scholarly journals Metallo-Beta-Lactamase-Producing Acinetobacter spp. from Clinical Isolates at a Tertiary Care Hospital in Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Michael A. Olu-Taiwo ◽  
Japheth A. Opintan ◽  
Francis Samuel Codjoe ◽  
Akua Obeng Forson
Keyword(s):  
Tertiary Care ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Infection Control Measures ◽  
Significant Difference

Metallo-beta-lactamase-producing Acinetobacter spp. is a major challenge for therapeutic treatment of nosocomial infections. This study is aimed at determining the prevalence of MBL-producing Acinetobacter spp. among 87 clinical isolates of Acinetobacter spp. from the Korle-Bu Teaching Hospital, Accra, between August 2014 and July 2015. Acinetobacter spp. was identified by standard bacteriological method, and resistance to different antibiotics was assessed with the Kirby–Bauer disc diffusion method. Meropenem-resistant Acinetobacter isolates were screened for enzyme activity using the modified Hodge test (MHT) and combined disc test (CDT). Additionally, multiplex PCR was used to determine MBL genes presence (blaVIM,blaIMP, and blaNDM). All Acinetobacter isolates showed high resistance to cefotaxime (90.8%), ceftazidime (75.9%), cotrimoxazole (70.1%), ciprofloxacin (64.4%), gentamicin (72.4%), levofloxacin (67.8%), and meropenem (59.8%). A total of 54 (62.1%) of Acinetobacter isolates were multidrug-resistant. Out of 52 (59.8%) meropenem-resistant Acinetobacter, 3 (5.8%) were carbapenemase producers by MHT, whilst, 23 (44.2%) were CDT positive. There was no significant difference between the resistance pattern of amikacin, ceftazidime, cotrimoxazole, ciprofloxacin, and meropenem amongst CDT-positive and CDT-negative isolates (p>0.05). A total of 7/87 (8.1%) CDT-positive Acinetobacter isolates harboured blaNDM; of these, 4 (57.1%) were from wound swabs, urine (n=2) (28.6%), and ear swab (n=1) (14.3%). The study revealed that less than 9% of Acinetobacter spp. contained blaNDM encoding genes. Strict antibiotics usage plan and infection control measures are required to prevent the spread of these resistance genes.

scholarly journals Antibiogram pattern and seasonality of Salmonella serotypes in a North Indian tertiary care hospital

2006 ◽  
Vol 134 (5) ◽  
pp. 961-966 ◽  
Author(s):  
S. MOHANTY ◽  
K. RENUKA ◽  
S. SOOD ◽  
B. K. DAS ◽  
A. KAPIL
Keyword(s):  
Enteric Fever ◽  
Monsoon Season ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Seasonal Distribution ◽  
Control Measures ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Biochemical Tests

The antibiogram pattern and seasonal distribution of Salmonella serotypes were analysed retrospectively over a 6-year period from January 1999 to December 2004. Blood cultures received in the Bacteriology Laboratory were processed by standard procedures and the Salmonella spp. isolates were identified with specific antisera and standard biochemical tests. Antimicrobial susceptibility testing was carried out by a standard disc diffusion method and the minimum inhibitory concentration (MIC) of ciprofloxacin for 332 representative Salmonella isolates was determined by E test. Salmonella Typhi (75·7%) was the predominant serotype among 830 Salmonella spp. isolated during the study period followed by S. Paratyphi A (23·8%). The maximum number of enteric fever cases occurred during April–June (dry season) followed by July–September (monsoon season). There was a decrease in multidrug-resistant (MDR) S. Typhi, but MDR S. Paratyphi A isolates increased. There was also a dramatic increase in nalidixic acid-resistant isolates. All isolates were susceptible to third-generation cephalosporins and ciprofloxacin except one S. Typhi strain which demonstrated high-level ciprofloxacin resistance with a MIC of 16 μg/ml. A knowledge of the seasonal distribution and antibiotic resistance pattern of Salmonella in a particular geographical region is helpful in the delineation of appropriate control measures required for prevention of enteric fever.

scholarly journals Drug Resistance and Biofilm Production among Pseudomonas aeruginosa Clinical Isolates in a Tertiary Care Hospital of Nepal

2019 ◽  
Vol 21 (2) ◽  
pp. 110-116
Author(s):  
Rajani Shrestha ◽  
N. Nayak ◽  
D.R. Bhatta ◽  
D. Hamal ◽  
S.H. Subramanya ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Drug Resistance ◽  
Biofilm Formation ◽  
Tertiary Care ◽  
Clinical Problem ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Care Hospital ◽  
Microbiological Methods

