scholarly journals The Prevalence and Antimicrobial Susceptibility Pattern of Gram-Positive Pathogens: Three-Year Study at a Private Tertiary Care Hospital in Mumbai, India

2021 ◽  
Author(s):  
Sweta Shah ◽  
Ritika Rampal ◽  
Pooja Thakkar ◽  
Sushima Poojary ◽  
Shweta Ladi
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Steady Increase ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Gram Positive ◽  
Tract Infections

Abstract Introduction The growing resistance pattern of the gram-positive pathogens along with a steady increase in minimum inhibitory concentration of the currently available antibiotics have led to an increase in morbidity and mortality rates in India. This study aims to access the shifting antibiotic susceptibility paradigm of the gram-positive pathogens in various infections at a tertiary care center. Methods This is a 3-year retrospective observational study which was performed from January 2016 to December 2018 at a tertiary care hospital in Mumbai. All clinically significant gram-positive cocci isolated from a variety of clinical specimens were studied for their prevalence and antimicrobial susceptibility. Results Out of 4,428 gram-positive isolates, Staphylococcus aureus (35.3%) was the commonly encountered pathogen, followed by Enterococcus spp. (32.1%) and coagulase-negative Staphylococcus (CoNS) (25.7%). S. aureus was majorly isolated from skin and soft tissue infections (60.3%), followed by patients with respiratory tract infections (18.2%) and blood stream infections (13%). Among S. aureus, particularly methicillin-resistant S.aureus (MRSA), prevalence increased from 29.5% in 2016 to 35.1% in 2018, with an overall prevalence of 33.6%. All S. aureus isolates were 100% sensitive toward vancomycin, linezolid, tigecycline, and teicoplanin. However, the CoNS isolates showed a higher resistance rate with reduced susceptibility toward linezolid and teicoplanin. High prevalence of resistance was observed across gram-positive isolates with commonly used antibiotics such as ciprofloxacin, levofloxacin, and erythromycin. While the prevalence of linezolid-resistant enterococcus (LRE) was 3.6%, vancomycin (VRE) and teicoplanin resistance among the enterococcus species was as high as 7.7% and 7.5%, respectively. Conclusion Rising methicillin resistance among the Staphylococcal species (MRSA and MR-CoNS) along with reduced susceptibility toward currently available anti-MRSA agents is a matter of serious concern as it limits the therapeutic options for treating multidrug resistant (MDR) gram-positive infections.

scholarly journals Microbiological profile and antibiotic susceptibility pattern of Gram-positive isolates at a tertiary care hospital

2019 ◽  
Vol 11 (02) ◽  
pp. 144-148 ◽  
Author(s):  
Dhruv Mamtora ◽  
Sanjith Saseedharan ◽  
Pallavi Bhalekar ◽  
Surekha Katakdhond
Keyword(s):  
Antibiotic Susceptibility ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Lower Sensitivity ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Antibiotic Susceptibility Pattern

Abstract OBJECTIVES: Gram-positive infections such as those by Staphylococcus aureus have contributed to the disease burden by increasing the morbidity and mortality rates in India. This study aims to determine the prevalence and the antibiotic susceptibility pattern of Gram-positive pathogens at a tertiary care hospital, Mumbai, Maharashtra, India. MATERIALS AND METHODS: This retrospective cross-sectional study was carried out from January, 2015 to December, 2017, at a tertiary care hospital in Mumbai, India. The clinical isolates were cultured, and identification was done using Vitek 2 culture system. The antibiotic susceptibility testing was done as per the Clinical Laboratory Standard Institute guidelines. RESULTS: Out of 2132 (29%) Gram-positive isolates, S. aureus (49%) was the most common encountered pathogen, followed by Enterococcus spp. (24.5%) and coagulase-negative Staphylococcus (16%). Majority of the S. aureus were observed in patients with skin and soft-tissue infections (61.2%) followed by those suffering from respiratory (41%) and bloodstream infections (35%). Among the infections caused by S. aureus, the prevalence of methicillin resistance was 30%. While the MRSA isolates showed lower sensitivity toward co-trimoxazole (39%), clindamycin (30%), erythromycin (23%), and ciprofloxacin (10%), they showed higher susceptibility to linezolid (98%), vancomycin (98%), and teicoplanin (98%). All the isolates were found to be sensitive to daptomycin and tigecycline. While vancomycin-resistant enterococci (VRE) formed 7.5%, the linezolid-resistant enterococcus species was as high as 4.1%. CONCLUSION: The study showed a high prevalence of MRSA and VRE, thereby emphasizing the increasing antimicrobial resistance pattern of the Gram-positive pathogens. Therefore, there is an urgent need for novel antimicrobial stewardship to restrict the ongoing resistance rate among the isolates.

