scholarly journals 1365. Profiling Extrapulmonary Nontuberculous Mycobacteria Infections and Predictors for rapid-growing Species: A Multi-Center Retrospective Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S494-S494
Author(s):  
Jung Ho Kim ◽  
Woon Ji Lee ◽  
Hye Seong ◽  
In Young Jung ◽  
Eun Jin Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Nontuberculous Mycobacteria ◽  
Joint Infection ◽  
Tertiary Care ◽  
Antimicrobial Susceptibility Testing ◽  
Soft Tissue Infections ◽  
Joint Infections ◽  
Bone And Joint Infections

Abstract Background Nontuberculous mycobacteria (NTM) disease is increasing worldwide and is an important cause of morbidity and mortality. It is found that 20 to 30% of NTM isolates are of extrapulmonary origin. However, Studies about extrapulmonary NTM infections have been limited. Thus, we aim to describe the diversity of NTM infections and correlate these observations with clinical data. Methods We analyzed all symptomatic patients with positive NTM cultures in sterile extrapulmonary sites at three tertiary care centers in South Korea between January 2006 and June 2018. We collected patient information including predisposing factors, diversity of NTM isolates, antimicrobial susceptibility testing, treatment regimens, and outcomes. Results A total of 117 patients (46 males vs. 71 females) were included. The median age of the patients was 54 years. There are a lot of infections associated with medical procedures like surgery, but about half of cases (54.7%) are unknown origin. Skin and soft-tissue infections predominated (34.2%), followed by bone and joint infections (28.2%). Of 117 NTM isolates, 66 NTM subspecies were identified. Mycobacterium intracellulare (34.8%) was the most common species identified, followed rapid-growing NTM (RGM) species such as M. fortuitum complex (21.2%), M. abscessus (15.2%), M. massiliense (10.6%), and M. chelonae (9.1%). In skin and soft-tissue infections, RGM species were predominantly identified (26/28, 92.9%), whereas slow-growing NTM (SGM) species were mainly identified in bone and joint infections (18/26, 69.2%). The difference of isolated sites was verified by post hoc test and female sex (OR 4.72; P < 0.001) and skin and soft-tissue infections (OR 25.33; P < 0.001) were identified as predictors of RGM by logistic regression analysis. Based on antimicrobial susceptibility testing, fluoroquinolone and macrolide were mainly used for RGM treatment, and rifamycin-ethambutol-macrolide-based regimen was predominantly used for SGM treatment. Conclusion Skin and soft-tissue infection were predominantly caused by RGM, whereas bone and joint infection is mainly caused by SGM. Species-specific and region-specific data that integrate clinical and microbiologic information is crucial in determining treatment direction. Disclosures All authors: No reported disclosures.

Occurrence of Non-Fermenting Gram-Negative Bacilli and Their In Vitro Susceptibility Pattern by Vitek 2 at a Tertiary Care Teaching Hospital – An Observational Study

2021 ◽  
Vol 8 (8) ◽  
pp. 429-434
Author(s):  
Atit Dineshchandra Shah ◽  
Urvashi Natubhai Limbachia ◽  
Bhavin K. Prajapati ◽  
Lata Patel ◽  
Dharati Tusharbhai Shah ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Multidrug Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Antimicrobial Susceptibility Testing ◽  
Clinical Samples ◽  
Gram Negative ◽  
Vitek 2

BACKGROUND Non fermenting gram-negative bacilli (NFGNB) are a group of heterogenous, aerobic and non-sporing saprophytic bacteria, found as commensals in humans and other animals primarily causing opportunistic healthcare-associated infections. They are innately resistant to many antibiotics and are known to acquire resistance by various mechanisms. They pose a particular difficulty for the healthcare community because multidrug resistance is common and increasing among them and a number of strains have now been identified that exhibit pan drug resistance. This study was conducted to isolate and identify various non-fermenter gram negative bacilli (NFGNB), to study their antibiotic sensitivity pattern and their clinical significance from various clinical samples. METHODS A study was undertaken from March 2019 to February 2020 to isolate NFGNB from various clinical samples received for culture and sensitivity in the department of microbiology in a tertiary care hospital, Ahmedabad. Non lactose fermenting colonies on MacConkey agar plates were further processed by Vitek 2 to identify them and to study their antimicrobial susceptibility testing (AST). RESULTS A total of 2010 NFGNB were isolated from various clinical samples and their AST was evaluated by Vitek 2. Pseudomonas aeruginosa (52.7 %) and Acinetobacter baumannii (36.5 %) were the most common NFGNB isolated. Carbapenem resistance was 93 % for Acinetobacter species and 61 % for Pseudomonas species. CONCLUSIONS Accurate and rapid identification and antimicrobial susceptibility testing of NFGNB help in early initiation of appropriate antimicrobial therapy and proper management of patients thereby help in reducing emergence of MDR strains of NFGNB, mortality and overall hospital stay. KEYWORDS NFGNB – Non-Fermenting Gram-Negative Bacilli, Multidrug Resistance, Pan Drug Resistance, Carbapenem Resistance

scholarly journals Antimicrobial resistance pattern of Acinetobacter; a multicenter study, comparing European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Clinical and Laboratory Standards Institute (CLSI); evaluation of susceptibility testing methods for polymyxin

