Antibiotics’ susceptibility patterns of bacterial isolates causing lower respiratory tract infections in ICU patients at referral hospitals in Namibia

2021 ◽  
pp. 1-8
Author(s):  
Pia Simeon ◽  
Brian Godman ◽  
Francis Kalemeera
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Isolates ◽  
Lower Respiratory Tract Infections ◽  
Icu Patients ◽  
Referral Hospitals ◽  
Antibiotics Susceptibility ◽  
Tract Infections ◽  
Susceptibility Patterns

scholarly journals Effectiveness of Electronic Guidelines (GERH®) to Improve the Clinical Use of Antibiotics in An Intensive Care Unit

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 521
Author(s):  
Paola Navarro-Gómez ◽  
Jose Gutierrez-Fernandez ◽  
Manuel Angel Rodriguez-Maresca ◽  
Maria Carmen Olvera-Porcel ◽  
Antonio Sorlozano-Puerto
Keyword(s):  
Urinary Tract ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Species ◽  
Lower Respiratory Tract Infections ◽  
Icu Patients ◽  
Study Results ◽  
Tract Infections

The objective of the study was to evaluate the capacity of GERH®-derived local resistance maps (LRMs) to predict antibiotic susceptibility profiles and recommend the appropriate empirical treatment for ICU patients with nosocomial infection. Data gathered between 2007 and 2016 were retrospectively studied to compare susceptibility information from antibiograms of microorganisms isolated in blood cultures, lower respiratory tract samples, and urine samples from all ICU patients meeting clinical criteria for infection with the susceptibility mapped by LRMs for these bacterial species. Susceptibility described by LRMs was concordant with in vitro study results in 73.9% of cases. The LRM-predicted outcome agreed with the antibiogram result in >90% of cases infected with the bacteria for which GERH® offers data on susceptibility to daptomycin, vancomycin, teicoplanin, linezolid, and rifampicin. Full adherence to LRM recommendations would have improved the percentage adequacy of empirical prescriptions by 2.2% for lower respiratory tract infections (p = 0.018), 3.1% for bacteremia (p = 0.07), and 5.3% for urinary tract infections (p = 0.142). LRMs may moderately improve the adequacy of empirical antibiotic therapy, especially for lower respiratory tract infections. LRMs recommend appropriate prescriptions in approximately 50% of cases but are less useful in patients with bacteremia or urinary tract infection.

Etiological Trends and Antibiotic Susceptibility of Bacterial Strains Causing Respiratory Tract Infections

2020 ◽  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Respiratory Tract ◽  
Haemophilus Influenzae ◽  
Moraxella Catarrhalis ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Isolates ◽  
Lower Respiratory Tract Infections ◽  
Streptococcus Pneumonia ◽  
Tract Infections

Background: Lower respiratory tract infections (LTRIs) are emerging as the most common infectious diseases of humans. Antibiotic resistance has increased in all the major pathogens therefore, this project engrossed on defining the current drift of bacterial etiologies of respiratory tract infections among the patients and their antimicrobial susceptibility pattern. Methods: This cross-sectional study with non-probability consecutive sampling was conducted in the microbiology laboratory of Ziauddin Hospital. Bacterial isolates (163) were recuperated from respiratory sputum specimens obtained from patients with lower respiratory tract infections. The pathogens collected for study were Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis. Frequencies and percentages were computed for categorical variables like microorganism, gender, age, duration of lower respiratory tract infections, etc. Mean and standard deviation were calculated for quantitative variables like age and infection duration. Furthermore, duration of disease was stratified by post stratification Chi Square with p value ≤ 0.05 was considered significant. Results: Most commonly isolated pathogen is Moraxella catarrhalis 72.39% followed by Haemophilus influenza 14.72% and Streptococcus pneumonia 12.88%. For Streptococcus pneumoniae 47% sensitivity showed to Ampicillin, 52% Penicillin, 61.9% Erythromycin and 57% to Ceftriaxone. For Haemophilus influenzae 100%, sensitivity showed to Ceftriaxone, 100% Amoxicillin and 62.5% Co-trimoxazole. Similarly, for Moraxella catarrhalis 54% sensitivity was showed to Erythromycin, 100% Ceftriaxone and 27% with Levofloxacin. Conclusion: Moraxella catarrhalis, Haemophilus influenzae and Streptococcus pneumoniae were the most common bacterial isolates recovered from LTRIs. We found M. catarrhalis resistant rate was elevated for Levofloxacin, Streptococcus pneumonia for Co-trimoxazole and Haemophilus influenzae to all β-lactams. Keywords: Respiratory Tract Infection; Haemophilus influenzae; Moraxella catarrhalis; Streptococcus pneumonia.

