scholarly journals Vancomycin and High Level Aminoglycoside Resistance inEnterococcusspp. in a Tertiary Health Care Centre: A Therapeutic Concern

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Seema Mittal ◽  
Pooja Singla ◽  
Antariksha Deep ◽  
Kiran Bala ◽  
Rama Sikka ◽  
...  

Aims. This study was aimed at knowing the prevalence of vancomycin and high level aminoglycoside resistance in enterococcal strains among clinical samples.Study Design. It was an investigational study.Place and Duration of Study. It was conducted on 100Enterococcusisolates, in the Department of Microbiology, Pt. BDS PGIMS, Rohtak, over a period of six months from July to December 2014.Methodology. Clinical specimens including urine, pus, blood, semen, vaginal swab, and throat swab were processed andEnterococcusisolates were identified by standard protocols. Antibiotic sensitivity testing of enterococci was performed using Kirby-Bauer disc diffusion method.Results. High level gentamicin resistance (HLGR) was more common in urine samples (41.5%) followed by blood (36%) samples. High level streptomycin resistance (HLSR) was more common in pus samples (52.6%) followed by blood samples (36%). Resistance to vancomycin was maximum in blood isolates.Conclusion. Enterococci resistant to multiple antimicrobial agents have been recognized. Thus, it is crucial for laboratories to provide accurate antimicrobial resistance patterns for enterococci so that effective therapy and infection control measures can be initiated.

2015 ◽  
Vol 3 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Nagalakshmi Narayana-Swamy ◽  
Padmasri Ramalingappa ◽  
Urvashi Bhatara

Background: The vagina contains dozens of microbiological species in variable quantities and is, therefore, considered a complex environment. Among the microorganisms, bacteria have important repercussions on women’s health. The present study was conducted to elucidate this type of vaginal isolates and their sensitivity towards currently used antibiotics. Methods: This was a retrospective study conducted at the Department of Obstetrics and Gynaecology, Sapthagiri Hospital, Bangalore, India from January 2012 to December 2013. All symptomatic women who had a high vaginal swab taken for culture and sensitivity testing were included in this study. Antibiotic susceptibility was tested using disc diffusion method (modified Kirby-Bauer’s method). The antibiotic sensitivity patterns of isolated microorganisms were studied. Results: Out of 200 patients, 95% had positive vaginal cultures. Fifteen types of microorganisms were isolated. The highest frequency of infection was seen at the age of 20-30 years, followed by 41-50 years and 31-40 years, and a low frequency of infection was observed above 50 years of age. The most prevalent pathogen was Escherichia coli, followed by Streptococcus agalactiae and diphtheroids with equal incidence. Among the antibiotics tested, isolated pathogens were completely resistant to nalidixic acid and highly sensitive to meropenem and imepenem. Conclusion: The high prevalence of gynaecological infections demands that patients with symptoms undergo thorough investigation with cultures and sensitivity essays. Changes in treatment protocols are required to treat vaginal infections effectively.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Amandeep Kaur ◽  
Satnam Singh

This study was conducted with an objective to find the prevalence of extended spectrum betalactamase (ESBL) and metallobetalactamase (MBL) inP. aeruginosaandA. baumanniiisolates obtained from various clinical samples. It was conducted in the Department of Microbiology, Adesh Institute of Medical Sciences and Research, Bathinda, over a period of two years from July 2014 to June 2016. Clinical specimens including urine, pus, blood, high vaginal swabs, respiratory samples, and various body fluids were processed andP. aeruginosaandA. baumanniiisolates were identified by standard protocols. Antibiotic sensitivity testing for all isolates was done using Kirby-Bauer disc diffusion method. Disc potentiation test was performed to check ESBL and MBL production in these bacteria. Maximum ESBL positive isolates ofP. aeruginosawere observed among pus samples and maximum MBL positive isolates were detected in tracheal aspirates.A. baumanniishowed maximum positivity for ESBL and MBL production in endotracheal secretions. This study gives an alarming sign towards high prevalence of cephalosporin and carbapenem resistance due to production of extended spectrum betalactamases and metallobetalactamases, respectively. Early detection, stringent antibiotic policies, and compliance towards infection control practices are the best defenses against these organisms.


