Changes in Causative Organisms and Their Antimicrobial Susceptibilities in Capd Peritonitis: A Single Center's Experience over one Decade

2004 ◽  
Vol 24 (5) ◽  
pp. 424-432 ◽  
Author(s):  
Dong Ki Kim ◽  
Tae-Hyun Yoo ◽  
Dong-Ryeol Ryu ◽  
Zhong-Gao Xu ◽  
Hyun Jin Kim ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Statistical Significance ◽  
Treatment Protocol ◽  
Major Complication ◽  
Catheter Removal ◽  
Coagulase Negative Staphylococcus ◽  
Removal Rates ◽  
Gram Positive ◽  
Gram Negative ◽  
Methicillin Resistant

Background In recent years, the rate of peritonitis during continuous ambulatory peritoneal dialysis (CAPD) has been significantly reduced. However, peritonitis remains a major complication of CAPD, accounting for considerable mortality and hospitalization among CAPD patients. Objective To generate a “center tailored” treatment protocol for CAPD peritonitis by examining the changes of causative organisms and their susceptibilities to antimicrobial agents over the past 10 years. Method Retrospective review of the medical records of 1015 CAPD patients (1108 episodes of peritonitis) who were followed up from 1992 through 2001. Results The overall incidence of peritonitis was 0.40 episodes/patient-year. The annual rate of peritonitis and the incidence of peritonitis caused by a single gram-positive organism were significantly higher in 1992 and 1993 compared with those in the rest of the years ( p < 0.05). The incidence of peritonitis due to coagulase-negative staphylococcus (CoNS) decreased significantly over time, whereas there was no significant change in the incidence of Staphylococcus aureus (SA)-induced peritonitis. Among CoNS, resistance to methicillin increased from 18.4% in 1992 – 1993 to 41.7% in 2000 – 2001 ( p < 0.05). In contrast, the incidence of methicillin-resistant SA was not different according to the calendar year. Catheter removal rates were significantly higher in peritonitis due to a single gram-negative organism (16.6%) compared with gram-positive peritonitis (4.8%, p < 0.005). The mortality associated with peritonitis was also higher in gram-negative (3.7%) compared with gram-positive peritonitis (1.4%), but there was no statistical significance. Among single gram-positive organism-induced peritonitis, catheter removal rates were significantly higher in SA (9.3%) than those in CoNS (2.9%, p < 0.01) and other gram-positive organisms (2.9%, p < 0.05). In peritonitis caused by CoNS, the methicillin-resistant group showed significantly higher removal rates than the methicillin-susceptible group (8.2% vs 1.0%, p < 0.01). Conclusion The incidence of peritonitis for 2001 decreased to less than half that for 1992, due mainly to a significant decrease in CoNS-induced peritonitis, whereas the proportions of peritonitis due to a single gram-negative organism and methicillin-resistant CoNS increased. These findings suggest that it is necessary to prepare new center-based guidelines for the initial empirical treatment of CAPD peritonitis.

scholarly journals Effects of a Statewide Protocol for the Management of Peritoneal Dialysis-Related Peritonitis on Microbial Profiles and Antimicrobial Susceptibilities: A Retrospective Five-Year Review

2015 ◽  
Vol 35 (7) ◽  
pp. 722-728 ◽  
Author(s):  
Amanda L. McGuire ◽  
Christine F. Carson ◽  
Timothy J. J. Inglis ◽  
Aron Chakera
Keyword(s):  
At Risk ◽  
Peritoneal Dialysis ◽  
Antimicrobial Agents ◽  
Treatment Protocol ◽  
Major Complication ◽  
Empirical Therapy ◽  
Gram Positive ◽  
Gram Negative ◽  
Resistance Patterns ◽  
Gentamicin Resistance

Background Peritonitis is a major complication of peritoneal dialysis (PD) and is associated with significant morbidity and mortality. Early empirical antibiotic therapy is recommended, with the choice of agents guided by local resistance patterns. As routine use of specific antimicrobial agents can drive resistance, regular assessment of causative organisms and their susceptibility to empirical therapy is essential. Methods We conducted a retrospective review of all PD peritonitis cases and positive PD fluid cultures obtained over a 5-year period in Western Australia following the introduction of a statewide protocol for the initial management of PD peritonitis with intraperitoneal vancomycin and gentamicin. Results The incidence of PD peritonitis decreased from 1 in 16 patient months (0.75/year at risk) to 1 in 29 patient months (0.41/year at risk) over the 5 years. There were 1,319 culture-positive samples and 1,069 unique isolates identified. Gram-positive bacteria accounted for 69.9% of positive cultures, with vancomycin resistance averaging 2% over the study period. Gram-negative bacteria accounted for 25.4% of positive cultures, with gentamicin resistance identified in an average of 8% of organisms. No increase in antimicrobial resistance to vancomycin or gentamicin occurred over the 5 years and there was no change in the proportion of gram-positive (69.9%), gram-negative (25.4%) or fungal (4.4%) organisms causing PD peritonitis. Conclusions Over time, the peritonitis rates have dramatically improved although the profile of causative organisms remains similar. Empirical treatment of PD peritonitis with intraperitoneal vancomycin and gentamicin remains efficacious, with high levels of susceptibility and no evidence that the introduction of this statewide empirical PD peritonitis treatment protocol is driving resistance to these agents.