scholarly journals A Cross -Sectional Study of Bacteriological Profile of Lower Respiratory Tract Infections in Neurosurgery Intensive Care Unit in Central Kerala

2021 ◽  
Vol 8 (24) ◽  
pp. 2077-2082
Author(s):  
Satheesh Chandra Sugatha Rao ◽  
Shara Beena
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Lower Respiratory Tract Infections ◽  
Cross Sectional ◽  
Tract Infections

BACKGROUND Lower respiratory tract infections are the most common bacterial infections in neurosurgery intensive care units (NSICU), resulting in high overall mortality. The emergence of antibiotic resistant pathogens poses a challenge to their empiric treatment. Regular surveillance of the prevalent strains and their susceptibility pattern, helps to revise the antibiotic policies and aids in better management of the patient. METHODS A cross sectional study was conducted in the Department of Neurosurgery and Microbiology, Government Medical College, Thrissur, over a period of 1 year, using lower respiratory tract specimens of 190 patients with acute respiratory symptoms admitted in neurosurgery intensive care unit. The specimens collected aseptically were processed immediately. Following culture, the bacterial isolates were identified using standard methods and antibiotic susceptibility was done by Kirby Bauer disc diffusion method. The data obtained was coded and entered in Microsoft Excel and expressed as percentage. RESULTS Bacterial isolates were obtained from 74 % samples. 82 % isolates were monomicrobial and 18 % were polymicrobial. Majority of the isolates were gram negative bacteria (94 %) followed by gram positive bacteria (6 %). The common gram-negative isolates were K. pneumoniae (36 %), A. baumannii (29 %), P. aeruginosa (20 %). Methicillin-resistant staph (MRSA) (3 %) and methicillinsusceptible staph (MSSA) (3 %) accounted for the gram positive cocci. 61 % isolates were multi drug resistant (MDR). Most common MDR organism was A. baumannii. It was observed that 26 % isolates were extended spectrum betalactamase (ESBL) producers. A high rate of resistance to cephalosporins, beta lactams, fluoroquinolones, aminoglycosides, and cotrimoxazole was observed. An emerging resistance to carbapenems was observed. CONCLUSIONS Proper microbiological work up and antibiotic stewardship programmes can limit spread of resistant organisms, thereby reducing the medical and economic burden of the patient. KEYWORDS Lower Respiratory Tract Infection, Neurosurgery ICU, Antimicrobial Susceptibility Tests, Multi Drug Resistant Organisms

scholarly journals 151. Simplifying Empiric Antimicrobial Therapy Selection for Lower Respiratory Tract Infections in Intensive Care Unit Patients: Using Resistance Frequency to Guide Decision Making

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S91-S91
Author(s):  
Kenneth Klinker ◽  
Levita K Hidayat ◽  
C Andrew DeRyke ◽  
Mary Motyl ◽  
Karri A Bauer
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Worst Case ◽  
Icu Patients ◽  
E Coli ◽  
Group 2 ◽  
Tract Infections ◽  
Group 1

