), Amikacin (91.67%), Amoxiclav (80%), Ceftazidime (73.33%), and Gentamycin (71.76%). The antibiotics Tobramycin and Azithromycin were found as moderately sensitive against E.coli with the susceptibility rate of 52.5% and 50% respectively. The isolates show low degree of susceptibility to Penicillin G (9.52%), Carbenicillin (10%), Erythromycin (19.48%), Amoxycillin (19.59%), and Ampicillin (25%). These findings have clinical and epidemiological significance and provide a benchmark for future studies on the pattern of susceptibility of clinical isolates of E.coli in this region as well as may help the clinician to prescribe the right empirical treatment.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 681-686

scholarly journals ISOLATION AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF MICROORGANISMS CAUSING INTRA-ABDOMINAL INFECTIONS AT TERTIARY CARE HOSPITAL OF NORTHERN INDIA

2021 ◽  
pp. 37-40
Author(s):  
PARMINDER SINGH ◽  
RITU GARG ◽  
HARIT KUMAR ◽  
RINKU
Keyword(s):  
Antimicrobial Susceptibility ◽  
Klebsiella Oxytoca ◽  
Tertiary Care ◽  
Effective Drug ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Negative Organisms

Objective: The objective of the study is to find out the resistance pattern of pathogenic organisms isolated from intra-abdominal infection (IAI). Methods: A total of 500 samples were collected from suspected IAIs of patients reporting to the hospital and cultured. Identification of the isolates was done using standard identification protocol. Antimicrobial susceptibility was performed by Kirby-Bauer disc diffusion method and interpretation was done using Central Laboratory Standard Institute guidelines. Results: Out of 500 samples, 170 were culture positive and 330 showed no growth. Gram-negative organisms (n=127) outnumbered the Gram-positive organisms (n=23). Among the Gram-negative organisms, Escherichia coli (n=67) was the most commonly isolated bacilli followed by Klebsiella sp. (n=32), Pseudomonas sp. (n=25), Acinetobacter baumannii (n=18), and Klebsiella oxytoca (n=05). Among Gram-positive organisms Staphylococcus aureus (n=17) and Enterococcus spp (n=06) isolates of were grown in culture. Among Gram-negative bacilli, Imipenem followed by Gentamicin was the most effective drug but in Acinetobacter spp. The second most effective drug was Tigecycline. Among Gram-positive isolates, Linezolid was the most effective drug. Conclusion: Prompt starting of empirical antimicrobials based on the local susceptibility pattern, followed by modification of treatment in accordance with the antimicrobial susceptibility report can significantly reduce the morbidity and the mortality associated with IAIs.

Antibiogram of Gram Negative Uropathogens in a Tertiary Care Hospital

2021 ◽  
Vol 8 (2) ◽  
pp. 80-84
Author(s):  
Milind Davane ◽  
Sanjivani Mundhe
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Susceptibility ◽  
Hospitalized Patients ◽  
Health Concern ◽  
Diffusion Method ◽  
Susceptibility Pattern ◽  
Gram Negative ◽  
Antimicrobial Susceptibility Pattern ◽  
Tract Infections ◽  
Klebsiella Spp

Background: Globally, urinary tract infection (UTI) is considered a major public health concern and the second most common bacterial infection affecting individuals of different ages worldwide. Urinary tract infections (UTIs) are caused by multiplicity of microorganisms. The chronicity of different bacterial isolates and their propensity to various antibiotics may differ widely, particularly in hospitalized patients, that makes the study of susceptibility pattern mandatory for a proper selection of antibiotics. Objective: To evaluate antimicrobial susceptibility pattern of the Gram negative organisms isolated from urine cultures of hospitalized patients. Material and Methods: A total of 500 urine samples from hospitalized patients which showed significant bacteriuria were studied. Samples were inoculated on Blood agar and MacConckey agar. Further identification and study of organisms was done by standard Microbiological methods. Antimicrobial Susceptibility pattern was studied by Modified Kirby- Bauer’s disc diffusion method with the panel of 15 drugs as per Clinical Laboratories Standard Institute (CLSI) guidelines. Results: UTIs were found more common in females 290 (58%). Commonest organism found was Escherichia coli 260 (52%) followed by Klebsiella spp. 120 (24%), Pseudomonas spp. 40 (8%), Proteus spp. 38 (7.6%), Citrobacter spp. 25 (5%) and Acinetobacter spp. 17 (3.4%). Majority of the strains were found sensitive to nitrofurantoin followed by amikacin, piperacillin-tazobactam and cotrimoxazole. Commonly prescribed fluroquinolones were found least effective for treatment of UTI. All the strains were found sensitive to imipenem. Extended spectrum beta lactamase (ESBL) was noted in E.coli and in Klebsiella spp. Conclusion: To discourage the indiscriminate use of antibiotics and to prevent further development of bacterial drug resistance, proper knowledge of susceptibility pattern of uropathogens in particular area is very important before prescribing any empirical antibiotic therapy.