scholarly journals Clinico-bacteriological profile of neonatal sepsis

2019 ◽  
Vol 6 (2) ◽  
pp. 796 ◽  
Author(s):  
Rashmi P. ◽  
Praveen B. K.
Keyword(s):  
Neonatal Sepsis ◽  
Clinical Suspicion ◽  
Coagulase Negative Staphylococcus ◽  
Gram Positive ◽  
Gram Negative ◽  
Methicillin Resistant ◽  
Early Onset Sepsis ◽  
Sensitivity Pattern ◽  
Gram Negative Organisms ◽  
Culture Positive

Background: Neonatal sepsis is the commonest cause of neonatal mortality responsible for about 30-50% of total neonatal deaths in developing countries. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship.Methods: A retrospective study, relevant data regarding the neonates diagnosed with culture positive sepsis was obtained from the case records during the period from July 2014 to June 2017. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results: Of the 414 neonates with clinical suspicion of sepsis, 110 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9 %) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus(MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusions: Gram positive sepsis was the most common type of sepsis among the neonates, although mortality was more in gram negative sepsis.

Trends of Antimicrobial Resistance of Sepsis Pathogens at a University Hospital in New Delhi, India

Drug Research ◽  
2020 ◽  
Vol 70 (10) ◽  
pp. 463-471
Author(s):  
Md Shamshir Alam ◽  
Prem Kapur ◽  
ParuKutty Pillai ◽  
Krishna Kolappa Pillai
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Salmonella Typhi ◽  
University Hospital ◽  
Coagulase Negative Staphylococcus ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Acinetobacter Species ◽  
Gram Negative

AbstractKnowledge of the aetiological agents and its susceptibility to antimicrobial agents enables the clinician to initiate appropriate empirical antimicrobial therapy and guides diagnostic procedures. The aims of the study were to identify prevalence of bacterial pathogens causing sepsis and observe their antimicrobial resistance trends in hospitalized patients. A prospective cohort study was conducted on patients of sepsis admitted at a university hospital over a period of six months. Pathogens were identified by morphological, biochemical and serological tests as per the American Society for Microbiology. Antibacterial sensitivity of bacterial strains isolated from clinically diagnosed sepsis was carried out by Kirby-Bauer disk diffusion method and interpreted according Clinical and Laboratory Standards Institute guidelines. The data were analyzed by using Statistical Package for Social Sciences, version 16.0 (SPSS 16.0, Chicago, IL, USA). Coagulase negative Staphylococcus (63.5%) and Staphylococcus aureus (23.1%) were the most frequently isolated Gram positive bacteria. Acinetobacter species (31%) and Salmonella typhi (24.1%) were the most frequently isolated Gram negative bacteria. Coagulase negative Staphylococcus showed significant resistance to ciprofloxacin and tetracycline. Acinetobacter species showed significant resistance to ampicillin, amoxicillin and amoxiclav. Salmonella typhi showed significant resistance to ampicillin, amoxicillin, cefotaxime, netilmicin and, tetracycline. Escherichia coli showed significant resistance to ampicillin and netilmicin. All the stains of Staphylococcus aureus were resistant to amoxicillin. Coagulase negative Staphylococcus and Acinetobacter species were predominant Gram positive and Gram negative bacteria, respectively, causing sepsis. Increasing rates of bacterial resistance to commonly use antimicrobial agents were observed.

scholarly journals Antibiogram for Haemodialysis Catheter-Related Bloodstream Infections

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Abdul Halim Abdul Gafor ◽  
Pau Cheong Ping ◽  
Anis Farahanum Zainal Abidin ◽  
Muhammad Zulhilmie Saruddin ◽  
Ng Kah Yan ◽  
...  
Keyword(s):  
Bacterial Resistance ◽  
Major Complication ◽  
Bloodstream Infections ◽  
Coagulase Negative Staphylococcus ◽  
Gram Negative Bacteria ◽  
Sensitivity Testing ◽  
Gram Positive ◽  
Gram Negative ◽  
Empirical Antibiotics