Abstract Background In the US, the burden of multidrug resistant bacterial infections, including carbapenem-resistant P. aeruginosa (CRPA) and ESBL-producing Enterobacterales (ESBL-E), is substantial. These resistant pathogens may affect the delivery of timely effective therapy. The aim of this study is to evaluate beta-lactam (BL) susceptibility trends based on the aggregate frequency of CRPA and a combined ESBL-E phenotype (K. pneumoniae (KPn) + E. coli (EC)) observed in critically ill patients with lower respiratory tract infections (LRTI). Methods In 2016-2019, ~20 US institutions per year submitted up to 250 gram-negative pathogens as part of the Study for Monitoring Antimicrobial Resistance Trends. A total of 871 PA, 380 KPn, and 336 EC isolates were collected from ICU patients with LRTI. MICs were determined using broth microdilution and interpreted using 2021 CLSI breakpoints. ESBL-E phenotype was defined as: ceftriaxone MIC ≥ 2 mcg/mL. Institutions were stratified into two groups based on frequency of CRPA and combined ESBL-E phenotype: Group 1: CRPA ≤ 15% and ESBL-E ≤ 15%; Group 2: CRPA > 15% and ESBL-E > 15%. Based on CLSI guidance, an empiric antibiotic susceptibility threshold of ≥90% was deemed optimal. Results Overall, CRPA and ESBL-E phenotypes were identified in 28.4% and 21.2% of isolates, respectively. Aggregate BL susceptibility in group 1 was above the 90% threshold for cefepime (FEP), piperacillin/tazobactam (TZP), meropenem (MEM), ceftolozane/tazobactam (C/T), and imipenem/relebactam (I/R) (Table 1). However, as frequency of CRPA and ESBL-E exceeded 15%, aggregate BL susceptibility declined to 77.3%, 79.3%, and 86.2% for FEP, TZP, and MEM, respectively. In contrast, C/T and I/R maintain susceptibility above the empiric susceptibility threshold. Table 1. Aggregate susceptibility of P. aeruginosa, E. coli, and K. pneumoniae ICU LRTI isolates stratified by resistance frequency: Best- (Group 1) and worst-case (Group 2) scenarios Conclusion In ICU patients, exceeding CRPA and combined ESBL-E phenotype frequency of 15% for both classifications, impacts susceptibility to 1st line BL’s resulting in a failure to achieve empiric susceptibility thresholds. This stratification could serve as a decision point for triggering earlier susceptibility testing or modifying empiric therapy recommendations for LRTI to include newer agents pending microbiology results. Disclosures Kenneth Klinker, PharmD, Merck & Co., Inc. (Employee, Shareholder) Levita K. Hidayat, PharmD BCIDP, Merck & Co., Inc. (Employee, Shareholder) C. Andrew DeRyke, PharmD, Merck & Co., Inc. (Employee, Shareholder) Mary Motyl, PhD, Merck & Co., Inc. (Employee, Shareholder) Karri A. Bauer, PharmD, Merck & Co., Inc. (Employee, Shareholder)

scholarly journals 709. Activity of Key β-Lactam Agents Against Gram-Negative Bacilli From ICU Patients with Lower Respiratory Tract Infections, SMART United States 2015–2017

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S255-S255
Author(s):  
Sibylle Lob ◽  
Krystyna Kazmierczak ◽  
Daryl Hoban ◽  
Meredith Hackel ◽  
Katherine Young ◽  
...  
Keyword(s):  
United States ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
The United States ◽  
Surveillance Program ◽  
Lower Respiratory Tract Infections ◽  
Icu Patients ◽  
Gram Negative ◽  
Tract Infections