Clinical isolates of Pseudomonas aeruginosa often exhibit multidrug resistance due to their inherent ability to form biofilms. Drug resistance in Ps. aeruginosa is a major clinical problem, especially in the management of patients with nosocomial infections and those admitted to ICUs with indwelling medical devices. To evaluate the biofilm forming abilities of the clinical isolates of Ps. aeruginosa and to correlate biofilm formation with antibiotic resistance. A total of 90 consecutive isolates of Ps. aeruginosa obtained from various specimens collected from patients visiting the Manipal Teaching Hospital, Pokhara, Nepal between January 2018 - October 2018 were studied. Isolates were identified by standard microbiological methods. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method. All the isolates were tested for their biofilm forming abilities by employing the tissue culture plate assay. Of the 90 Ps. aeruginosa isolates, maximum i.e 42 (46.6%) were from patients in the age group of > 50 years. Majority (30; 33.3%) of the isolates were obtained from sputum samples. However, percentage isolation from other specimens like urine, endotracheal tube (ETT), pus, eye specimens and blood were 18.9%, 16.7%, 16.7%, 7.8% and 6.7% respectively. All the isolates were sensitive to polymixin B and colistin, 91.1% of the organisms were sensitive to imipenem, and more than 80% to aminoglycosides (80% to gentamicin, 83.3% to amikacin). A total of 29 (32.2%) organisms were biofilm producers. Maximum numbers of biofilm producing strains were obtained from ETT (8 of 15; 53.3%), pus (8 of 15; 53.3%) and blood (2 of 6; 33.3%) i.e from all invasive sites. None of the isolates from noninvasive specimens such as conjunctival swabs were biofilm positive. Significantly higher numbers of biofilm producers (23 of 29; 79.3%) were found to be multidrug resistant as compared to non-biofilm (6 of 61; 9.8%) producers (p=0.000). Ps. aeruginosa colonization leading to biofilm formation in deep seated tissues and on indwelling devices is a therapeutic challenge as majority of the isolates would be recalcitrant to commonly used antipseudomonal drugs. Effective monitoring of drug resistance patterns in all Pseudomonas clinical isolates should be a prerequisite for successful patient management.

scholarly journals Prevalence and Susceptibility Profiles of Methicillin Sensitive Staphylococcus aureus from Community and Hospital Associated Infections

2021 ◽  
Author(s):  
. Preeja ◽  
Sanath Kumar ◽  
Veena A Shetty
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Control Measures ◽  
Patient Treatment ◽  
Diffusion Method ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Hospital Associated Infections

Introduction: Methicillin Sensitive Staphylococcus aureus(MSSA) is a significant human pathogen, involved in both hospital and community associated settings. MSSA, being more susceptible to antibiotics compared to Methicillin Resistant Staphylococcus aureus(MRSA), is found to acquire Multidrug Resistance (MDR) and with the presence of virulence factors can pose difficulty in patient treatment. Aim: To study the prevalence and antibiotic resistance profile of MSSA from community and hospital associated infections. Materials and Methods: The present cross-sectional study was conducted in tertiary care hospital in Mangalore, Karnataka, India from January 2015 to February 2017. Three hundred and five Staphylococcus aureuswere isolated from various clinical specimens and tested for methicillin susceptibility using cefoxitin disc. Antibiotic resistance profiles against 23 antibiotics were determined by disc diffusion method. The difference was compared for antibiotic sensitivity with respect to Community Associated Methicillin Sensitive Staphylococcus aureus (CA-MSSA) and Hospital Associated Methicillin Sensitive Staphylococcus aureus (HA-MSSA) and Chi-square test was used for statistical analysis. Results: Of 305 MSSA isolated, 219 (71.8%) were CA-MSSA and 86 (28.2%) were HA-MSSA. S. aureus was isolated mostly from Skin and Soft Tissue Infections (SSTI, 61.3%). Resistance was observed against ciprofloxacin (64.6%), erythromycin (43.9%), ofloxacin (42.3%), clindamycin (20.7%), ampicillin (100%) and penicillin (90.5%). There was a significant difference (p<0.05) between the resistance of CA-MSSA and HA-MSSA against cefotaxime and co-trimoxazole. Conclusion: The present study showed the increasing prevalence of MSSA in the community and hospital settings with the emergence of MDR which has to be dealt immediately with appropriate control measures.

scholarly journals Gram Negative Extended Spectrum Beta-Lactamase Producing Bacteria Prevalence in Jouf Region Tertiary Care Hospital, Saudi Arabia

2021 ◽  
Author(s):  
Javid Iqbal Rather ◽  
Zahoor Mohi ud din ◽  
Farkhanda N. Syed ◽  
Mir Haris ◽  
Mudasar Nabi ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Control Measures ◽  
Clinical Samples ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Infection Control Measures ◽  
Antimicrobial Sensitivity ◽  
Extended Spectrum