Background. Haemodialysis (HD) catheter-related bloodstream infections (CRBSIs) are a major complication of long-term catheter use in HD. This study identified the epidemiology of HD CRBSIs and to aid in the choice of empiric antibiotics therapy given to patients with HD CRBSIs.Methods. Patients with HD CRBSIs were identified. Their blood cultures were performed according to standard sterile technique. Specimens were sent to the microbiology lab for culture and sensitivity testing. Results were tabulated in antibiograms.Results. 18 patients with a median age of 61.0 years (IQR: 51.5–73.25) were confirmed to have HD CRBSIs based on our study criteria. Eight (44.4%) patients had gram-negative infections, 7 (38.9%) patients gram-positive infections, and 3 (16.7%) patients had polymicrobial infections. We noted that most of the gram-negative bacteria were sensitive to ceftazidime. Unfortunately, cloxacillin resistance was high among gram-positive organisms.Coagulase-negative StaphylococcusandBacillussp. were the most common gram-positive organisms and they were sensitive to vancomycin.Conclusion. Our study revealed the increased incidence of gram-negative organism in HD CRBSIs. Antibiogram is an important tool in deciding empirical antibiotics for HD CRBSIs. Tailoring your antibiotics accordingly to the antibiogram can increase the chance of successful treatment and prevent the emergence of bacterial resistance.

scholarly journals Recurrent Challenges for Clinicians: Emergence of Methicillin-resistant Staphylococcus aureus, Vancomycin Resistance, and Current Treatment Options

2013 ◽  
Vol 5 (02) ◽  
pp. 071-078 ◽  
Author(s):  
Bansidhar Tarai ◽  
Poonam Das ◽  
Dilip Kumar
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Agents ◽  
Hospital Setting ◽  
Vancomycin Resistance ◽  
Control Measures ◽  
Healthcare Personnel ◽  
Coagulase Negative Staphylococcus ◽  
Gram Positive ◽  
Methicillin Resistant ◽  
Resistant Strains

ABSTRACTGram-positive pathogens mainly, Staphylococcus aureus, Enterococcus and coagulase-negative Staphylococcus, are developing increasing resistance to glycopeptides that pose a problem in treating infections caused by these pathogens. Vancomycin is the treatment of choice in treating methicillin-resistant S. aureus (MRSA). Community-acquired MRSA is associated with infections in patients without recent history of hospital admission and without the classical risk factors for MRSA carriage (including healthcare personnel). MRSA poses new threats and challenges beyond the hospital with the emergence of community-acquired MRSA. Indiscriminate use of vancomycin leads to the emergence and spread of vancomycin resistance in multidrug resistant strains is of growing concern in the recent years. Minimum Inhibitory concentration (MIC) remains an important determinant in choosing the right antibiotics. Infections caused by MRSA strains with vancomycin MIC > 4 μg/mL leads to the vancomycin treatment failure. The Clinical Laboratory Standards Institute had also lowered the cut-off susceptibility and resistance breakpoints for vancomycin. Despite the availability of newer antimicrobial agents (Linezolid, Daptomycin, Tigecycline) for drug-resistant Gram-positive pathogens, clinicians and patients still need options for treatment of MRSA infection. There is a need to reduce the global burden of infections caused by Gram-positive pathogens and its resistant strains (mainly MRSA). Continuous efforts should be made to prevent the spread and the emergence of glycopeptide resistance by early detection of the resistant strains and using the proper infection control measures in the hospital setting.

The epidemiology of central venous catheter-related bloodstream infection in our renal units is changing

2021 ◽  
pp. 112972982199022
Author(s):  
Salvatore Mandolfo ◽  
Adriano Anesi ◽  
Vanina Rognoni
Keyword(s):  
Burkholderia Cepacia ◽  
Present Report ◽  
Statistical Significance ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Renal Unit ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Over Time

