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.

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 Molecular Characterization Identifies Upstream Presence of ISAba1 to OXA Carbapenemase Genes in Carbapenem-Resistant Acinetobacter baumannii Isolated from a Tertiary Care Hospital in Western Maharashtra

2021 ◽  
Author(s):  
Nageswari Gandham ◽  
Neetu Gupta ◽  
Chanda Vyawahare ◽  
Shahzad Beg Mirza ◽  
Rabindra Nath Misra
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Clinical Samples ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Resistant Strains ◽  
Polymerase Chain ◽  
Antibiotics Sensitivity

Abstract Background Evaluating the expression pattern of oxacillinases (OXA) carbapenemases is essential to understand the prevalence and spread of carbapenem resistance Acinetobacter baumannii. Objectives The aim of the study is to evaluate the presence of OXA carbapenemase genes and ISAba1 upstream to these genes in carbapenem-resistant A. baumannii clinical isolates. Material and Methods A. baumannii isolated from clinical samples were phenotypically identified and antibiotics sensitivity was performed. Multiplex polymerase chain reaction (PCR) was used to detect OXA51-like gene, OXA carbapenemases genes (OXA-23-like, OXA-24-like, and OXA-58-like), and ISAba1 in carbapenem-resistant isolates. Results Out of 55 Acinetobacter isolates, 54 were confirmed as A. baumannii by PCR. Bla OXA-23-like gene was observed in 51 isolates of A. baumannii and none of the isolates showed the presence of bla OXA-24-like and bla OXA-58-like genes. Presence of ISAba1 upstream to OXA-23-like gene, OXA-51-like gene, and both OXA-51-like/OXA-23-like genes was observed in 51, 7, and 4 A. baumannii isolates, respectively. Conclusion The genetic pattern of carbapenem-resistant A. baumannii isolated in this study was unique, which should be factored for clinical protocols to manage infections caused by emerging resistant strains of A. baumannii.

Molecular detection of blaOXA-23gene and blaOXA-51 gene in carbapenem resistant strains of Acinetobacterbaumannii in patients with ventilator associated pneumonia at tertiary care hospital

2021 ◽  
Vol 71 (11) ◽  
pp. 2576-2581
Author(s):  
Saima Ishtiaq ◽  
Sidrah Saleem ◽  
Abdul Waheed ◽  
Arslan Ahmed Alvi
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Conventional Polymerase Chain Reaction ◽  
Diffusion Method ◽  
Military Hospital ◽  
Care Hospital ◽  
Acinetobacter Baumanii ◽  
Cross Sectional ◽  
Carbapenem Resistant

Objective: To evaluate carbapenem resistance and to detect blaOXA-23 and blaOXA-51 genes in carbapenem-resistant acinetobacter baumanii isolates recovered from patients having pneumonia secondry to ventilation. Methods: The cross-sectional study was conducted from July 2017 to June 2018 at the Department of Microbiology, University of Health Sciences, Lahore, Pakistan, and comprised endotracheal aspirates / tracheobroncheal lavage samples from patients irrespective of age and gender who developed pneumonia after being on the ventilator for 48 hrs at the Combined Military Hospital, and Jinnah Hospital, Lahore.  The samples were inoculated on MacConkey and blood agar and aerobically incubated at a temperature of 370C for 18-24 hours. The isolated organisms were further assessed by standard morphological, cultural and biochemical profile. Antibiotic susceptibility was done by Kirby-Bauer disc diffusion method. Carbapenem-resistant acinetobacter baumannii were checked for carbapenemase production using Modified Hodge Test. Conventional polymerase chain reaction and agarose gel electrophoreses were performed to detect blaOXA-23 and blaOXA-51 genes. Data was analysed using SPSS 17. Results: Out of 157 samples, 92(58.6%) yielded growth of bacteria, and, among them, 39(42.4%) were identified as acinetobacter baumannii. All (100%) acinetobacter baumannii cases showed resistance to carbapenem, were producing carbapenemase enzyme, and were positive for blaOXA-51 gene. The blaOXA-23 gene was amplified in 38(97.4%) isolates. Conclusion: BlaOXA-23 gene appeared to be the major cause of carbapenem resistance. Continuous...

scholarly journals Emerging resistance to carbapenem among Gram-negative bacteria in a tertiary care hospital