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 Study of antimicrobial susceptibility pattern of Gram positive organisms causing UTI in a tertiary care hospital in eastern region of Nepal

2013 ◽  
Vol 11 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Ratna Baral ◽  
S Timilsina ◽  
P Jha ◽  
NR Bhattarai ◽  
N Poudyal ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Bacterial Resistance ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Eastern Region ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are the most important cause of mortality and morbidity affecting all age groups with an estimated 150 million cases occurring globally per year. Resistance to antibiotics is highly prevalent in bacterial isolates causing UTI. Objectives: To observe the isolation of gram positive bacteria causing UTIs and determine their resistance pattern to antibiotics. Methods: A retrospective study was conducted in BPKIHS from August 2009- August 2010. A total of 11022 urine samples from patients who visited BPKIHS were analyzed. All specimens were inoculated on routine culture media. Bacterial isolates were identified by conventional bacteriological methods. Susceptibility testing was performed by standard methods as recommended by clinical laboratory standard institute. Results: A total of 459 gram positive uropathogens were isolated. Altogether 5 different gram positive bacteria were isolated among which Staphylococcus aureus (47%) was the most predominant organism followed by Enterococcus species (34%), Enterococcus faecalis (18%), and Coagulase-negative Staphylococci (1%). UTI caused by gram positive uropathogens was seen in 68.8% females as compared to 31.2% males. Multidrug resistance (MDR) isolates accounted for 308 out of 459 isolates (67.10%). Multidrug resistance was commonest with Enterococcus spp (71.5%) followed by Streptococcus spp (66.6%). Drugs, which retained usefulness for Gram-positive isolates were vancomycin, nitrofurantoin, ciprofloxacin and norfloxacin. Conclusion: The study revealed that bacterial resistance in gram positive uropathogens in tertiary hospital in eastern region continues to be a great problem. So, regular monitoring of emergence of resistance is highly recommended and specific antibiotics should be given only after the laboratory results are available. Health Renaissance, January-April 2013; Vol. 11 No.1; 119-124 DOI: http://dx.doi.org/10.3126/hren.v11i2.8218

scholarly journals Analysis of WHONET Surveillance Data of Antimicrobial Sensitivity of Uropathogens in a Tertiary Care Hospital: An Indicator to Empirical Antimicrobial Treatment for Urinary Tract Infection

2020 ◽  
Author(s):  
Vandana A Agarwal ◽  
Gopal Nandlal Agrawal ◽  
Bhavana Bazare ◽  
Sunanda Zodpey
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Empirical Treatment ◽  
Surveillance Data ◽  
World Health ◽  
Care Hospital ◽  
Hospitalised Patients ◽  
Tract Infections

Introduction: Urinary Tract Infections (UTIs) are among the most common bacterial infections. A regular surveillance of local aetiology and susceptibility profile could support the most effective empirical treatment. WHONET (World Health Organisation Network) is free software developed since 1989 by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance. Aim: Analysis of WHONET surveillance data was undertaken to know the aetiological profile of uropathogens and their antimicrobial susceptibility pattern to formulate an empirical treatment policy in a tertiary care hospital. Materials and Methods: The present study was retrospective and cross-sectional study. Uropathogens and their antimicrobial susceptibility from a tertiary care hospital during July 2018 to June 2019 were studied. For analysis, the software WHONET 5.6 version was used. An inclusion criterion was uropathogens with significant growth of one pathogen and only the first isolate of a given species encountered in case there were repeat samples from the same patient. Chi-square test was used to compare percentages and p-value <0.05 was considered as statistically significant. Results:Of the 1152 non-duplicate uropathogens, Enterobacteriaceae was the causative agent in 75% cases, E. coli accounting for more than two third of the cases. Gram positive cocci and Non-fermenters were isolated in 13% and 10% cases respectively. S. aureus, E. faecalis and Enterobacteriaceae showed high sensitivity to nitrofurantoin. Conclusion: For uropathogens, nitrofurantoin can be the drug of choice for empirical treatment of UTI. However, in serious hospitalised patients with UTI, additional parenteral administration of piperacillin-tazobactam may be considered.

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