scholarly journals Phenotypical and Genotypical Comparison of Clostridium difficile Isolated from Clinical Samples: Homebrew DNA Fingerprinting versus Antibiotic Susceptibility Testing (AST) and Clostridial Toxin Genes

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Javid Sisakhtpour ◽  
Fatemeh Savaheli Moghadam ◽  
Sepideh Khodaparast ◽  
Nima Khoramabadi ◽  
Ashraf Mohabati Mobarez
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Dna Fingerprinting ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Inhibitory Concentration ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Antibiotic Susceptibility Testing ◽  
Anaerobic Culture ◽  
Toxin Genes

Background. Clostridium (Clostridioides) difficile is recognized as the major cause of healthcare antibiotic-associated diarrhea. We surveyed a molecular epidemiological correlation between the clinical isolates from two general hospitals in Iran through clustering toxigenic types and antibiotic susceptibility testing (AST) accuracy. Methods. Study population included 460 diarrhoeic specimens from inpatients with a history of antibiotic therapy. All samples underwent enriched anaerobic culture, confirmed by detection of gluD gene with PCR. Toxin status and AST were assessed by the disk diffusion method (DDM) and minimal inhibitory concentrations (MICs) of metronidazole, vancomycin, and rifampin. C. difficile outbreak was analyzed through conventional PCR by tracing toxin genes and Homebrew pulsed-field gel electrophoresis (PFGE) for characterizing isolates within our healthcare systems. Results. A total of 29 C. difficile strains were isolated by enriched anaerobic culture from the clinical samples. Among them, 22 (4.8%) toxigenic profiles yielded toxins A and B (tcdA, tcdB) and binary toxins (cdtA, cdtB). The minimum inhibitory concentration (MIC) was 18.1% and 9% for vancomycin and metronidazole, and all isolates were susceptible to rifampicin and its minimum inhibitory concentration was at <0.003 μg/mL. The most dominant toxigenic and antibiotic-resistant “pulsotype F” was detected through PFGE combined with multiple Clostridial toxigenic pattern and AST. Conclusions. DNA fingerprinting studies represent a powerful tool in surveying hypervirulent C. difficile strains in clinical settings. Resistance to vancomycin and metronidazole, as first-line antibiotics, necessitate accomplishment of proper control strategies and also prescription of tigecycline as a more appropriate option.

scholarly journals Prevalence of constitutive and inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a tertiary care institute in North India

2017 ◽  
Vol 5 (7) ◽  
pp. 3120
Author(s):  
Jeevan Shetty ◽  
Zarrin Afroz
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Antibiotic Susceptibility Testing ◽  
Sensitivity Testing ◽  
Inducible Clindamycin Resistance

Background: Clindamycin is an important drug used in the treatment of Methicillin Sensitive Staphylococcus aureus (MSSA) as well as in Methicillin-resistant Staphylococcus aureus (MRSA) infections. This drug is widely used in the treatment of skin and soft tissue infections caused by them. Therapeutic failure caused by macrolide-lincosamine-streptogramin B constitutive and inducible clindamycin resistance (MLSBc and MLSBi) is being more commonly reported.Methods: The present study was conducted over a period of six months from October 2016 to March 2017 to know the incidence of MLSBc and MLSBi in Staphylococcus aureus (S. aureus) isolates obtained in our hospital by D-test as per CLSI guidelines. A total of 130 isolates of S.aureus were obtained from different clinical specimens which included pus/ wound swab (n=266), urine (n=577), sputum (n=225), blood (n=221), throat swab (n=71), ear/eye discharge (n=21), high vaginal swab (n=20) and body fluids (n=50). All the isolates were subjected to antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Amoxyclav, Erythromycin, Clindamycin, Co-trimoxazole, Tetracycline, Ofloxacin, Gentamicin, Linezolid and Vancomycin were the antibiotics used.Results: Out of 130 (8.9%) isolates of S. aureus obtained from 1451 clinical samples, 82 (63.1%) were found to be MSSA and 48 (36.9%) were MRSA. Among S. aureus, 43 (33.1%) isolates showed MLSBc resistance, 22 (16.9%) isolates showed MLSBi resistance and 20 (15.4%) isolates showed MS phenotype. The remaining 45 (34.6%) isolates remained sensitive to Erythromycin. Among MSSA, MLSBc were observed in 18 (22%) isolates and MLSBi in 9 (11%) while in MRSA, MLSBc were observed in 25 (52.1%) isolates and MLSBi in 13 (27.1%) isolates. Almost all clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing. Both MLSBc and MLSBi resistance was significantly higher (p<0.05) in MRSA than in MSSA.Conclusions: The study emphasizes the importance of conducting D test along with routine antibiotic susceptibility testing for better utilization of clindamycin in S. aureus infections.