2011 ◽  
Vol 64 (9-10) ◽  
pp. 481-485 ◽  
Author(s):  
Mira Mihajlovic-Ukropina ◽  
Deana Medic ◽  
Zora Jelesic ◽  
Vera Gusman ◽  
Biljana Milosavljevic

Introduction. Enterococci are important hospital-acquired pathogens. The most commonly isolated species of the genus, Enterococcus faecalis and Enterococcus faecium are the third to fourth-most prevalent nosocomial pathogens worldwide. The aim of this study was to determine the frequency of resistance to vancomycin and other antimicrobial agents of Enterococcus spp strains isolated from blood cultures of hospitalized patients. Material and methods. During the three-year period, from 2008 to 2010, 132 strains of Enterococcus spp isolated from blood cultures of hospitalized patients were tested for their susceptibility to ampicillin, vancomycin, gentamycin (high-level resistance), erythromycin, chloramphenicol, teicoplanin, ciprofloxacin by disc diffusion method according to the Clinical and Laboratory Standards Institute recommendations. Susceptibility of vancomycin resistant E. faecium to the same antibiotics and to linezolid, quinopristin/dalfopristin and tigecyclin was determined using VITEK system. Results and discussion. Resistance to vancomycin was detected in 21 (15.9%) Enterococcus spp strains. The percentage of resistance to other antimicrobial agents varied from 23.1% for chloramphenicol to 81.3% for ciproflxacin. All vancomycin resistant enterococci were identified as E. faecium and belonged to phenotype VanA. The resistance to other antibiotics was very high, except for linezolid and quinopristin/dalfopristin (4.7%). The high-level aminoglycoside resistance was 87.6% for gentamycin and 95.2% for streptomycin. All isolates were resistant to ampicillin, teicoplanin and ciprofloxacin. Conclusion. The detected high frequency of multidrug-resistant isolates among vancomycin resistant enterococci is of great importance and suggests the need for further monitoring of susceptibility in order to take adequate measures to prevent and control spreading of resistant strains.


2017 ◽  
Vol 66 (2) ◽  
pp. 163-169
Author(s):  
Mona T. Kashef ◽  
Omneya M. Helmy

Aminoglycosides are used in treating a wide range of infections caused by Gram-positive and Gram-negative bacteria; however, aminoglycoside resistance is common and occurs by several mechanisms. Among these mechanisms is bacterial rRNA methylation by the 16S rRNA methyl transferase (16S-RMTase) enzymes; but data about the spread of this mechanism in Egypt are scarce. Cephalosporins are the most commonly used antimicrobial agents in Egypt; therefore, this study was conducted to determine the frequency of 16S-RMTase among third generation cephalosporin-resistant clinical isolates in Egypt. One hundred and twenty three cephalosporin resistant Gram-negative clinical isolates were screened for aminoglycosides resistance by the Kirby Bauer disk diffusion method and tested for possible production of 16S-RMTase. PCR testing and sequencing were used to confirm the presence of 16S-RMTase and the associated antimicrobial resistance determinants, as well as the genetic region surrounding the armA gene. Out of 123 isolates, 66 (53.66%) were resistant to at least one aminoglycoside antibiotic. Only one Escherichia coli isolate (E9ECMO) which was totally resistant to all tested aminoglycosides, was confirmed to have the armA gene in association with blaTEM-1, blaCTX-M-15, blaCTX-M-14 and aac(6)-Ib genes. The armA gene was found to be carried on a large A/C plasmid. Genetic mapping of the armA surrounding region revealed, for the first time, the association of armA with aac(6)-Ib on the same transposon. In conclusion, the isolation frequency of 16S-RMTase was low among the tested aminoglycoside-resistant clinical samples. However, a novel composite transposon has been detected conferring high-level aminoglycosides resistance.


Author(s):  
Sumitra Kumari Sanju Pannu ◽  
Anjli Gupta Geeta Tinna ◽  
B.P. Sharma

This study was conducted with an objective to find the prevalence of extended spectrum betalactamase (ESBL) and metallo betalactamase (MBL) in Acinetobacter species. It was conducted in the Department of Microbiology, Sardar Patel Medical college, Bikaner from Feb 2018 to Feb.2019. in various clinical specimens including urine, pus, blood, vaginal swabs, respiratory samples, and various body fluids were processed Acinetobacter species isolates were identified by standard protocols. Antibiotic sensitivity testing for all isolates was done using Kirby-Bauer disc diffusion method. Disc potentiation test was performed to check ESBL and MBL production in these bacteria. Maximum ESBL and MBL positive isolates of Acinetobacter species were observed among E.T. tube samples. Early detection, stringent antibiotic policies, and compliance towards infection control practices are the best defenses against this organisms.


