Coexistence of β-Lactamases in Community-Acquired Infections in a Tertiary Care Hospital in India

Introduction. The trends of β-lactamases producing Enterobacteriaceae is ever increasing, and limited studies have reported investigating coexistence of β lactamases in Enterobacteriaceae. A cross-sectional study after approval from the Institutional Ethical committee was conducted between June 2014 and May 2016 in community-acquired infections due to multidrug-resistant organisms in our tertiary care. Nonrepetitive clinical samples from the out-patient department (OPD) were processed for bacteriological culture and identification of Enterobacteriaceae. An antibiotic susceptibility test, screening, and phenotypic confirmation for ESBLs and carbapenemases and AmpC producers were performed to check for coexistence of these enzymes. Results. Nonrepetitive clinical specimens processed for culture and identification in our hospital revealed 417 positive isolates in community acquired infections which were multidrug-resistant organisms, and on screening for β-lactamases, 293 isolates were positive for one of the three beta lactamases, ESBL, AmpC, or carbapnemases. Coproduction of ESBL and MBL was seen in 5 isolates, 35 isolates showed coproduction of ESBL and AmpC enzymes, and AmpC and MBL coproduction was exhibited in only in 5 isolates. Conclusions. Coexistence of ESBLs, AmpC producers, and carbapenemases has been described. Continuous monitoring and surveillance and proper infection control and prevention practices will limit the further spread of these superbugs within the hospital and beyond.

Download Full-text

Multidrug-resistant urinary tract isolates of escherichia coli: Frequency and patient demographics in a Tertiary Care Hospital.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.02.3854 ◽

2020 ◽

Vol 27 (02) ◽

pp. 335-340

Author(s):

Salman Azhar ◽

Muhmmad Wasif Baig ◽

Shahid Rasool ◽

Rizwan Rasool Khan ◽

Talha Munir ◽

...

Keyword(s):

Urinary Tract ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

E Coli ◽

Patient Demographics ◽

Tract Infections

Urinary tract infections (UTIs) are a major burden to the health care as it is estimated that around 150 million UTIs occur yearly worldwide. Enterobacteriaceae are the most common agent causing serious urinary tract infections; and MDR cases are increasing day by day. Objectives: To determine the frequency and patient demographics of multidrug resistant urinary tract isolates of Escherichia Coli in a Tertiary Care Hospital. Study Design: Retrospective cross sectional study. Setting: Medicine Department of Madinah Teaching Hospital / The University of Faisalabad, Faisalabad. Period: From May 2016 to Sep 2018. Material & Methods: 187 patients of age 15 to 90 years with positive E. coli on urine culture and sensitivity were included in this Retrospective cross sectional study. All those patients with history of dysuria (pain during urination) or frequent urination (more than 7 times per day) were advised urine complete analysis and those with >5 WBCs or pus cells /HPF or having positive for leukocyte esterase and/or nitrite, were advised urine culture and sensitivity. Main outcome variable was the frequency of MDRE cases among the culture positive E. coli UTI patients. Results: Among all the cases of E. coli UTI, frequency of MDRE UTI was 66.8% (n=125) and rest 33.2% (n= 62) cases were not MDR UTI. 97.3% patients were resistant to lactam antibiotics, 95.7% were resistant to quinolones and 68.4% were resistant to aminoglycosides.

Download Full-text

Phenotypic and Genotypic Characterization of Metallo Beta Lactamases among Gram-Negative Uropathogens from a Tertiary Care Hospital in Egypt: A Cross Sectional Study

Microbes and Infectious Diseases ◽

10.21608/mid.2021.59593.1113 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Doaa Abo-Alella ◽

Mahmoud Malek ◽

Mai Malek

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Gram Negative ◽

Beta Lactamases ◽

Phenotypic And Genotypic Characterization

Download Full-text

Colonization and Antibiotic Resistance Profiling of Methicillin Resistant Staphylococcus Aureus (Mrsa) in Patients from Tertiary

THE JOURNAL OF MICROBIOLOGY AND MOLECULAR GENETICS ◽

10.52700/jmmg.v1i3.11 ◽

2020 ◽

Vol 1 (3) ◽

pp. 31-39

Author(s):