Extended Spectrum beta lactamase producing pathogens are reported in many clinical samples and pose an emerging threat health. To find the prevalence of ESBL producing Enterobactriacea pathogens isolated from inpatients (Medical and Surgical Wards; Hospital stay > 72 h) admitted to Prince, Mutib, Hospital Sakaka, Jouf. A total of 1043 Enterobactriacea were isolated during April 2015 to October 2016 study period. Vitek -2 compact (biomeriux Leon, France) was used for identification and antimicrobial sensitivity (AST) test. A Total of 115/1043 (11.02%) ESBL producing pathogens were isolated from urine 15.07% (n=242), sputum 13.6 % (n=220), wound 10.8% (n=287) and blood 5.4 % (n=294). Klebsiella pneumonia is most dominant followed by E coli and Proteus miribilis. Cephamycins and carbapenems were found most effective (100% sensitivity) against the pathogens isolated. The aminoglycosides, beta lactams and Fluroquinolnes class of antibiotics, microorganisms have gained the resistance of 20%, 22.7%, 40-70% respectively. The infection control measures should be taken seriously and making of effective use of antibiotics is need of hour.

scholarly journals Antibiotic Sensitivity Pattern of Clinical Isolates of Pseudomonas aeruginosa at a Tertiary Care Hospital in Saudi Arabia

2020 ◽  
Vol 19 (1) ◽  
pp. 77-82
Author(s):  
Shamweel Ahmad ◽  
Muslih A Alotaibi ◽  
Mohmmed S Alamri
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Saudi Arabia ◽  
Tract Infection ◽  
Antibiotic Susceptibility ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Sensitivity Pattern

Among gram-negative microorganisms Pseudomonas aeruginosa is the most common bacteria identified in different clinical specimens of hospitalized patients. A few studies have been conducted in Saudi Arabia regarding antibiotic susceptibility pattern. The purpose of this study was to evaluate the current levels of antibiotic susceptibility and to assess the resistance pattern of antibiotics among the clinical isolates of P. aeruginosa in the King Khalid Hospital, Alkharj, Kingdom of Saudi Arabia. This study was carried out during January, 2015 to May, 2015. A total of 180 different specimens such as sputum, urine, pus swabs, wound swabs etc. were collected from different patients admitted to the hospital. Thirty (30) clinical isolates of P. aeruginosa were isolated from different specimens of the patients suspected of having respiratory tract infection, urinary tract infection, wound infections, etc. The antibiotic susceptibility profiles of all the isolates were determined using Kirby-Bauer disk diffusion method. Piperacillin-tazobactam was found to be the most active antimicrobial agent with 96.7% susceptibility followed by cefepime (83.3%), ceftazidime (83.3%), and ciprofloxacin (76.7%). All isolates were resistant to ertapenem, cefuroxime, cefoxitin and nitrofurantoin. Anti-bacterial treatment strategies should focus on P. aeruginosa, for which the prevalence rates are increasing every year. The usage of piperacillin-tazobactam, cefepime, ceftazidime and ciprofloxacin must be reserved and only be given to the patients after susceptibility test to reduce the resistance of P. aeruginosa against these agents. Dhaka Univ. J. Pharm. Sci. 19(1): 77-82, 2020 (June

scholarly journals Prevalence of various Beta-lactamases in Enterobacteriaceae in a tertiary care hospital in South India: A Cross-sectional study

2021 ◽  
Vol 7 (3) ◽  
pp. 186-191
Author(s):  
Soumya Kaup ◽  
S Roopashree
Keyword(s):  
Tertiary Care ◽  
Resistance Mechanism ◽  
Control Measures ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Strict Adherence ◽  
Extended Spectrum Beta Lactamase

Antimicrobial resistance among bacteria has constantly increased over the years with emergence of novel resistance mechanism among these versatile organisms. Identifying the resistance pattern of the isolates both regionally and globally is essential for the institution of appropriate antimicrobial therapy. This study was conducted to assess the prevalence of beta-Lactamase enzymes among species of Enterobacteriaceae.312 consecutive isolates belonging to the family of Enterobacteriaceae were included in the study conducted over a period of one year. After preliminary antibiotic susceptibility testing using standard guidelines, production of various beta-Lactamase enzymes was assessed by phenotypic methods.22.76% of the isolates were found to be Extended-Spectrum Beta-Lactamase producers, 37.82% were AmpC Beta-Lactamase producers and 7.37% of the isolates produced the Carbapenemase enzyme.Our study estimates the prevalence of various beta-Lactamase enzymes in isolates of Enterobacteriaceae in a tertiary care centre. The increase in production of these enzymes among bacteria necessitates the implementation of strict adherence to antibiotic policy and infection control measures.