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 153-156
Author(s):  
Pooja Nair ◽  
Renu Mathews ◽  
Kalyani M
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Diffusion Technique

The emergence of bacterial antibiotic resistance is a cardinal concern in the health care system. The spread of resistance in Enterobacteriaceae and non-fermenters to the currently available drugs make the treatment of serious nosocomial infections troublesome.  The purpose of the study is to find out the carbapenem resistance among Gram-negative bacilli in a tertiary care hospital. Antibiotic susceptibility pattern of 1913 aerobic Gram-negative bacilli isolated from clinical samples was made for a period of 6 months. All the isolates were tested for susceptibility to antibiotics by the Kirby-Bauer disc diffusion technique according to CLSI guidelines. Carbapenemase production was confirmed by the Modified Hodge Test (MHT). Minimum Inhibitory Concentration (MIC) by Epsilometer (E) test was performed (for Imipenem and Meropenem) for carbapenem-resistant strains. A total of 1731 clinical samples, 1913 Gram-negative bacilli were isolated. 1476 (77.1%) were Enterobacteriaceae and 433 (22.6%) were non-fermenters. 54 were carbapenemase-producing Gram-negative bacilli. Meropenem E test was done for carbapenemase-producing Gram-negative bacilli. The minimum inhibitory concentration for Meropenem ranged from 0.002μg/ml to 32μg/ml. To overcome the problem of emerging resistance, combined interaction and cooperation of microbiologists, clinicians and the infection control team is needed.

scholarly journals Frequency and susceptibility pattern of metallo-beta-lactamase producers in a hospital in Pakistan

2010 ◽  
Vol 4 (12) ◽  
pp. 810-813 ◽  
Author(s):  
Fatima Kaleem ◽  
Javaid Usman ◽  
Afreenish Hassan ◽  
Aslam Khan
Keyword(s):  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Medical College ◽  
Strip Method ◽  
Carbapenem Resistant ◽  
Microbiological Methods ◽  
National University

Introduction: The rapid spread of acquired metallo-beta-lactamases (MBLs) among major Gram-negative pathogens is an emerging threat and a matter of particular concern worldwide. Methodology: This descriptive study was conducted between January and August 2009 in the department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, to determine the frequency and susceptibility patterns of MBL-producers among carbapenem-resistant Gram-negative rods (GNRs) from clinical isolates of a tertiary care hospital. All clinical samples were processed according to standard microbiological methods. Isolated GNRs were subjected to susceptibility testing against various antibiotics by disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.  Carbapenem-resistant isolates were subjected to the detection of MBL production by the E-test MBL strip method. Results: Out of 50 carbapenem resistant isolates, 39 (78%) of were confirmed to be MBL producers by the E-strip method.  Acinetobacter baumannii were the most frequent MBL producers, followed by Pseudomonas aeruginosa. A total of 19 (37%) of the MBL producers were susceptible to cefoperazone-sulbactam. Conclusion: The findings strongly suggest that there is a need to track the detection of MBL producers and that judicious use of carbapenems is necessary to prevent the further spread of these organisms.

scholarly journals Prevalence of multidrug-resistance and bla and blaIMP genes among gram-negative clinical isolates in tertiary care hospital, Kathmandu, Nepal

2021 ◽  
Author(s):  
Mehraj Ansari ◽  
Subhas Chandra Aryal ◽  
Ganesh Rai ◽  
Kul Raj Rai ◽  
Susil Pyakurel ◽  
...  
Keyword(s):  
Multiplex Pcr ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Research Centre ◽  
Diffusion Method ◽  
Diagnostic Tools ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Carbapenem Resistant

