scholarly journals Burden of Shigella spp and Vibrio spp, and their antibiotic sensitivity pattern in the patients with acute gastroenteritis in tertiary care hospital in Nepal

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Shiv Kumar Sah ◽  
Shreejana Basnet ◽  
Sushma Shrestha ◽  
Kusum Ghale ◽  
Sabita Tamang ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Nalidixic Acid ◽  
Acute Gastroenteritis ◽  
Tertiary Care ◽  
High Rate ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Cross Sectional ◽  
Vibrio Cholera ◽  
Sensitivity Pattern

Abstract Objectives The present study aims to investigate the etiology, clinical profile and resistance pattern of the isolated pathogens in Nepalese adults with acute gastroenteritis. This cross-sectional study was conducted at Sukraraj Tropical and Infectious Disease Hospital, from April 2016 to Sep 2017. Subjects’ ages 14 or above, presenting with gastroenteritis with positive stool culture were enrolled for analysis. Results Of total 153 patients, 47.72% subjects confirmed the presence of bacterial infection. Vibrio cholerae spp and Shigella spp were detected in 36.6% and 23.28% respectively. The most common resistance among Vibrio cholerae was to nitrofurantoin (92.8%), cotrimoxazole (92.8%) and nalidixic acid (92.8%). Among 17 isolates of Shigella spp, the most frequent drug resistant was observed in ampicillin (64.7%), nalidixic acid (58.8%), ceftriaxone (47%). Chloramphenicol (94.1%), tetracycline (88.2%), and cotrimoxazole (82.3%) were found to be the most sensitive towards this pathogen. High rate of diarrhea due to bacterial infection, especially Shigella spp and Vibrio spp and their high rate of drug resistance emphasize an urgent need of designing a surveillance system for antimicrobial resistance in Nepalese setting.

scholarly journals Pattern of Antibiotic Sensitivity in Enteric Fever: A Tertiary Care Hospital Experience

2014 ◽  
Vol 15 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Md. Mehedi Hasan ◽  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
...  
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Drug Resistant Strains

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124

scholarly journals A comparative study of Bacterial culture isolates, site of infections and drug resistance pattern between COVID and non COVID patients admitted in a tertiary care hospital: A Pilot study

2021 ◽  
Author(s):  
Arup Halder ◽  
Deep Narayan Mukherjee ◽  
Soumyadeep Seal ◽  
Hindol Dasgupta ◽  
Mainak Chakraborty
Keyword(s):  
Drug Resistance ◽  
Pilot Study ◽  
Bacterial Infection ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Secondary Bacterial Infection ◽  
Sensitivity Pattern ◽  
Drug Resistance Pattern

AbstractIntroductionSARS-CoV2 which is a corona virus also predisposes patient to secondary bacterial infection by various mechanisms like-damaging the respiratory epithelium, profoundly affecting the innate and adaptive immunity, antagonising Interferon responses that enhance bacterial adherence, colonisation and invasion to respiratory tissue. In addition, prolonged hospital stay, invasive therapeutic devices, widespread use of empiric antibiotics and most importantly use of immune-suppressants like Steroid or Tocilizumab further increases the chances of bacterial infection. As opposed to this concept-physical distancing, frequent hand washing and use of gloves and protective gear by the healthcare workers also diminishes the chance of secondary bacterial infection. The present study is done to delineate the bacteriological profile, infection site predisposition or to gain knowledge on antibiotic sensitivity pattern.MethodRetrospective data will be analyzed from June 2020, when the first COVID wave came to June 2021, corresponding to second COVID wave. The present study is a pilot study before collecting and analyzing the whole data Only those samples which were positive for bacterial isolates were randomly selected and the COVID status and drug resistance patterns were checked.Results and discussionThe most common organism found was Klebsiella. Acinetobacter was also found in few patients. But most striking finding was that COVID positive patients showed higher incidence of antibiotic resistance with Acinetobacter. Though E Coli was also found commonly in COVID positive patients, they were not drug resistant.ConclusionMDR infections are common in COVID patients. Acinetobacter and Klebsiella are prone to develope MDR infections. While E.Coli is also common in COVID patients, chance of drug resistance is less among them.

scholarly journals Phenotypic Characterisation, Virulence Determination and Antimicrobial Resistance Pattern of Enterococcus Species Isolated from Clinical Specimen in a Tertiary Care Hospital in Kolkata

2021 ◽  
Author(s):  
Subhendu Sikdar ◽  
Sampa Sadhukhan ◽  
Amit Kumar Majumdar ◽  
Somnath Bhunia ◽  
Soma Sarkar ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Clinical Specimen ◽  
High Rate ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Cross Sectional ◽  
Clinical Specimens ◽  
Phenotypic Characterisation ◽  
High Level

