scholarly journals Prevalence and effect of bacterial co-infections on clinical outcomes in hospitalized COVID-19 patients at a tertiary care centre of India

Author(s):  
Ashutosh Pathak ◽  
Sweta Singh ◽  
Sanjay Singh ◽  
Sangram Singh Patel ◽  
Nida Fatima ◽  
...  

Abstract Background: Bacterial co-infections are a leading cause of morbidity and mortality during viral infections including COVID-19. Systematic testing of COVID-19 patients having bacterial co-infections is essential to select the correct antibiotic for treatment in order to reduce mortality and also prevent spread of antimicrobial resistance (AMR). The present study aims to evaluate the prevalence, demographic parameters, antibiotic sensitivity patterns and outcomes in hospitalized COVID-19 patients with bacterial co-infections. Methods: A total of 1019 COVID-19 patients were selected for the study. We analyzed the prevalence, antibiotic sensitivity pattern and clinical outcomes in COVID-19 patients having bacterial co-infections. Results: Out of a total 1019 COVID-19 patients screened, 5.2% of patients demonstrated clinical signs of bacterial co-infection. Bacteremia was found in majority of the patients followed by respiratory and urinary infections. Escherichia coli, Pseudomonas aeruginosa and Klebsiella spp. were most common isolates among the Gram-negative and Coagulase-negative Staphylococci (CONS) and Staphylococcus aureus among the Gram-positive bacterial infections. Antibiotic sensitivity profiling revealed that colistin, imipenem and fosfomycin were the most effective drugs against the Gram-negative isolates while vancomycin, teicoplanin and doxycycline against the Gram-positive isolates. Analysis of clinical outcomes revealed that the mortality rate was higher (39%) among the patients with bacterial co-infections as compared to the group without co-infection (17%). Conclusions: This study reveals that the rate of bacterial co-infections is significantly increasing among COVID-19 patients and leading to increase in mortality. Systematic testing of bacterial co-infections is therefore essential in COVID-19 patients for better clinical outcomes and to reduce AMR.

Author(s):  
Aroop Mohanty ◽  
Shantikumar Singh T ◽  
Ankita Kabi ◽  
Pratima Gupta ◽  
Priyanka Gupta ◽  
...  

Objective: The objective of this study was to determine the bacterial agents responsible for hospital acquired septicaemia and to determine the antibiotic sensitivity profile of the bacterial isolates.Methods:  Three hundred fifty hospitalized clinically suspect septicaemia cases were included in this cross sectional observational study during a period of one year. Blood samples were collected with aseptic precautions for culture following universal precautions. Anti-microbial susceptibility test of the bacterial isolates was performed according to Clinical and Laboratory Standards Institute (CLSI, USA) guidelines.    Results: Over two-thirds of cultures showed gram positive organism. The most frequently identified Gram positive bacteria were coagulase negative staphylococci and Staphylococcus aureus. Among gram negative bacteria Escherichia coli, Klebsiella spp and Salmonella typhi were isolated. In our study, coagulase negative staphylococci showed maximum resistance to penicillin and erythromycin. Enterobactereciae had maximum sensitivity to carbapenems, tigecycline and aminoglycosides.Conclusion: Gram positive pathogens predominated in the blood stream infections. Résistance to fluoroquinolones, especially in Gram negative bacteria was significantly high. Therefore, rapid microbiological diagnosis and the determinants of antimicrobial susceptibility become relevant for early initiation of antimicrobial therapy.     


2019 ◽  
Vol 17 (2) ◽  
pp. 70-74
Author(s):  
Ankita Singh ◽  
Vikash Verma ◽  
Ritesh Singh