Background and Objectives: Carbapenems have been the choice of antibiotics for the treatment of infections caused by multidrug-resistant bacteria. The main objective of this study was to determine the prevalence of carbapenemase (blaVIM and bla ) producing isolates among Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Materials and Methods: A total of 1,151 clinical samples were collected from the patients visiting Annapurna Neurological Institute and Allied Science and Annapurna Research Centre, Kathmandu, between June 2017 and January 2018. Antibiotic susceptibility testing (AST) was performed on the Enterobacteriaceae, P. aeruginosa and A. baumannii isolates using the Kirby-Bauer disk diffusion method. The modified Hodge test (MHT) was performed on the carbapenem-resistant isolates to confirm carbapenemase production. DNA was extracted and then screened for blaVIM and blaIMP genes by multiplex PCR. Results: Of the total 1,151 clinical samples, 253 (22.0%) showed positive growth. Of them, 226 (89.3%) were identified as Enterobacteriaceae, P. aeruginosa, and A. baumannii. Among the 226 isolates, 106 (46.9%) were multidrug-resistant. Out of the 106, 97 (91.5%) isolates showed resistance to at least one of the carbapenem used. Among the 97 carbapenem-resistant isolates, 67 (69.1%) showed the modified Hodge test (MHT) positive results. bla isolates respectively using multiplex PCR assay. Conclusion: This study determined a high prevalence of MDR and carbapenem resistance among Enterobacteriaceae, P. aeruginosa, and A. baumannii as detected by the presence of blaVIM and blaIMP genes. This study recommends the use of rapid and advanced diagnostic tools along with conventional phenotypic detection methods in the clinical settings for early detection and management of drug-resistant pathogens to improve treatment strategies.

Descriptive Study for Detection of Carbapenem Resistant Enterobacteriaceae by the Modified Carbapenem Inactivation Method in a Tertiary Care Hospital of Western Maharashtra

2021 ◽  
Vol 8 (05) ◽  
pp. 261-266
Author(s):  
Suraj Giri ◽  
Sourav Sen ◽  
Mahima Lall
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Test Method ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Care Hospital ◽  
Disk Diffusion Method ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

BACKGROUND In an infection caused by multidrug-resistant Enterobacteriaceae, carbapenems is one the last antibiotics used, but the carbapenemase producing Enterobacteriaceae pose a clinical challenge. A relatively new test which was described few years back known as modified carbapenem inactivation method (mCIM) is used to detect the presence of carbapenemase activity in Gramnegative bacilli. Various studies show this test be to be very sensitive and specific. We aim to study mCIM positivity on samples which are positive by Kirby-Bauer disk diffusion antibiotic sensitivity test method used for detection of carbapenem resistant Enterobacteriaceae (CRE) from clinical specimens. METHODS The study is a cross sectional descriptive study conducted in a tertiary care hospital. Samples received from February 2019 to September 2019 were included in the study. During this period 150 samples were collected which were resistant to meropenem by Kirby-Bauer disk diffusion method. These CREs isolates were further subjected to mCIM and the result was analysed. RESULTS Out of the total 150 CRE isolates which were 100 % resistant to meropenem by the conventional disc diffusion method it is found that mCIM was positive for 148 (98.66 %) isolates and negative for only 02 (1.33 %). Two most common CRE were Klebsiella pneumonia (58 %) and Escherichia coli (32 %). In statistical analysis chi square test revealed statistically significant difference (P < 0.05) in percentage of positivity between the two methods (98.66 % vs 100 %). CONCLUSIONS mCIM is highly sensitive and specific method; however, in practice it showed no added advantage over Kirby-Bauer disk diffusion method in detecting CRE. KEYWORDS Modified Carbapenem Inactivation Method (mCIM), Kirby-Bauer Disk Diffusion Method, Carbapenem Resistant Enterobacteriaceae

scholarly journals Biofilm formation and antibiotic resistance of Klebsiella pneumoniae isolated from clinical samples in a tertiary care hospital, Klaten, Indonesia

2019 ◽  
Vol 13 (S11) ◽  
Author(s):  
Hera Nirwati ◽  
Kian Sinanjung ◽  
Fahrina Fahrunissa ◽  
Fernando Wijaya ◽  
Sarastia Napitupulu ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Disk Diffusion Method ◽  
Wide Range