Madiha Khan ◽

Wafa Komal ◽

Mushtaq A. Saleem ◽

Naveed Ahmad ◽

Zara Rafaque ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Culture Media ◽

Tertiary Care ◽

Age Groups ◽

Cross Sectional Study ◽

Clinical Samples ◽

Care Hospital ◽

Cross Sectional ◽

Methicillin Resistant

The methicillin resistant Staphylococcus aureus (MRSA) is affecting the economy worldwide contributing to the increased morbidity and treatment costs. The present cross sectional study was conducted to determine the association of MRSA with kidney and liver patients from Tertiary Care Hospital in Lahore, Pakistan and its antibacterialresistance patterns. The study was conducted for the period of one year; from April 2019 to April 2020. A total of 1984 different samples were obtained and examined for bacterial cultures using standard procedures. From total samples, 51.05% were collected from male and the rest 48.95% were collected from females including different age groups. Samples were inoculated on different culture media for isolation of S. aureus and susceptibility testing. A total of 253/1984 clinical samples exhibited S. aureus characteristics while 39 of 253 S. aureus (15.41%) were identified as MRSA. MRSA strains were found highly resistant to Amikacin (AK), Cefoxitin (FOX),Clindamycin (DA), Fusidic acid (FD), Gentamicin (CN) and Tobramycin (TOB) while highest sensitivity was noted against Vancomycin (100%) and Linezolid (100%). The presence of MRSA and multidrug resistance pose serious therapeutic burden to critically ill patients. A systematic and concerted effort is essential to identify high-risk patients rapidly and to reduce the burden of antimicrobial resistance.

Download Full-text

Prevalence and risk factors associated with multi-drug resistant organisms (MDRO) carriage among pediatric patients at the time of admission in a tertiary care hospital of a developing country. A cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-021-06275-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sonia Qureshi ◽

Noshi Maria ◽

Mohammad Zeeshan ◽

Seema Irfan ◽

Farah Naz Qamar

Keyword(s):

Risk Factors ◽

Pediatric Patients ◽

Tertiary Care ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Nasal Swabs ◽

Prior Use ◽

Time Of Admission

Abstract Background The rise of Multidrug-resistant organisms (MDROs) poses a considerable burden on the healthcare systems, particularly in low-middle income countries like Pakistan. There is a scarcity of data on the carriage of MDRO particularly in the pediatrics population therefore, we aimed to determine MDRO carriage in pediatric patients at the time of admission to a tertiary care hospital in Karachi, Pakistan, and to identify the risk factors associated with it. Methods A cross-sectional study conducted at the pediatric department of Aga Khan University Hospital (AKUH) from May to September 2019 on 347 children aged 1–18 years. For identification of MDRO (i.e., Extended Spectrum Beta-Lactamase (ESBL) producers, Carbapenem Resistant Enterobacteriaceae (CRE), Vancomycin Resistant Enterococci (VRE), Methicillin Resistant Staphylococcus aureus (MRSA), Multidrug-resistant (MDR) Acinetobacter species and MDR Pseudomonas aeruginosa), nasal swabs and rectal swabs or stool samples were cultured on specific media within 72 h of hospitalization. Data was collected on a predesigned structured questionnaire on demographics, prior use of antibiotics for > 48 h in the last 6 months, history of vaccination in last 6 months, exposure to health care facility regardless of the time of exposure, ICU stay for > 72 h, and about the prior use of medical devices (urinary catheter, central venous lines etc.) in last 1 year. Statistical analysis was performed by Standard statistical software. Results Out of 347 participants, 237 (68.3%) were found to be MDRO carriers. Forty nine nasal swabs from 346 children (14.2%) showed growth of MRSA. The majority of the stool/rectal swabs (n = 222 of 322; 69%) collected were positive for MDRO. The most isolated species were ESBL Escherichia coli 174/222 (78.3%) followed by ESBL Enterobacter species 37/222 (16.7%) and ESBL Klebsiella pneumoniae 35/222 (15.8%). On univariate analysis, none of the risk factors showed statistically significant association with MDRO carriage. Conclusion Overall, a high prevalence of MDRO carriage was identified among admitted pediatric patients. Implementation of systematic screening may help to identify true burden of MDROs carriage in the health care settings.