2020 ◽  
Vol 7 (1) ◽  
pp. e04-e04
Author(s):  
Shirin Afhami ◽  
Mohammad Ali Borumand ◽  
Negin Esmailpour Bazzaz ◽  
Hiva Saffar ◽  
Azar Hadadi ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Kappa Coefficient ◽  
Antimicrobial Susceptibility Testing ◽  
Resistance Pattern ◽  
Acinetobacter Species ◽  
European Committee ◽  
Kappa Agreement

Introduction: Acinetobacter species in clinical isolates cause severe infections including meningitis, bloodstream infection, ventilator-associated pneumonia, and surgical site infections. Objectives: In the present study, we evaluated Acinetobacter drug resistance using both European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the Clinical and Laboratory Standards Institute (CLSI) antimicrobial susceptibility test methods. Materials and Methods: Clinical specimens of 128 patients who were admitted in three referral tertiary care teaching hospitals were enrolled in 2014. Blood and other sterile fluid samples, endotracheal secretion, ulcer, urine and other clinical specimen cultures were included, and microbial resistance of Acinetobacter isolates was determined and compared with disk diffusion and E-test antimicrobial susceptibility methods, using both the EUCAST and CLSI standards. Cohen’s kappa coefficient was also reported. Results: The highest percentage of resistance (96.9%) was found for meropenem and imipenem antimicrobials, and the lowest resistance (82.8%) was found for amikacin. The highest kappa agreement coefficient was for ciprofloxacin (kappa coefficient = 0.783), and the lowest kappa was for amikacin (kappa coefficient = 0.21). Conclusion: According to the results, it is better to consider amikacin as a choice in combination with another effective antimicrobial for treatment of drug resistant Acinetobacter.

scholarly journals Incidence of Diphtheria among Clinically Probable Cases in a Tertiary Care Centre- A Prospective Study

2020 ◽  
Author(s):  
Gunturu Sowjanya ◽  
Pennagaram Sarguna
Keyword(s):  
Antimicrobial Susceptibility ◽  
Microscopic Examination ◽  
Susceptibility Testing ◽  
Throat Swab ◽  
Tertiary Care ◽  
Antimicrobial Susceptibility Testing ◽  
Diffusion Method ◽  
Upper Respiratory Tract ◽  
Tertiary Care Centre ◽  
Presumptive Diagnosis

Introduction: Diphtheria is a vaccine preventable communicable acute infectious disease of upper respiratory tract caused by Corynebacterium diphtheriae (C. diphtheria) which is endemic in India. Delayed diagnosis of the disease leads to spread of infection in the community and causes increased morbidity and mortality in the affected individuals. To reduce the delay, an early attempt for microbiological diagnosis of diphtheria should be done as it is crucial and complimentary to clinical diagnosis. Aim: To know the prevalent toxin producing biotypes of Corynebacterium among the clinically probable cases of diphtheria. Materials and Methods: Throat swab samples from 300 clinical cases of diphtheria were processed by direct microscopy and culture. Microscopic examination was done by direct throat swab and samples were inoculated in Loeffler’s Serum Slope (LSS). Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method. Results were analysed using MS Excel. Results: Out of 300 samples, presumptive diagnosis of diphtheria by microscopic examination of direct throat swab was 3% and swab inoculated in LSS was 10%. Confirmed cases of diphtheria by culture were 48 (16%). A 100% sensitivity was seen for all antibiotics tested for all 48 isolates in antimicrobial susceptibility testing. Conclusion: A shift in the age wise incidence of the disease from pre-school to school age has been observed with more cases reported. C. diphtheriae gravis was the highly prevalent strain isolated. Culture should be considered as confirmatory method for diagnosis.

scholarly journals Epidemiology and antibiotic resistance trends of Pantoea species in a tertiary-care teaching hospital: A 12-year retrospective study

2019 ◽  
Vol 2 (3) ◽  
pp. 72-75 ◽  
Author(s):  
M Gajdács
Keyword(s):  
Retrospective Study ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Antimicrobial Susceptibility Testing ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Empiric Antibiotic

Purpose Pantoea species are pigmented, Gram-negative rods belonging to the Enterobacterales order. They are considered rare, opportunistic pathogens and are mostly implicated in nosocomial outbreaks affecting neonates and immunocompromised patients. The aim of this study was to describe the prevalence and antibiotic susceptibility of Pantoea species during a 12-year period. Materials and methods This retrospective study was carried out using microbiological data collected between January 1, 2006 and December 31, 2017. Patients’ data such as age, sex, inpatient/outpatient status, and empiric antibiotic therapy were also collected. Antimicrobial susceptibility testing was performed using E-tests; the interpretation was based on European Committee on Antimicrobial Susceptibility Testing breakpoints for Enterobacterales. Results Seventy individual Pantoea spp. isolates were identified; the most frequently isolated species was Pantoea agglomerans. Most isolates were susceptible to relevant antibiotics. In 61 out of 68 patients, ampicillin was the empirically administered antibiotic. The highest levels of resistance were to amoxicillin–clavulanic acid and ampicillin. No extended spectrum beta-lactamase-positive isolate was detected. Conclusions There is a scarcity of data available on the susceptibility patterns of Pantoea species, but our results correspond to what we could find in the literature. The development of multidrug-resistant (MDR) Gram-negative bacteria is a grave concern, and the development of MDR Pantoea spp. may be expected in the future.

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