Abstract Background Klebsiella pneumoniae (K. pneumoniae) is a common cause of health-care associated infections (HAIs) and has high levels of antibiotic resistance. These bacteria are well-known for their ability to produce biofilm. The purpose of this study was to identify the antibiotic resistance pattern and biofilm-producing capacity of K. pneumoniae isolated from clinical samples in a tertiary care hospital in Klaten, Indonesia. Methods K. pneumoniae was isolated from inpatients in Soeradji Tirtonegoro Hospital Klaten from June 2017 to May 2018. Identification of K. pneumoniae isolate was done by analyzing colony morphology, microscopic examination, and by performing biochemical testing. Testing of antibiotics susceptibility and biofilm-producing capacity used the Kirby-Bauer disk diffusion method and adherence quantitative assays, respectively. Results A total of 167 (17.36%) K. pneumoniae isolates were isolated from 962 total clinical bacterial isolates during the study. Most of them were collected from patients aged more than 60 years old and were mainly obtained from respiratory specimens (51.50%). Most of K. pneumoniae isolates were extensively resistant to antibiotics. A more favorable profile was found only towards meropenem, amikacin, and piperacillin-tazobactam, showing 1.20%; 4.79% and 10.53% of resistance, respectively. The overall proportion of multidrug-resistant K. pneumoniae isolates was 54.49%. In addition, 148 (85.63%) isolates were biofilm producers, with 45 (26.95%) isolates as strong, 48 (28.74%) isolates as moderate, and 50 (29.94%) isolates as weak biofilm producers. Conclusion Most of the K. pneumoniae isolates demonstrated resistance to a wide range of antibiotics and are biofilm producers.

scholarly journals Phenotypic detection of carbapenem resistance in gram negative bacilli from various clinical specimens of a tertiary care hospital in Western Uttar Pradesh

2017 ◽  
Vol 5 (8) ◽  
pp. 3511 ◽  
Author(s):  
Jyoti Diwakar ◽  
Rajesh K. Verma ◽  
Dharmendra P. Singh ◽  
Amit Singh ◽  
Sunita Kumari
Keyword(s):  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Carbapenem Resistance ◽  
Diffusion Method ◽  
Public Health Issue ◽  
Care Hospital ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Gram Negative

Background: Carbapenemase producing multidrug-resistant organisms (i.e., MDROs) is a critical medical and public health issue globally. These bacteria are often resistant to all beta-lactam agents and are also co-resistant to other multiple classes of antimicrobial agents, leaving very few antimicrobial options.Methods: This study was carried out at UP University of medical sciences Saifai, Etawah, Uttar Pradesh, India, from January 2015 to June 2016. 110 isolates were found resistant by the Kirby Bauer’s disc diffusion method according to the CLSI guidelines. Modified Hodge test and combined disk test were performed for resistant isolates.Results: A total of 800-gram negative isolate were included in the study. 110 isolates were found resistant to imipenem by disk diffusion method. Out of these 90 (81.81%) were positive for carbapenemase production by modified Hodge test.Conclusions: We conclude that the modified Hodge test is a useful method for detection of carbapenemase production. Combined disc method is useful to detect metallo beta lactamase production.

scholarly journals Prevalence of Multidrug-resistant and Carbapenemase-producing Klebsiella Pneumoniae and Pseudomonas Aeruginosa Isolates in Tertiary Care Hospital in Kathmandu, Nepal

2021 ◽  
Vol 23 (4) ◽  
pp. 290-296
Author(s):  
Rojina Darnal ◽  
Mehraj Ansari ◽  
Ganesh Rai ◽  
Kul Raj Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Disk Diffusion Method

Carbapenemases are the enzymes that catalyze β–lactam groups of antibiotics. The carbapenemase producers are resistant to β–lactam antibiotics and are usually multidrug-resistant bacteria challenging widely used therapeutics and treatment options. Therefore, the detection of carbapenemase activity among clinical isolates is of great therapeutic importance. We aimed to study the MDR and carbapenemase-producing Klebsiella pneumoniae and Pseudomonas aeruginosa isolated from various clinical samples at a tertiary care hospital in Nepal. A total of 3,579 clinical samples were collected from the patients visiting the Department of Microbiology, B&B Hospital, Gwarko, Lalitpur. The samples were processed to isolate K. pneumoniae and P. aeruginosa and then subjected to antibiotic susceptibility testing (AST) by the Kirby-Bauer disk diffusion method. Phenotypic detection of carbapenemase activity was performed in the imipenem-resistant isolates by the modified Hodge test (MHT). Of the total samples, 1,067 (29.8%) samples showed significant growth positivity, out of which 190 (17.3%) isolates were K. pneumoniae and 121 (11.3%) were P. aeruginosa. Multidrug resistance was seen in 70.5% of the K. pneumoniae isolates and 65.3% of the P. aeruginosa isolates. Carbapenemase production was confirmed in 11.9%, and 12.2% of the imipenem-resistant K. pneumoniae and P. aeruginosa isolates, respectively, by the MHT. This study determined the higher prevalence of MDR among K. pneumoniae and P. aeruginosa; however, carbapenemase production was relatively low.

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