Epidemiology and clinical outcome of ventilator-associated events at a tertiary care hospital from North India

2020 ◽  
pp. 004947552098245
Author(s):  
Pooja Kumari ◽  
Priya Datta ◽  
Satinder Gombar ◽  
Deepak Sharma ◽  
Jagdish Chander
Keyword(s):  
Mechanical Ventilation ◽  
Tertiary Care Hospital ◽  
Late Onset ◽  
Tertiary Care ◽  
Control Measures ◽  
North India ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Utilisation Rate

The aim of our study was to determine the incidence, microbiological profile, risk factors and outcomes of patients diagnosed with ventilator-associated events in our tertiary care hospital. In this prospective study, intensive care patients put on mechanical ventilation for >48 h were enrolled and monitored daily for ventilator-associated event according to Disease Centre Control guidelines. A ventilator-associated event developed in 33/250 (13.2%); its incidence was 3.5/100 mechanical ventilation days. The device utilisation rate was 0.86, 36.4% of patients had early and 63.6% late-onset ventilator-associated pneumonia whose most common causative pathogen was Acinetobacter sp. (63.6%). Various factors were significantly associated with a ventilator-associated event: male gender, COPD, smoking, >2 underlying diseases, chronic kidney disease and elevated acute physiological and chronic health evaluation II scores. Therefore, stringent implementation of infection control measures is necessary to control ventilator-associated pneumonia in critical care units.

scholarly journals Molecular and Epidemiological Characterization of IMP-Type Metallo-β-Lactamase-Producing Enterobacter cloacae in a Large Tertiary Care Hospital in Japan

2014 ◽  
Vol 58 (6) ◽  
pp. 3441-3450 ◽  
Author(s):  
Kayoko Hayakawa ◽  
Tohru Miyoshi-Akiyama ◽  
Teruo Kirikae ◽  
Maki Nagamatsu ◽  
Kayo Shimada ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Tertiary Care ◽  
Enterobacter Cloacae ◽  
Control Measures ◽  
Care Hospital ◽  
Invasive Procedures ◽  
Content Type ◽  
Infection Control Measures ◽  
Large Tertiary Care ◽  
Close Relationship

ABSTRACTIMP-type metallo-β-lactamase enzymes have been reported in different geographical areas and in various Gram-negative bacteria. However, the risk factors and epidemiology pertaining to IMP-type metallo-β-lactamase-producingEnterobacter cloacae(IMP-producingE. cloacae) have not been systematically evaluated. We conducted a retrospective, matched case-control study of patients from whom IMP-producingE. cloacaeisolates were obtained, in addition to performing thorough molecular analyses of the clinically obtained IMP-producingE. cloacaeisolates. Unique cases with IMP-producingE. cloacaeisolation were included. Patients with IMP-producingE. cloacaewere matched to uninfected controls at a ratio of 1 to 3. Fifteen IMP-producingE. cloacaecases were identified, with five of the isolates being obtained from blood, and they were matched to 45 uninfected controls. All (100%) patients from whom IMP-producingE. cloacaeisolates were obtained had indwelling devices at the time of isolation, compared with one (2.2%) uninfected control. Independent predictors for isolation of IMP-producingE. cloacaewere identified as cephalosporin exposure and invasive procedures within 3 months. Although in-hospital mortality rates were similar between cases and controls (14.3% versus 13.3%), the in-hospital mortality of patients with IMP-producingE. cloacae-caused bacteremia was significantly higher (40%) than the rate in controls. IMP-producingE. cloacaeisolates were frequently positive for other resistance determinants. The MICs of meropenem and imipenem were not elevated; 10 (67%) and 12 (80%) of the 15 IMP-producingE. cloacaeisolates had a MIC of ≤1 μg/ml. A phylogenetic tree showed a close relationship among the IMP-producingE. cloacaesamples. Indwelling devices, exposure to cephalosporin, and a history of invasive procedures were associated with isolation of IMP-producingE. cloacae. Screening for carbapenemase production is important in order to apply appropriate clinical management and infection control measures.

scholarly journals MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

2017 ◽  
Vol 10 (6) ◽  
pp. 78
Author(s):  
Bhuvaneshwari Gunasekar
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Multiple Antibiotic Resistance ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Mar Index ◽  
Surgery Department

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of  surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

scholarly journals Susceptibility of Clinical Isolates of Staphylococcus aureus to Ceftaroline

2021 ◽  
Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.

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