Download Full-text

Prevalence and Antibiogram of Acinetobacter Species Isolated from Various Clinical Samples in a Tertiary Care Hospital

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v16i1.28224 ◽

2020 ◽

Vol 16 (1) ◽

pp. 26-32

Author(s):

Sanjana Rajkumari ◽

Shanti Pradhan ◽

Damodar Sharma ◽

Brajesh Jha

Keyword(s):

Health Care ◽

Intensive Care ◽

Intensive Care Units ◽

Tertiary Care ◽

Multidrug Resistant ◽

Clinical Samples ◽

Care Hospital ◽

Cross Sectional ◽

Acinetobacter Species ◽

Acinetobacter Spp

Background: Acinetobacter species has emerged as a significant hospital pathogen, and are becoming increasingly drug resistance. They cause outbreaks in intensive care units and health care units. Methods: A cross-sectional study was conducted to determine the prevalence and antibiotic susceptibility pattern of Acinetobacter spp isolated from various clinical samples collected from patients admitted in various wards and intensive care units of the hospital over a period of one year (March 2018 to Feb 2019). Results: Out of 2,623 samples, 1,201(45.78%) yielded significant growth and out of these positive cultures, 138(11.49%) Acinetobacter spp were isolated. Majority of isolates 24(17.39%) were isolated from General intensive care unit (GICU). Maximum sensitivity of Acinetobacter spp was seen towards polymyxin B 138(100%) and colistin 138(100%), followed by tigecycline 127(92.02%). Hundred and one (80.43%) isolates were found to be multidrug resistant. Conclusions: Acinetobacter isolates showed multidrug resistant pattern mostly in inpatients. To avoid resistance, antibiotics should be used judiciously. There is also an urgent need for emphasizing the importance of hand washing and use of disinfectants in prevention of transmission of infection in health care setup. Keywords: Acinetobacter spp; prevalence; antibiotic resistance; intensive care units; multidrug resistance.

Download Full-text

BlaOXA-48 Genotypic Detection of Carbapenem Resistance in Isolates of Pseudomonas Aeruginosa

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2019133 ◽

2021 ◽

Vol 10 (02) ◽

pp. 89-93

Author(s):

Shaista Bakhat ◽

Yasmeen Taj ◽

Faisal Hanif ◽

Saman Nadeem

Keyword(s):

Pseudomonas Aeruginosa ◽

Real Time ◽

Real Time Pcr ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Cross Sectional Study ◽

Care Hospital ◽

Cross Sectional ◽

Antibiotic Susceptibility Test ◽

Serious Infections

Objective: To determine the prevalence of carbapenem resistance in strains of Pseudomonas aeruginosa at a molecular level by detecting OXA-48 gene which transcribe for resistance to the antibiotic carbapenem among indoor patients of a tertiary care hospital Karachi. Study Design and Setting: This observational cross-sectional study was conducted from September 2018 to May 2019 at PNS Shifa hospital of Karachi. Methodology: Total 140 strains of Pseudomonas aeruginosa were received and cultured from pus samples. These samples were collected from different wards like medicine, surgery, burn unit, ICU, ENT, plastic surgery, paedriatic and family ward. Carbapenem resistance was screened phenotypically by AST (Antibiotic susceptibility test), MHT (Modified Hodge test) and mCIM (Modified Carbapenem Inactivation Method) in all samples. Only in resistant cases OXA-48 gene was detected by real time PCR (polymerase chain reaction). Data was analyzed by following the proper loading sequence on product specification sheet. Data was statistically analyzed by SPSS version 23.0. Results were expressed as frequencies (percentages). Results: Out of 140, 17 (12%) were found to be resistant to carbapenem by AST, 20 (14%) by MHT, 25 (17.8%) by mCIM. Out of 25 resistant cases, 4 (16%) presence of OXA-48 gene by real time PCR were detected. Conclusion: OXA-48 gene showed 16% carbapenem resistance in this study. Pseudomonas aeruginosa is an opportunistic organism which causes multidrug resistance especially in hospitalized patients. Carbapenem is the last resort for serious infections

Download Full-text

High Prevalence of Multidrug-Resistant Klebsiella pneumoniae in a Tertiary Care Hospital in Ethiopia