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.

scholarly journals Bacteriological Profile of Chronic Osteomyelitis with Special Reference to Antibiotic Resistance Mechanisms/Patterns – A Cross-sectional Prospective Study from Tertiary Care Hospital in Central India

2020 ◽  
pp. 43-52
Author(s):  
Aparna Pandey ◽  
Prachi Shaw ◽  
Aamir Johar
Keyword(s):  
Multidrug Resistance ◽  
Antimicrobial Susceptibility ◽  
Chronic Osteomyelitis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Central India ◽  
Diffusion Method ◽  
Care Hospital ◽  
Age Group ◽  
Gram Negative

Objective: Chronic osteomyelitis is the infection and inflammation of the bone. Inappropriate use of antibiotics and multidrug resistance has raised the morbidity and mortality rate in chronic osteomyelitis. This study aims to determine the bacterial profile and antimicrobial susceptibility patterns of chronic osteomyelitis with special mention to various resistant mechanisms. Methods: The study is a prospective design. Hundred (100) clinically diagnosed cases of chronic osteomyelitis of all age group and both sex admitted in a tertiary care hospital at central India, in one year were included. Samples like pus, sinus discharge or exudates were collected aseptically and sent for microbiological investigation. Antimicrobial susceptibility of bacterial isolates to the commonly used antibiotics was done by using modified Kirby Bauer disc diffusion method. Results: The aerobic bacteriological study of chronic osteomyelitis showed Staphylococcus aureus is being continued to be major etiological agent followed by Pseudomonas aeruginosa and Staphylococcus epidermidis. Gram-positive isolates were sensitive to linezolid, teicoplanin while gram-negative isolates were sensitive to colistin, ciprofloxacin in the majority. The disease occurs mostly due to traumatic injuries commonly affecting the middle age group. In present study prevalence of methicillin-resistant Staphylococci aureus and β Lactamase producing (ESBL, Amp-C and MBL) gram-negative bacilli is found to be on the higher side. Conclusion: It has been the major cause of morbidity for a long time. The emerging multidrug-resistant strain is a major concern for the treatment. Identification of causative isolates and using a judicious selection of antibiotics will help the clinician in starting the empirical treatment accordingly would limit the multidrug resistance strains in the hospital as well as the community.

scholarly journals Aerobacterial Vaginosis among Women Attending an Infertility Clinic at a Tertiary Care Hospital in Chennai, India and Susceptibility Pattern of Isolates

2021 ◽  
Author(s):  
Abigail R. Sopia ◽  
Pushpa Innocent D. Joseph ◽  
M. Kalyani ◽  
B. Ananthi ◽  
Suresh Dhanaraj ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Protein Synthesis Inhibitors ◽  
Gram Positive ◽  
Gram Negative