scholarly journals Study of antibiotic resistance profiling of Staphylococcus aureus isolated from clinical specimens of the patients attending a tertiary teaching hospital from Chhattisgarh

2017 ◽  
Vol 5 (11) ◽  
pp. 4808
Author(s):  
Archana Bhimrao Wankhade ◽  
Sanjibkumar Panda ◽  
Riddhi Hathiwala ◽  
Yogendra Keche
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistance ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Antibiotic Susceptibility Testing ◽  
Microbiological Methods ◽  
Tertiary Teaching

Background: Staphylococcus aureus is a pathogen causing wide spectrum of infections. It has tendency for the development of multidrug resistance thereby exposing the selection of appropriate treatment. Therefore, the present study was undertaken to find out the antibiotic susceptibility pattern of Staphylococcus aureus isolated from various clinical samples in teaching tertiary hospital.Methods: Total 85 Staphylococcus aureus was isolated from clinical samples (pus, urine, sputum and blood) tested. Identification of Staphylococcus aureus was done by standard conventional microbiological methods. Antibiotic susceptibility testing was done by using disk diffusion method as per CLSI guidelines.Results: Staphylococcus aureus was isolated maximum from pus samples followed by urine samples. Antibiotic susceptibility testing showed highest resistance against Penicillin (69%) and Erythromycin (51%) followed by Cotrimoxazole (50%) & Nitrofurantoin (50%). All the strains were sensitive to Vancomycin. Amongst the urine isolates all were sensitive to Norfloxacin. These percentages of sensitivities are characteristically higher in our study than the previous studies in the literature. In addition, out of 85 Staphylococcus aureus isolates, 26 isolates showed sensitivity   to all antibiotics.Conclusions: From the present study we conclude that though the Staphylococcus aureus is usually having multidrug resistance pattern. So regular antimicrobial susceptibility surveillance is essential for area‐wise monitoring of the resistance patterns. This will be beneficial to preserve the effectiveness of antibiotics and for better patient management.

scholarly journals Phenotypic Assays for Detection of AmpC and MBL Producers among the Clinical Isolates of Multi Drug Resistant Pseudomonas aeruginosa

2018 ◽  
Vol 4 ◽  
pp. 23-31
Author(s):  
Sarita Manandhar ◽  
Sarashwoti Adhikari ◽  
Sujeeb Rajbhandari
Keyword(s):  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Drug Resistant ◽  
Antibiotic Susceptibility Testing ◽  
Cross Sectional

Objectives: In order to determine the prevalence of multi-drug resistance along with AmpC and metallo-β-lactamase producing P. aeruginosa, a six month cross-sectional study was carried out at Shahid Gangalal National Heart Center.Methods: A total of 756 clinical specimens were analyzed for bacteriological profile. The bacterial isolates were identified by cultural and biochemical techniques. Antibiotic susceptibility testing of the isolates was performed by Kirby-Bauer disc diffusion method. MDR isolates were screened and tested for MBL and AmpC production. Ceftazidime resistant isolates were tested for MBL and Cefoxitin resistant isolates for AmpC.Results: Among all the clinical samples analyzed, P. aeruginosa was detected in 75 samples (9.92%). Antibiotic susceptibility testing showed Imipenem as the most effective drug with susceptibility of 76% followed by Piperacillin-Tazobactam (74.7%) and Piperacillin (41.3%). Out of 75 P. aeruginosa isolates, 53 (70.6%) of them were found to be resistant to at least three out of four anti-pseudomonal agents, thus were considered as MDR. Out of 53 multi-drug resistant P. aeruginosa (MDRPA), all were resistant to ceftazidime whereas 85% (45/53) were resistant to cefoxitin. Out of 53 isolates, 11 (20.75%) showed positive result for MBL. Similarly, 7 out of 45 i.e. 13.2% were found to be AmpC producers.Conclusion: This study signified the high prevalence of MDRPA which is an alarming rate. Also multiple β-lactamase producing P. aeruginosa were detected which can further complicate the treatment options. Regular monitoring of antibiotic susceptibility and rational use of antibiotics would be helpful in eliminating the outbreaks of multiple β-lactamase producing MDRPA.

scholarly journals Staphylococcus aureus with inducible clindamycin resistance and methicillin resistance in a tertiary hospital in Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Devi Thapa ◽  
Susil Pyakurel ◽  
Sabita Thapa ◽  
Suresh Lamsal ◽  
Mahesh Chaudhari ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Methicillin Resistance ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Antibiotic Susceptibility Testing ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