Author(s):  
Rohit Kumar ◽  
Jagarti . ◽  
Mrinmoy Sarma ◽  
Gautam Shalini

Background: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the usage of Macrolides-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcus aureus infection. Clindamycin is an important drug used in the treatment of MRSA and MSSA infection. The aim of this study was to determine inducible and constitutive clindamycin resistance among clinical isolates of Staphylococcus aureus by D-test.Methods: During a period of 6 months from July 2018 to December 2018, a total of 100 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Methicillin-resistance was determined by using the cefoxitin (30 µg) disc. Incidence of MLSBc and MLSBi in Staphylococcus aureus isolates by D-test as per CLSI guidelines.Results: Out of 100 isolates of Staphylococcus aureus obtained from 350 clinical samples, 70(70%) were found to be MRSA and 30(30%) were MSSA. Among 100 Staphylococcus aureus isolates, 40% isolates showed MLSBi resistance, 28% isolates showed MLSBc resistance, 6% isolates showed MS phenotype and 26% isolates showed Sensitive phenotype. MLSBc and MLSBi were found to be higher in MRSA as compared to MSSA (21%, 27% and 7%, 10% respectively). All clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing.Conclusions: Continuous surveillance of the MLSB resistance is important and required before the prescription of clindamycin to treat MRSA infections.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Vishal Shete ◽  
Naveen Grover ◽  
Mahadevan Kumar

Enzymatic modification results in high-level resistance to aminoglycoside (HLAR), which eliminates the synergistic bactericidal effect of combined exposure to a cell wall-active agent and an aminoglycoside. So aim of the study was to determine prevalence of HLAR enterococcal isolate and to study distribution of aminoglycoside modifying enzyme genes in them. A total of 100 nonrepeat isolates of enterococci from various clinical samples were analyzed. As per Clinical and Laboratory Standards Institute guidelines enterococci were screened for HLAR by Kirby-Bauer disc diffusion method. Minimum inhibitory concentration of all isolates for gentamicin and streptomycin was determined by E-test. Multiplex polymerase chain reaction (PCR) was carried out for HLAR enterococcal isolates to identify aminoglycoside modifying enzymes genes responsible for resistance. 60% isolates were found to be high-level gentamicin resistant (HLGR) whereas 45% isolates were found to be high-level streptomycin resistant (HLSR). By multiplex PCR 80% HLGR isolates carried bifunctional aminoglycoside modifying enzyme geneaac(6′)-Ie-aph(2′′)-Iawhereas 18 out of 45 high-level streptomycin resistant, that is, 40%, isolates carriedaph(3′)-IIIa.However,aph(2′′)-Ib, aph(2′′)-Ic, aph(2′′)-Id,andant(4′)-Iagenes which encode other aminoglycosides modifying enzymes were not detected. Bifunctional aminoglycoside modifying enzyme geneaac(6′)-Ie-aph(2′′)-Iais the predominant gene responsible for HLAR.


2020 ◽  
Vol 3 ◽  
pp. 31-35
Author(s):  
A. I. Umar ◽  
I. Garba ◽  
M. L. Jidda ◽  
A. M. Ganau ◽  
A. S. Fana ◽  
...  