Background: Microbial pathogens cause human skin and soft tissue infections (SSTI) and surgical site infections (SSI) after surgical procedures. These can result in the production of pus, yellowish fluid comprising of dead WBCs and cellular debris. The microorganisms responsible for pus production vary greatly in relation to their spectrum of prevalence in different hospital and also in their antibiotic sensitivity. Further, the antibiotic sensitivity also changes because of the emergence of resistant strains. It is therefore, important that the common bacterial pathogens causing infection in a particular hospital and their sensitivity should be known. This will help in the choice of prophylactic antibiotic and in initiating the empirical antibiotic prescription for the infected cases before the culture sensitivity report is made available which takes about 2-3 days. Objective: To identify the spectrum of aerobic bacteria which are responsible for SSTI and SSI and their antibiotic sensitivity pattern. Method: This cross sectional hospital based study was conducted in Nepalgunj Medical College and Teaching Hospital (NGMCTH), Kohalpur from January 2019 to November 2019. These pus swabs were obtained from the Department of Surgery and Department of Gynaecology & Obstretics. Samples were cultured in the Microbiology laboratory of NGMCTH, Kohalpur. Identification and characterization of isolates were performed on the basis of Gram staining and cultural characteristics. Antibiotic sensitivity test was performed in vitro by Bauer-Kirby method. Collected data were statistically analyzed using SPSS 20.0 and Microsoft Excel 2015. Results: During the study period, a total number of 311 pus swabs were obtained among which only 164 (52.73%) pus swab showed bacterial growth. Out of 164 pus swabs, 150 pus swabs yielded monomicrobial growth (150 bacterial isolates) and 14 pus swabs yielded polymicrobial growth (33 bacterial isolates). Gram Negative Bacteria (60.1%) was more prevalent than Gram Positive Bacteria (39.9%). Combined together, the most common isolate was S. aureus (36.1%) followed by E.coli (24.0%), Klebsiella (14.2%), Enterobacter (11.5%), Pseudomonas (9.8%), S. pyogenes (3.3%) and Proteus (1.1%). S. aureus was highly sensitive to Doxycycline (90.6%), Chloramphenicol (81.5%), Amikacin (79.5%) and Ceftraixone (72.7%). S. pyogenes showed 100% sensitivity to Cefexime, Amikacin, Chloramphenicol, Azithromycin and 80% sensitivity to Doxycycline. Similarly, most common gram negative isolate E.coli showed higher sensitivity to Chloramphenicol(71.4%) and Amikacin (66.7%) , Klebsiella showed higher sensitivity to Doxycycline(92.3%), Gentamicin(87.5%) and Amikacin (81.0%), Enterobacter showed higher sensitivity to Amikacin(90.9%) and Pseudomonas was highly sensitive to Chloramphenicol (71.4%) and Amikacin (66.7%). Piperacillin, Amikacin, Gentamicin, Ofloxacin and Ceftriaxone showed 100% sensitivity to Proteus spp. Amoxyclav, Cefepime and Cefexime (except in S. pyogenes) showed least sensitivity in both gram negative and gram positive bacterial isolates. Conclusion: In our study, the most common isolate wasS. aureus. Amikacin, as a single drug was found to be effective for empirical therapy of both gram negative and gram positive bacteria whereas Doxycycline and Amikacin was found effective in gram positive isolates. Amoxyclav and Cefepimewas commonly resistant in all bacterial isolates.


2019 ◽  
Vol 39 (1) ◽  
pp. 1-5
Author(s):  
Susan Bhattarai ◽  
Ram Hari Chapagain ◽  
Deepak Mishra ◽  
Anil Kumar Shrestha ◽  
Sushan Man Shrestha

Introduction: Neonatal sepsis is the most common cause of neonatal morbidity and mortality. The causative organisms of neonatal sepsis are changing and so do their antibiotic sensitivity pattern. So it is important to regularly monitor the change in bacteriological profile and their antimicrobial sensitivity pattern to help update the treatment guidelines of neonates. This study aimed to study the microbiological patterns of neonatal sepsis and their antibiotic susceptibility pattern in a tertiary care centre in Kathmandu. Methods: A prospective study was carried out among cases of neonatal sepsis admitted in Neonatal Intermediate Care Unit (NIMCU) of a tertiary care referral hospital from August 2015 to August 2016. Prospective data were collected with pretested and standardised proforma and analysed using SPSS version 20. Results: Out of 311 neonates admitted over a period of one year with diagnosis of neonatal sepsis, male:female ratio was 2.1:1. Among them 234 (75.2%) cases were of LONS and 77 (24.8%) were of EONS. Blood culture was positive in 47 neonates (15.1%). The organisms isolated included staphylococcus aureus (34.0%), klebsiella (32%), CONS (24%), escherechia coli (6%) and enterobacter (4%). In LOS, gram positive organisms staphylococcus and CONS were the commonest ones (61.4%). In EOS, gram negative organism klebsiella (65%) was more common. Most of staph aureus were susceptible to penicillins, amikacin and cefotaxime. Klebsiella was found to be resistant to penicillins, amikacin and cefotaxime. Conclusion: There is possible increasing incidence of gram positive septicemia in LONS and increasing emergence of resistance of kleibsella to the common antibiotics ampicillin, amikacin and cefotaxime.