Introduction: Enterococci are usually normal human commensal of gastrointestinal tract predominantly. They are considered as an important nosocomial pathogen now a day due to its intrinsic as well as increasing acquired antibiotic resistance resulting in a great threat to modern Medicine. Aim: To determine prevalence of Enterococci isolated from clinical specimens with special reference to its virulence and antibiogram conventionally. Materials and Methods: A cross-sectional observational study was conducted over a period of two years (January 2019 to December 2020) with 326 Enterococci, isolated from various clinical specimens received by Department of Microbiology. Enterococci isolated from stool samples were excluded. They were identified and speciated conventionally as per standard laboratory protocol. Gelatinase, haemolysin and biofilm formation was determined for each isolate. Their antibiogram was also determined by disc diffusion methods over Blood agar followed by Minimum Inhibitory Concentration (MIC) testing (as per Clinical and Laboratory Standards Institute (CLSI) guideline). All statistical analysis was done by Chi-square test using Software Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Among the total 4516 samples collected, growth of Enterococci was noted in 7.22% cases. Out of them, E. faecalis (84.05%) out numbered E. faecium. Urine was the most predominant (55.22%) sample. 73.93% isolates produced biofilm whereas 18.40% produced haemolysin and 19.94% produced gelatinase. Most of the isolates were susceptible to vancomycin (94.79%) and linezolid (98.77%). High level gentamicin resistance was seen in 54.6% cases. Ciprofloxacin was the most resistant antibiotic. Vancomycin Resistance Enterococcus (VRE) was detected in 5.21% cases only, out of which Van A type was detected phenotypically in most cases. Conclusion: The high rate of resistance to high-level gentamicin could fail treatment of gentamicin in combination with penicillin group of antibiotics. In clinical samples, the emergence of VRE strains makes treatment options more challenging.

scholarly journals Antimicrobial Resistance Patterns in Clinically Significant Isolates from Medical Wards of a Tertiary Care Hospital in North India

2020 ◽  
Vol 12 (03) ◽  
pp. 196-202
Author(s):  
Venkatesh Sudharsan Vaithiyam ◽  
Neha Rastogi ◽  
Piyush Ranjan ◽  
Niranjan Mahishi ◽  
Arti Kapil ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Resistance Pattern ◽  
Resistant Organism ◽  
Care Hospital ◽  
Cross Sectional ◽  
Drug Resistance Pattern ◽  
Clinically Significant ◽  
Medical Wards

Abstract Background The global burden of infections due to multidrug-resistant organism (MDRO) has a significant impact on patients’ morbidity and mortality along with increased healthcare expenditure. Aim This article estimates the prevalence of MDRO and the spectrum of clinical infectious syndromes caused by these organisms in medical wards of a tertiary care hospital in India. Design and Methods A cross-sectional observational study was performed among patients admitted in medicine wards diagnosed with the various infectious syndromes and one or more clinically significant positive culture at a tertiary care hospital in North India over a period of 18 months. Results Out of 323 clinically significant microbiological culture isolates from 229 patients included in the study, 86 (27%) isolates showed multidrug resistance (MDR) pattern, 197 (61%) isolates showed possible extremely drug-resistance pattern, and only 40 (12%) isolates showed nonmultidrug-resistance pattern of antibiogram. Conclusion The prevalence of MRDOs is high in clinically significant culture isolates from medicine wards in India. This emphasizes the importance of appropriate antibiotic usage and implementation of antibiotic stewardship programs in this part of the world.

scholarly journals A study on the bacterial isolates from blood cultures of a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 171-174
Author(s):  
KMS Mohamed Ali ◽  
K Girija
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Tertiary Care Centre ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Blood Samples

Blood stream infections are the most important and common cause of morbidity and mortality in tertiary care hospitals. Since the results are usually not available promptly a knowledge of epidemiologic and antimicrobial susceptibility pattern of blood pathogens is life saving and very useful for early treatment and recovery of patients. The aim of this study is to describe the epidemiological, bacterial profile and antimicrobial resistance pattern of bloodstream infections in a tertiary care centre.A prospective cross-sectional study was done on seven hundred and eight blood samples collected over a period of six months in the Microbiology laboratory. Blood samples collected under aseptic conditions were cultured by aerobic culture method. Identification of bacterial isolates were done using standard bacteriologic and biochemical testing methods and antibiotic sensitivity testing done by Kirby - Bauer disc diffusion method.Bacteria was isolated in 201 (28.3%) samples with highest rates among newborns 84(41.8%). The most frequent isolates were 111 (55.2%) followed by 49 (24.4%). Results showed high susceptibilities of CoNS 111 (100%) to Vancomycin, Linezolid and 51 (98%) to Meropenem. This study highlights the common prevalent bacteriological agents in bacteremia, their antibiotic susceptibility & resistance patterns. and multi drug resistant were the leading causes of septicaemia in our hospital with Vancomycin, Linezolid and Carbapenems the effective antibiotics against these pathogens respectively.