Objective: Pseudomonas aeruginosa is a metabolically versatile bacterium that can cause a wide range of severe opportunistic infections in patients with serious underlying conditions and can be found in most communities in Nigeria. The study was to determine the prevalence, resistance pattern and distribution of multiple drug resistant P. aeruginosa (MDR-PA) isolated from ear and wound specimens in patients attending Specialist Hospital Sokoto and Maryam Abacha Women and Children Hospital Sokoto. Materials and Methods: A total of 150 samples were analysed by standard bacteriological methods. Screening for MDR-PA was carried out by antibiotic sensitivity testing using disc diffusion method with ceftazidime (30 µg), ofloxacin (5 µg), cefuroxime (30 µg), cloxacillin (30 µg), amoxicillin (30 µg), ceftriaxone (30 µg), imipenem (10 µg), gentamycin (10 µg) and colistin (10 µg) discs on Mueller Hinton agar. Results: Of a total of 55 (36.7%) isolates of P. aeruginosa strains were obtained, 30 (54.5%) isolates were resistant to imipenem, 31 (56.3%) were resistant to ofloxacin, 44 (80.0%) to gentamycin, 53 (96.3%) to ceftazidime and cefuroxime, 50 (90.9%) to ceftrizone, 54 (98.1%) to cloxacillin and amoxycillin and lastly 15 (27.2%) to colistin. All the isolates were multi drug resistant, this probably due to improper use or over the counter purchase of antibiotics without professional oversight. Conclusion: Almost all the isolates were resistant to all the antibiotics used including colistin. There is need to improve on the public health awareness on the indiscriminate use of antimicrobial agents as it is one of the major ways microbes develop resistance to them.


Author(s):  
Manisha Paul ◽  
Prem Singh Nirwan ◽  
Preeti Srivastava

Background: The emergence of Enterococcus species in causing nosocomial infections poses a therapeutic challenge to clinicians. Enterococci are intrinsically resistance to multiple antibiotics. Acquired resistance to commonly used antibiotics like Ampicillin, Vancomycin and Aminoglycosides have made the situation worse and difficult to treat serious Enterococcal infections. The present study aimed at detection of high-level aminoglycoside resistance by disc diffusion and E-test amongst the Enterococcus species isolated from various clinical samples in a tertiary care hospital.Methods: A total of 102 Enterococcus species isolated from various clinical samples and antimicrobial susceptibility was performed by Kirby Bauer disc diffusion method as per CLSI guidelines. E-test was done for all high level aminoglycoside resistance Enterococcus species isolated by disc diffusion test.Results: Among 102 isolates, 81 were E. faecalis, 18 were E. faecium and 3 were another Enterococcus. Their antimicrobial susceptibility pattern shows all isolates were sensitive to vancomycin, linezolid and teicoplanin with HLGR, HLSR detected in 40 and 38 isolates of E. faecalis, 17  and 13 isolates of E. faecium respectively by disc diffusion whereas by E-test it was detected in 44 and 40 in E. faecalis and 17 and 14 in E. faecium respectively. E. faecium is found to be more resistance to high level aminoglycoside than E. faecalis.Conclusions: Authors hereby conclude that Enterococci being the common cause of hospital acquired infections with their increasing resistance to multiple drugs and acquisition of HLAR; it must be routinely screened for various drugs to prevent drug resistance in hospital settings for serious Enterococcal infections.


Author(s):  
Archana P. Nikam ◽  
Pramod R. Bhise ◽  
Mukta M. Deshmukh

Background: Staphylococcus aureus is a leading cause of nosocomial and community acquired infection in every region of world. Clindamycin is a frequent therapeutic option in the treatment of skin and soft tissue infection caused by Staphylococcus aureus. However resistance to this drug is again a problem which may be inducible or constitutive. The present study was carried out to determine the prevalence of inducible clindamycin resistance among Staphylococcus aureus and to find out the relationship between methicillin resistant Staphylococcus aureus and inducible clindamycin resistance.Methods: A total of 177 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer disc diffusion method. All were tested for Methicillin resistance by using cefoxitin 30 µg disc. Inducible clindamycin resistance was detected by ‘D’ test as per CLSI guidelines.Results: Out of the 177 Staphylococcus aureus isolates, 77 (43.50%) were MRSA and 100 (56.50%) were MSSA. 101 (57.06%) isolates were erythromycin resistant. These erythromycin resistant isolates when subjected to ‘D’ test, 27 isolates showed MS phenotype, 26 showed inducible MLSB phenotype and 48 showed constitutive MLSB phenotype. Out of 77 MRSA isolates 23 (29.87%) showed Inducible MLSB phenotype and 33 (42.85%) showed Constitutive MLSB phenotype, while in 100 methicillin sensitive Staphylococcal isolates 03 (3%) showed Inducible MLSB phenotype and 15 (15%) showed Constitutive MLSB phenotype. The percentage of inducible and constitutive resistance was higher amongst MRSA isolates as compared to MSSA isolates.Conclusions: Study showed that ‘D’ test should be used routinely to detect inducible clindamycin resistance.


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