Author(s):  
Kirti Hemwani ◽  
P. S. Nirwan ◽  
Preeti Shrivastava ◽  
Abhiraj Ramchandani

Background: Nonfermentative gram negative bacilli (NFGNB) frequently considered as commensals or contaminants but the pathogenic potential of nonfermenters has been proved beyond doubt. They are resistant to commonly used antimicrobials. Aim: This study was undertaken to identify the nonfermenters isolated from various clinical samples and to know their Antibiotic sensitivity pattern. Materials and Methods: The present study was carried out on 150 strains of Nonfermenters isolated from 1200 various non repetitive clinical samples received in Department of Microbiology, NIMS Jaipur. Nonfermenters were identified using a standard protocol and their antibiotic susceptibility testing was performed with the help of the modified Bauer disc diffusion method. Results: Out of 150 nonfermenters isolated, Pseudomonas aeruginosa was the most common isolate 134 (89.33%) followed by Acinetobacter baumannii 16 (10.67%). Among all clinical samples Pus and Wound Discharge yield maximum isolates of NFGNB i.e. 54 (36%) % followed by sputum (39.0%). Most sensitive drug against NFGNB was Polymyxin-B (100%) followed by Imipenem (86 %) and Amikacin (71.33 %). Conclusion: Nonfermenters have a great potential to survive in a hospital environment so implementation of antibiotic stewardship programs and strict infection control practices will be required to prevent or slow down their emergence and spread. Keywords:  Nonfermenters,  Polymyxin-B, Pseudomonas, Acinetobacter.


Author(s):  
Sanjana Ramakrishnan ◽  
Sourabh Radhakrishnan ◽  
Sonu Lazar Cyriac

Background: Opportunistic bacterial infections remain a serious morbidity among cancer patients. This study was aimed to determine the bacteriological and antibiotic profile of cancer patients admitted to the ICU of a tertiary care centre.Methods: Cross sectional study was done among cancer patients admitted in the Oncology neutropenic ICU during the period from August 2017 to July 2019. All patients admitted with a proven diagnosis of cancer for whom at least one bacterial culture was sent from any site were included in the study. Laboratory on culture reports were obtained from patient files and analysed.Results: A total of 278 samples from 256 patients (60±11.6 years) were analysed. Among the 111/278 positive cultures, 29 were blood samples and 1 was a pleural fluid sample. Gram negative organisms were 62.1% with Escherichia coli (25, 36.2%) as prevalent. Among the 37.8% gram positives, Staphylococcus aureus (18. 42.8%) was prevalent. Most of the E. coli strains showed highest resistance to ceftazidime (96%) and highest sensitivity to amikacin. The commonest gram-positive organism, Staphylococcus species were 100 % sensitive to vancomycin and linezolid and 100 % resistance to penicillin.  Conclusions: E. coli (gram negative) showed highest resistance to ceftazidime and sensitivity to amikacin. S. aureus (gram positive) was sensitive to vancomycin and linezolid and resistance to penicillin. An antibiogram for cancer patients helps the clinician to initiate an appropriate empirical antibiotic therapy to reduce mortality and morbidity.


Author(s):  
Abdul Hameed Tunio ◽  
Delijan Mugheri ◽  
Muhammad Khan ◽  
Wasim Sarwar Bhatti ◽  
Abdul Majeed Soomro ◽  
...  

Background: The drug resistance and pathogens are different in various Hospitals of any country. Very high resistance pattern is observed nowadays to the frequently used antibiotics. The important observation has been noted that most of the doctors do not obtain blood cultures before start of the antibiotics, which becomes competent source of resistance. For the same purpose, this study has been done to find out the responsible microbes causing ailment and their susceptibility towards antibiotics to plan early and effective management. Materials and Methods: A number of 100 new borns admitted in the NICU CMC Children Hospital Larkana with signs and symptoms of sepsis were included in this research work. The study will help in provision of a comprehensive record on microorganisms causing sepsis in the neonates and their antibiotic sensitivity. The epidemiology and presence of neonatal sepsis in particular area makes it more easy and convenient to implement the rationale of empirical antibiotic strategy. Results: From100 neonatal blood samples taken for culture, only 21 proved to be positive which stands 21%. In majority gram positive bacteria were found in (85.71%=18 cases) and gram negative bacteria stood (14.28%=3 cases).Staphylococcus species were found on the large scale (52.38%=11 cases) secondly Streptococcus species (33.33%=7 cases) and the remaining were Escherichia species being least common (14.28%=3 cases). Conclusion: Staphylococcus species provided major share as gram positive bacteria and Escherichia species were found to be major gram negative bacterial population responsible for neonatal sepsis. Profound resistance pattern is seen against widely used antibiotics. It is mandatory to have a routine check over the antibiotic resistance.