Abstract Background Relebactam (REL), formerly MK-7655, is a β-lactamase inhibitor of class A and C β-lactamases that is in clinical development in combination with imipenem (IMI). In this study, we evaluated the activity of IMI/REL against Gram-negative bacilli and resistant phenotypes collected in the United States as part of the SMART surveillance program from patients with lower respiratory tract infections (RTI) in ICUs, where antimicrobial resistance is typically higher than in non-ICU wards. Methods In 2015–2017, 26 hospitals in the United States each collected up to 100 consecutive Gram-negative pathogens from RTI per year. Antimicrobial susceptibility was determined for 1,298 non-Proteeae Enterobacteriaceae (NPE) and 638 P. aeruginosaisolates collected in ICUs, using CLSI broth microdilution and breakpoints; for comparison purposes, the IMI susceptible breakpoint was applied to IMI/REL. Proteeae were excluded due to intrinsic nonsusceptibility to IMI. Susceptibility was calculated for the 4 United States census regions and overall. Results Susceptibility of NPE was lowest in the Midwest to ceftazidime (81%) and cefepime (87%) and highest in the Northeast (88% and 94%, respectively); susceptibility to imipenem (89–93%) and piperacillin–tazobactam (86–90%) showed less variability across regions. Susceptibility of P. aeruginosa to the four agents was lowest in the West region (57–65%) and highest in the Northeast (68–76%). Susceptibilities to IMI/REL of NPE and P. aeruginosa as well as of phenotypes nonsusceptible (NS) to β-lactams are shown below. Conclusion The studied β-lactams showed some variability in activity against pathogens from RTI patients in ICUs across census regions, whereas IMI/REL maintained activity in all regions against NPE (>96%) and P. aeruginosa (90–95%). IMI/REL remained active against ≥98% of resistant phenotypes of NPE, except the imipenem-NS subset (67.5% susceptible), which was composed mainly of Serratia spp., and remained active against 77–82% of resistant phenotypes of P. aeruginosa, including 77.2% of imipenem-NS isolates. IMI/REL may provide a valuable therapeutic option for the treatment of ICU patients with respiratory tract infections caused by organisms resistant to commonly used β-lactams. Disclosures S. Lob, IHMA, Inc.: Employee, Salary. Merck: Consultant, Consulting fee. K. Kazmierczak, Merck: Consultant, Consulting fee. IHMA, Inc.: Employee, Salary. D. Hoban, IHMA, Inc.: Employee, Salary. Merck: Consultant, Consulting fee. M. Hackel, IHMA, Inc.: Employee, Salary. Merck: Consultant, Consulting fee. K. Young, Merck: Employee and Shareholder, Dividends and Salary. M. Motyl, Merck: Employee and Shareholder, Dividends and Salary. D. Sahm, IHMA, Inc.: Employee, Salary. Merck: Consultant, Consulting fee.

scholarly journals Antibiotic susceptibility of bacterial strains and bacteriological profile from patients with lower respiratory tract infections in a teaching hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 326-330
Author(s):  
Ritu Vaish
Keyword(s):  
Respiratory Tract ◽  
Teaching Hospital ◽  
Antibiotic Susceptibility ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Isolates ◽  
Lower Respiratory Tract Infections ◽  
Female Ratio ◽  
Gram Negative ◽  
Tract Infections

Lower respiratory tract infections (LRTI) are one of the commonest health problems demanding frequent consultation and hospitalization. Unnecessary and inappropriate initial antibiotic therapy is a potentially modifiable factor that is associated with increased mortality in patients with serious infections. To study bacterial profile and susceptibility pattern of lower respiratory tract infections in a teaching hospital.Prospective study done in the department of Microbiology at Prathima Institute of Medical Sciences, Nagunuru, Karimnagar, Telangana., Tover a period of 18 months ie from January 2019 to July 2020. A total of 120 samples from respiratory tract were studied for bacterial isolates and antibiotic susceptibility. A total of 120 cases were studied. The male to female ratio was 2:1. Among the bacterial isolates, 76.6% were Gram negative bacilli and 23.3% were gram positive cocci. Among Gram negative bacteria, the predominant bacterial isolate was Klebisella. pneumoniae (45.8%) followed by Pseudomonas. aeruginosa (28.3%.)Present study, was based on the pattern of resistance to commonly used antibiotics by organisms causing lower respiratory tract infections (LRTIs) in our institute. This may help us to study the more susceptible group of drugs in our institute which would help prepare an antibiogram and develop a policy for rational antibiotic prescription.

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