Recent reports have shown an increase in the rate of Gram-negative bacteremia in several settings, including catheter-related bloodstream infections (CRBSI). To analyze if the epidemiology of CRBSI is also changing in hemodialysis patients, we revisited the etiology of CRBSIs in our renal unit over 8 years. During the observed periods, 149 episodes of CRBSIs were reported and the CRBSI incidence rate, ranged between 0.67 and 0.82 episodes/1000 tCVC days. Of these 149 episodes, 84 (56.3%) were due to Gram-positive bacteria, 62 (41.6%) to Gram-negative bacteria, and 3 (2.1%) to polymicrobial flora, no episodes of fungi were found. There was a trend, but not statistically significative, increase over time in the number of Gram-negative CRBSIs among the total CRBSIs, rising from 37.8% in the first period to 41.2% in the second period and to 44.3% in the last period, with a parallel decrease in the percentage of Gram-positive CRBSIs (from 59.5% to 56.9% and subsequently to 54.1%). Between Gram-negative, we reported an intensification of CRBSI due to Enterobacterales, particularly Escherichia coli. Among the Gram-negative, we have isolated germs rarely reported in the literature, such as Burkholderia cepacia, Pantoea agglomerans, and Rhizobium radiobacter. Regarding Gram-positive bacteria, a triplicate incidence of Staphylococcus aureus was reported with MRSA accounting for 42% in the third period. Among the Gram-positive bacteria, we reported two episodes of Kocuria kristinae and two of Bacillus spp. Our data demonstrated that the epidemiology of CRBSI in the same center, will change over time and Gram-negative strains are an increasing cause of CRBSI. The limitation of the present report is that statistical significance has not been reached, probably due to the limited number of CRBSI. New bacteria, both Gram-negative and Gram-positive, are emerging. Collaboration with the Microbiology Department appears essential to an appropriate diagnosis.

Effectiveness of ZnO Nano Particles against the Foodborne Microbial Pathogens E. coli and S. aureus

2020 ◽  
Vol 15 (2) ◽  
pp. 87-94
Keyword(s):  
Antimicrobial Agents ◽  
Inhibitory Concentration ◽  
Antimicrobial Effect ◽  
Nano Particles ◽  
Microbial Pathogens ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Antimicrobial Susceptibility Tests ◽  
Susceptibility Tests

In this work, various concentrations of ZnO nano particles, prepared by the coprecipitation method with a size range of 47-68 nm, have been investigated as antimicrobial agents. Dilution antimicrobial susceptibility tests were carried out on two kinds of microbes (Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli) according to the standard method recommended by Clinical and Laboratory Standards Institute, CLSI-2015-M07-A10. The results showed that the antimicrobial effect is larger, the higher the concentration of ZnO nano particles in solution. It was also found that Gram-positive microbes are more sensitive to ZnO nano particles when compared with the Gram-negative ones. The minimum inhibitory concentration (MIC) for E. coli was found to be 50 mg/mL while that for S. aureus was 25 mg/mL. The minimum bactericidal concentration (MBC) was 1600 mg/mL for E. coli and 800 mg/mL for S. aureus.

scholarly journals Microwave Assisted Synthesis and Antimicrobial Evaluation of Schiff Bases of Indole-3-aldehyde

2011 ◽  
Vol 8 (1) ◽  
pp. 305-311 ◽  
Author(s):  
Priyanka Kamaria ◽  
N. Kawathekar ◽  
Prerna Chaturvedi
Keyword(s):  
Schiff Bases ◽  
Antimicrobial Agents ◽  
Microwave Assisted Synthesis ◽  
Bacterial Strains ◽  
Mass Spectral Analysis ◽  
Gram Positive ◽  
Gram Negative ◽  
Mass Spectral ◽  
Microwave Assisted ◽  
Antimicrobial Evaluation

In order to develop new antimicrobial agents, a series of Schiff bases of indole-3-aldehyde were synthesized by microwave assisted synthesis by takingDMFas solvent and evaluated for their antimicrobial activity. All the synthesized compounds were characterized byIR,1HNMRand mass spectral analysis. All compounds were tested against five gram positive and five gram negative bacterial strains and one fungal strain. All compounds exhibited better activity against gram positive strains than against gram negative strains and the compounds were found more active againstS.aureusandB.subtilis.

scholarly journals Construction of Leaderless-Bacteriocin-Producing Bacteriophage Targeting E. coli and Neighboring Gram-Positive Pathogens

2021 ◽  
Author(s):  
Yoshimitsu Masuda ◽  
Shun Kawabata ◽  
Tatsuya Uedoi ◽  
Ken-ichi Honjoh ◽  
Takahisa Miyamoto
Keyword(s):  
Antimicrobial Agents ◽  
Host Strain ◽  
Phage Resistance ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Gram Positive Bacteria ◽  
T7 Phage

We demonstrated that we could combine LLB and phage to construct promising novel antimicrobial agents, LLB-phage. The first LLB-phage, lnqQ -T7 phage, can control the growth of both the Gram-negative host strain and neighboring Gram-positive bacteria while preventing the emergence of phage resistance in the host strain.

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