Abstract Background Staphylococcus aureus is a global public health issue in both community and hospital settings. Management of methicillin-resistant S. aureus (MRSA) infections are tough owing to its resistance to many antibiotics. Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are commonly used for the management of MRSA. This study was aimed to determine the occurrence of inducible clindamycin- and methicillin-resistant S. aureus at a tertiary care hospital in Kathmandu, Nepal. Methods A total of 1027 clinical samples were processed following standard laboratory procedures and antibiotic susceptibility testing of S. aureus was performed by disc diffusion method. MRSA isolates were detected phenotypically using cefoxitin disc, and inducible clindamycin resistance was detected phenotypically using the D-zone test. Results Of 1027 samples, 321 (31.2%) were culture positive, of which 38 (11.8%) were S. aureus. All S. aureus isolates were susceptible to vancomycin, and 25 (67%) of S. aureus isolates were multidrug-resistant. Similarly, 15 (39.5%) of S. aureus were MRSA and 14 (36.5%) were inducible clindamycin-resistant phenotypes. Conclusion Inducible clindamycin and methicillin resistance were common in S. aureus. This emphasizes that the methicillin resistance test and the D-zone test should be incorporated into the routine antibiotic susceptibility testing in hospital settings.

scholarly journals Determination of minimum inhibitory concentration (MIC) of cloxacillin for selected isolates of methicillin-resistant Staphylococcus aureus (MRSA) with their antibiogram

1970 ◽  
Vol 6 (1) ◽  
pp. 121-126 ◽  
Author(s):  
MA Islam ◽  
MM Alam ◽  
ME Choudhury ◽  
N Kobayashi ◽  
MU Ahmed
Keyword(s):  
Staphylococcus Aureus ◽  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Agar Plate ◽  
Susceptibility Test ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Antibiotic Susceptibility Test ◽  
Mrsa Strains

The minimum inhibitory concentration (MIC) represents the concentration of antimicrobial at which there is complete inhibition of growth of organism. In order to determine the MIC of cloxacillin, 10 MRSA were previously detected from 40 clinical isolates of Staphylococcus aureus by polymerase chain reaction (PCR). Agar plate dilution test was used to determine the MIC of cloxacillin. The clinical samples were collected from Mymensingh Medical College Hospital, Mymensingh. The study was done in the Department of Medicine, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh from July 2006 to June 2007. The MIC of the cloxacillin for 5 MRSA strains were ≥32 (mg/ml), for 1 MRSA strain was ≥ 128(mg/ml) and for another 4 MRSA strains were above ≥128 (mg/ml). Antimicrobial susceptibility test of the isolated organisms were done by disc diffusion method. On antibiotic susceptibility test, MRSA strains showed 100% resistant against penicillin, oxacillin, cloxacillin and amoxycillin. Cent per cent susceptibility of MRSA was found against vancomycin, ciprofloxacin, erythromycin, fusidic acid and rifampicin. Key words: Minimum inhibitory concentration (MIC), antibiotic resistance, cloxacillin, methicillin-resistant Staphylococcus aureus (MRSA) DOI = 10.3329/bjvm.v6i1.1350 Bangl. J. Vet. Med. (2008). 6 (1): 121-126

scholarly journals COLISTIN RESISTANCE IN CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE STRAINS

2017 ◽  
Vol 10 (9) ◽  
pp. 70
Author(s):  
Beena Hosdurg Bhaskar ◽  
Shalini Shenoy Mulki ◽  
Sangeeta Joshi ◽  
Ranjeeta Adhikari ◽  
Bhavana Malavalli Venkatesh
Keyword(s):  
Antibiotic Susceptibility ◽  
Antimicrobial Agents ◽  
Susceptibility Testing ◽  
Ethylenediaminetetraacetic Acid ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Antibiotic Susceptibility Testing ◽  
Carbapenem Resistant