Genital infections and subsequent vaginosis diagnosed through high vaginal swab in women is caused due to fungi or bacteria. The presented study focused on determining the types, numbers and antibacterial susceptibility pattern of aerobic bacteria causing vaginosis in 147 female patients attending infertility centre in Chennai, Tamil Nadu, India. Candida spp. caused 17% of infections with 15.7% of vaginosis caused by E.coli, Klebsiella spp., Acinetobacter spp., Citrobacter spp. and Gram positive cocci – Methicillin Sensitive Staphylococcus aureus (MSSA), Coagulase Negative Staphylococci(CONS), Staphylococcus aureus and Enterococcus spp. causing 12.9% of vaginitis in the study population. A total of 20 different antibiotics – cell wall inhibitors, protein synthesis inhibitors and nucleic acid synthesis inhibitors; were tested to determine the response of bacterial isolates by Kirby-Bauer disc diffusion method. The study result determined that the most effective drug for treating Gram positive bacterial vaginitis as per CLSI guidelines based on susceptibility pattern as: Linezolid(100%), Gentamycin(91.6%), Amikacin(87.5%),Erythromycin(79.2%), Co-Trimoxazole(72.2%), Ciprofloxacin(65.6%) and least Chloramphenicol(44.3%). High level gentamycin(83.3%) was found to be effective in treating Enterococci. The descending order of susceptibility of Gram negative aerobacteria causing vaginitis as per CLSI guidelines are: Amikacin(87.5%), Gentamycin(82.5%), Cefoperazone sulbactam (76.3%), Ciprofloxacin(68.5%), Ceftazidime(62.5%) and least Amoxyclav(25%).All Gram negative bacteria tested were susceptible to– Imipenem and Meropenem as well as Chloramphenicol. Ceftriaxone (87.5%) and Nitrofurantoin(72.3%) among other antibiotics was effective against Gram negative bacteria while all Enterobacteriaceae members were found to be resistant to tetracycline.

scholarly journals ANTIMICROBIAL SUSCEPTIBILITY;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Javeria Gul ◽  
Iffat Javed ◽  
Sohaila Mushtaq ◽  
Muhammad Saeed Anwar
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Diffusion Method ◽  
Medical Institute ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Pathology Department

Background: The emergence and spread of antibiotic resistant bacteria causing infection is a great health issue for clinicians. The problem of multidrug resistant (i.e. resistant to at least three groups of antimicrobial) is becoming more and more threatening. The rate of resistance among Gram negative bacteria especially non fermenters are increasing to all available antibiotic groups. Objectives: The aim of study was to detect the pattern of antimicrobial susceptibility in non-fermenter Gram negative bacilli (NFGNB) in a tertiary care hospital (Postgraduate Medical Institute, Lahore). Study Design: Descriptive study. Settings: The study was conducted in Pathology Department, Postgraduate medical institute (PGMI), Lahore. Study Period: Six months from August 2014 to December 2014. Material and Methods: Non-fermenter Gram negative bacteria were collected from various clinical specimen including blood, pus, urine, fluid aspirates and respiratory tract in a period of six months in pathology department, PGMI. All non-fermenter Gram negative isolates were identified up to species level by standard laboratory procedures using API (Analytical profile index) 20 NE (non-enterobacteriaceae). Antimicrobial susceptibility testing of non-fermenter Gram negative isolates were performed by modified Kirby Bauer disk diffusion method as recommended in CLSI. Results: Out of the total 51 samples the most commonly isolated NFGNB were Acinetobacterbaumanni and Burkholderiacepacia (16 each) followed by Pseudomonas aeruginosa (7), Pseudomonas luteola (5), Stenotrophomonasmaltophilia (4), Pseudomonas fluorescens (2) and Pseudomonas stutzeri(1). Conclusion: The study showed that rate of multidrug resistance increased in non-fermenter Gram negative organisms.

scholarly journals Antimicrobial Susceptibility Pattern of Klebsiella Species from Various Clinical Samples at a Tertiary Care Hospital

2020 ◽  
pp. 143-147
Author(s):  
K. Sathyavathy ◽  
B. Kiran Madhusudhan
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Susceptibility Pattern ◽  
Disc Diffusion Method ◽  
Klebsiella Species ◽  
Antimicrobial Susceptibility Pattern

The aim of the study was to investigate the antimicrobial susceptibility pattern of Klebsiella species from different clinical samples at Sree Balaji Medical College and Hospital, India. Overall 189 samples out of 980 non repetitive clinical samples obtained from wound/pus, urine, sputum swab and blood by disc diffusion method and identified as Klebsiella and analysed. Out of total 189 Klebsiella isolates, 76 out of 155 K. pneumoniae (49%) were resistant and none out of 34 Klebsiella oxytoca (0%) showed resistance to cefotaxime and ceftazidime by disc diffusion method. Antimicrobial susceptibility testing of Klebsiella exhibited 100% resistance to Ampicillin. The present study highlights the need for the continued monitoring of antimicrobial susceptibility patterns of important bacterial pathogens, so that rational antibiotic policies can be formulated.

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