2018 ◽  
Vol 5 (6) ◽  
pp. 2203 ◽  
Author(s):  
Rohitashwa Rajana ◽  
Dhan Raj Bagri ◽  
J. N. Sharma ◽  
Vijay Agrawal

Background: The present study was designed to evaluate the clinical spectrum, bacteriological profile, antibiotic sensitivity pattern and mortality due to neonatal septicemia in neonates admitted in neonatal units attached to the SMS Medical College, Jaipur.Methods: In born and out born babies of postnatal age up to 28 days who were bacteriological proven cases of septicemia were subjected to history, clinical examination and laboratory evaluation and data were analyzed statistically.Results: Out of 150 cases 67.33% neonates were preterm and 77.33% were low birth weight neonates. Gram negative organisms were most common cause of septicemia (66.6%), Both the Gram negative and Gram positive organisms were sensitive to piperacillin-tazobactam, linezolid, fosfomycin, teicoplanin, polymyxin B, colistin, ofloxacin. Both the Gram negative and Gram positive organisms were resistant against cephalosporins, ampicillin, Amoxyclav, cotrimoxazole. Gram negative isolates were most sensitive to Polymyxin B (70%) and had the highest resistance to cefepime (36%). Gram-positive organisms were most sensitive to vancomycin (84%) and linezolid (82%). Highest resistance was noted from Amoxyclav (52%).Conclusions: Preterm (<37 week) and low birth weight (<2500gm) neonates are considered as major susceptible causes of neonatal sepsis. Proper hygiene and hand washing, early detection of sepsis and judicial use of antibiotics to prevent multidrug resistance is needful in our setup.


2021 ◽  
pp. 44-46
Author(s):  
Achintya Narayan Ray ◽  
Sandip Saha ◽  
Smarajit Banik ◽  
Biplab Mondal ◽  
O P. Pandey

Background: Urinary tract infections (UTIs) are the most common bacterial infection encountered in tertiary care settings UTI is one of the most common bacterial infections in humans and a major cause of morbidity. Its antibiotic sensitivity pattern varies with the widespread availability of antimicrobial agents; UTI has become difcult to treat because of appearance of pathogens with increasing resistance to antimicrobial agents. This prospec Methods: tive and observational Study was conducted on patients attending the outpatient and indoor admitted patients at North Bengal Medical College at Darjeeling district of West Bengal. From 2016 to 2018. A total 100 patients were taken who having clinical features of UTI. The study region covers the various districts of North Bengal. Template was generated in MS excel sheet and analysis was done on SPSS 20.0 software. A Results: mong 100 UTI patients, 34 (34%) were male and 66 (66%) were female. The majority of patients (30%) were 46-60 yrs of age. In the study group symptomatic presentation in order of frequency were, dysuria 85%, urgency74%, fever with chill 60%, hypogastric pain and tenderness 70%, ank pain 30%. E.coli & klebsiella were most common isolates among i.e 66% and11.% respectively. Proteus were sensitive to Netlimycine 90%, Imipenem 87%, Meropenem 79%, Amikacin 75% Gentamycin 68 %, levooxacin 82 % of patients. In the present study, females (66%) Conclusions: were mostly affected and the most common organisms were E.Coli and Klebsiella. These organisms were most sensitive to Amikacin, Nitrofurantoin etc. The sensitivity and resistance pattern of uropathogens to common antimicrobial agents must be taken into account when selecting treatment plans for UTI.


2021 ◽  
Vol 08 (01) ◽  
pp. 1-8
Author(s):  
Gajender Singh Ranga ◽  

Introduction: Diabetic foot is any foot pathology due to diabetes or sequelae of diabetes mellitus. This study was conducted to identify the common microorganisms isolated from diabetic foot and to analyse the antibiotic susceptibility pattern of bacteria isolated from diabetic foot. Materials and Method: The study was a hospital based cross-sectional study where 146 foot ulcer samples (who had type 2 diabetes) were analysed. Swabs were collected from the edge and margins of ulcers, and organisms were identified by gram staining culture and biochemical reactions. Result:Out of 146 patients, 69 specimens showed growth of organisms. Total 84 aerobic organisms were isolated and out of them, 64 cases showed bacterial growth, in which 84 bacteria were isolated, which represented an average of 1.28 organisms per case. Among these organisms, 62 gram-negative and 22 gram-positive organisms were isolated. E. coli was the most common gram-negative isolate (23.81%), followed by Pseudomonas aeruginosa (21.4%), and Klebsiella pneumonia(8.33%), while among gram-positive bacteria, S. aureus was the most common isolate (22.6%). Conclusion: Incidence of growth was 47.2% in which E. coli (23.8%) was the most common isolate. Gram-negative bacteria were more common than gram-positive bacteria. Diabetic foot infections are polymicrobial in nature.


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