Antibiotics ◽

10.3390/antibiotics10081007 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1007

Author(s):

Tewachew Awoke ◽

Brhanu Teka ◽

Aminu Seman ◽

Shemse Sebre ◽

Biruk Yeshitela ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Antimicrobial Agents ◽

Addis Ababa ◽

Tertiary Care ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

High Rate ◽

Care Hospital ◽

Biochemical Tests ◽

Cross Sectional

Klebsiella pneumoniae poses an urgent public health threat, causing nosocomial outbreaks in different continents. It has been observed to develop resistance to antimicrobials more easily than most bacteria. These days, multidrug-resistant strains are being increasingly reported from different countries. However, studies on the surveillance of multidrug-resistant Klebsiella pneumoniae are very rare in Ethiopia. This study aimed to determine the antimicrobial resistance patterns and magnitude of MDR K. pneumoniae isolates from patients attending or admitted to Tikur Anbessa Specialized Hospital (TASH). A cross-sectional study was conducted from September 2018 to February 2019 at TASH, Addis Ababa, Ethiopia. Identification of K. pneumoniae was done by examining the Gram stain, colony characteristics on MacConkey agar and 5% sheep blood agar, as well as using a series of biochemical tests. Antimicrobial susceptibility testing of the isolates for 21 antimicrobials was done by the Kirby–Bauer disc diffusion technique. Data were double entered using Epidata 3.1 and exported to SPSS version 25 software for analysis. Among the total K. pneumoniae isolates (n = 132), almost all 130 (98.5%) were MDR. Two (1.5%) isolates showed complete non-susceptibility to all antimicrobial agents tested. Moreover, a high rate of resistance was observed to cefotaxime and ceftriaxone 128 (97%), trimethoprim-sulfamethoxazole 124 (93.9%), and cefepime 111 (84.1%). High susceptibility was recorded to amikacin 123 (93.2%), imipenem 107 (81.1%), meropenem 96 (72.7%), and ertapenem 93 (70.5%). K. pneumoniae isolates showed a high rate of resistance to most of the tested antimicrobials. The magnitude of MDR K. pneumoniae was very alarming. Therefore, strengthening antimicrobial stewardship programs and antimicrobial surveillance practices is strongly recommended in TASH.

Download Full-text

A Bacterial Profile of Nosocomial Infections in a Tertiary Care Hospital

Journal of Sheikh Zayed Medical College ◽

10.47883/jszmc.v12i1.157 ◽

2021 ◽

Vol 12 (1) ◽

pp. 21-24

Keyword(s):

Nosocomial Infections ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

Clinical Samples ◽

Clinical Microbiology Laboratory ◽

Care Hospital ◽

Cross Sectional ◽

Wound Discharge ◽

Hospital Acquired

Background: Nosocomial infections, may appear either during the hospital stay of the patient or after discharge. Objective: To find out the bacterial profile of nosocomial infections in a tertiary care hospital. Methodology: This cross-sectional study was based on the records of the patients admitted in Ghurki Trust Teaching hospital during the period of January 2016 to December 2017, who developed infections after their hospital admission, and their record was available in the Microbiology section of the Department of Pathology. A total of 1000 complete records of the patients were retrieved. Bacterial culture tests from clinical samples of these patients were performed in the clinical microbiology Laboratory of Lahore Medical and Dental College. Specimens included in this study were urine samples, pus samples from wound discharge, infected implants, and dead necrotic tissue. Data were analyzed using SPSS version 26. Results: Out of 1000 samples, 150 (15%) samples showed positive growth, and among 150 83 (55%) were from females patients. The bacterial profile of these 150 positive samples showed that the most frequently isolated bacteria were Staphylococcus Aureus 45 (30%), MRSA 45 (30%) followed by Klebsiella, 21 (14%), Pseudomonas 15 (10%), E. Coli 12 (8%), Acinetobacter 9 (6%), and Proteus 3 (2%). Conclusion: Staph. Aureus, MRSA, Pseudomonas, Acinetobacter, Klebsiella, E.Coli and Proteus are frequently isolated bacteria from nosocomial infections in our study. Such studies should be done frequently to keep track of bacteria that are prevalent in hospital-acquired infections.

Download Full-text