Objective: There is an increasing use of colistin consequent to increase in the infections caused by carbapenem-resistant Klebsiella pneumoniae.The present study was conducted to determine the minimum inhibitory concentration (MIC) of colistin and the resistance pattern of colistin in carbapenem-resistant K. pneumoniae (CRKP) strains in our intensive care unit (ICU).Methods: Antibiotic susceptibility testing for other antimicrobial agents was done by Kirby-Bauer disk diffusion method. MIC of colistin was determined by agar dilution method. The results of antibiotic susceptibility testing were interpreted as per Clinical Laboratory Standard Institute guidelines 2016 and MIC of colistin were interpreted as per European Committee on Antimicrobial susceptibility testing. The carbapenem resistance was phenotypically detected by modified hodge test and imipenem/imipenem ethylenediaminetetraacetic acid disk method.Results: Out of 518 K. pneumoniae, 329 were resistant to carbapenems, and 91 isolates showed resistance to colistin. The MIC of colistin ranged between 4 and >512 ug/ml and MIC90 was 16 ug/L and MIC50 was 4 ug/ml. A majority of the colistin-resistant isolates were found in multidisciplinary ICU (85/91).Conclusion: The emergence of colistin-resistant strains is a major problem due to limited treatment options for infections caused by CRKP carbapenemase producing K. pneumoniae. Colistin should not be used alone, combination therapy should be preferred.

scholarly journals INCREASED VANCOMYCIN MINIMUM INHIBITORY CONCENTRATION (MIC) AMONG MRSA ISOLATES IN A TERTIARY CARE HOSPITAL

2013 ◽  
Vol 03 (04) ◽  
pp. 010-012
Author(s):  
Asha Pai K. B. ◽  
Sweetha N. N. ◽  
Sanjeev H. ◽  
Rekha R. ◽  
Vimal K. K. ◽  
...  
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Dilution Method ◽  
Care Hospital ◽  
Vancomycin Minimum Inhibitory Concentration ◽  
Success Of Treatment

Abstract Introduction:Methicillin Resistant Staphylococcus aureus (MRSA) is not only an important nosocomial pathogen but also an incipient community pathogen in many geographical areas. Recommended therapeutic agent for treatment of MRSA infections are glycopeptides, in particular vancomycin. The distribution of vancomycin Minimum Inhibitory Concentration (MIC) values among MRSA isolates in our hospital is unknown. We conducted this study to Determine the distribution of vancomycin MIC values among MRSA isolates from clinical samples in our hospital. Material and Methods:Fifty six MRSA isolates were included in the study. These isolates were obtained from different clinical samples received in the department of Microbiology over a period of six months from august 2012 to January 2013. Screening for MRSA was done by disc diffusion method using Cefoxitin disc. Determination of vancomycin MIC of all the isolates was done by macro broth dilution method. Results:All 56 isolates were sensitive to vancomycin. Out of the 56 isolates tested, 25 (44.64%) and 12 (21.4%) had Vancomycin MIC of 1μg/ml and 2 μg/ml respectively. Conclusion:The high vancomycin MIC values observed among our strains are a cause of concern, as this may have an impact on the success of treatment with vancomycin.

scholarly journals Potential Role of Door Handles in the Spread of Drug Resistant Bacteria in Makerere University.

2021 ◽  
Author(s):  
◽  
Immaculate Nabawanuka
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Susceptibility ◽  
Pathogenic Bacteria ◽  
Susceptibility Testing ◽  
Bacterial Load ◽  
Plate Count ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Antibiotic Susceptibility Testing ◽  
Makerere University

Background: The transmission of diseases caused by pathogenic bacteria is still a threat. One of the potential sources of bacterial diseases is the door handles. This study aimed at isolating, identifying bacteria, determining total bacterial load, and determining antibiotic susceptibility patterns of bacteria obtained from door handles in Makerere university. Methodology:  A total of 60 samples randomly scattered within the university were swabbed and analyzed for bacterial growth. Samples were inoculated on MacConkey and blood agar and then incubated at 37 ºC for 24 hours. All sample isolates were sub cultured and identified based on macro and micromorphology, and standard biochemical tests. The establishment of the total bacterial load was done using the standard plate count method. Antibiotic susceptibility testing was done using the disc diffusion method on Muller Hilton agar. Results: The following bacterial species and genera were obtained from door handles, staphylococcus aureus (30.8%), Coagulase-negative staphylococcus (12.0%), Streptococcus species (24.2%), Escherichia coli (7.7%), Pseudomonas aeruginosa (14.3%), bacilli species (11.0%). The study showed that there was a significant difference in the prevalence of bacilli species (p= 0.017) and E. coli (p= 0.015) among the study group. The results from total bacterial count indicated that toilet door handles had the highest bacterial load compared to office door handles and classrooms. Antibiotic susceptibility testing of isolates showed that all bacteria were resistant and intermediately resistant to commonly used antibiotics except for Escherichia coli that was susceptible to amoxicillin Conclusion and recommendations: The study reveals that door handles are a considerable source of pathogenic bacteria thus play a major role in the transmission of diseases caused by such bacteria. Further studies could be done and different study groups could be included for example routinely opened doors and the doors which are not routinely opened.

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