scholarly journals The profile of patients’ complaints in a tertiary care hospital in South India

2018 ◽  
Vol 5 (8) ◽  
pp. 3567
Author(s):  
Mohammed Jezeel Nalakath ◽  
P. M. Thasneem ◽  
K. V. Deepak ◽  
N. A. Uvais
Keyword(s):  
Medical Staff ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Standard ◽  
Cross Sectional Study ◽  
High Rate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Results ◽  
Research Population

Background: Complaints from patients and their carers are important indicators of problems in a healthcare system and provide valuable insights into safety-related problems within healthcare organisations. The objectives of the present study are to identify the frequency distribution of the people complained about, the units complained about and the total number of complaints.Methods: We employed a descriptive, cross-sectional study to conduct this research. The research population included cases registered at the complaints unit of a tertiary care hospitals in selected months of May 2017 to August 2017. The data were collected through observation of available documents. Excel software program was used for data analysis.Results: The administration received 692 complaints between the study period. The highest rate of complaints was filed against admission process (30.06%) and the lowest rate of complaints are filed against staff (2.51%). Our study results showed a significantly less complaints against nursing staff and no complaints against medical staff, indicates that the nursing and medical staff of the hospital might be observing medical ethics and professional commitment to a high standard and communicating well with the patients. High rate of complaints against admission unit, house keeping unit and high billing amount indicates the unrealistic expectations prevailing in the minds of clients from the health care provider.Conclusions: The current study generated the profile of patient’s complaints in a tertiary care hospital running in a charitable model. Such data can be utilised to identify common problems and to plan strategies. 

scholarly journals Antibiotic Resistance to Escherichia coli among Urine Culture-Positive Patients in a Tertiary Care Hospital in Nepal: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (233) ◽  
Author(s):  
Anu Kushwaha ◽  
Khilasa Pokharel ◽  
Anuj Raj Kadel
Keyword(s):  
Escherichia Coli ◽  
Urine Culture ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Culture Positive

Introduction: Urinary tract infection is treated by the antibiotic sensitivity pattern of uropathogensin our population. Present infection cases have been showing an increase in resistance to the currentfirst-line of antibiotics. The objective of this study is to determine the resistance of antibiotics inEscherichia coli in a tertiary care center. Methods: This is a descriptive cross-sectional study done in Kathmandu Medical College TeachingHospital from October 2018 to February 2019. The sample size was calculated, and convenientsampling was done. Patients with urine culture positive (i.e., Colony-forming unit >105) wereincluded in the study. All positive samples were tested for antibiotics sensitivity and resistance. Theresistance to the antibiotics was recorded using Statistical Package for Social Sciences version 20.Point estimate at 95% confidence interval was calculated along with frequency and proportion forbinary data. Results: Out of 100 samples, the highest number of organisms isolated was Escherichia coli, 71 (71%).Escherichia coli showed the highest resistance to drugs like Norfloxacin, 37 (52.11%), AmoxicillinClavulanic acid 37 (52.11%), followed by Co-trimoxazole 32 (45.1%), Ceftriaxone, 24 (33.8%), andCiprofloxacin 23 (32.3%). Conclusions: Escherichia coli showed the highest resistance to commonly used antibiotics likeNorfloxacin, Amoxicillin-Clavulanic acid, Co-trimoxazole, Ceftriaxone, and Ciprofloxacin.

scholarly journals Frequency and Sensitivity Pattern of Neisseria gonorrhoae Isolated from Women at a Tertiary Care Hospital in Dhaka City

2015 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Fatema Nusrat ◽  
K.M. Shahidul Islam ◽  
S.M. Shamsuzzaman ◽  
Md. Abdullah Yusuf ◽  
Aleya Farzana ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Care Hospital ◽  
Cross Sectional ◽  
Carbohydrate Utilization ◽  
Medical College ◽  
Gram Staining ◽  
Child Bearing ◽  
Sensitivity Pattern ◽  
Presumptive Identification

Background: Antibiotic sensitivity pattern of Neisseria gonorrhoae is changing frequently. Objective: The purpose of the present study was to see the antibiotic sensitivity pattern of Neisseria gonorrhoae isolated from women presented with cervicitis.Methodology: This cross sectional study.carried out in the Department  of Microbiology at Dhaka Medical College, Dhaka from July 2011 to December 2012 for a period of one and half year. All the women presented with or without the clinical features of  cervicitis at child bearing age (15 to 49 yrs) with or without pregnancy were enrolled as study population. Endocervical swabs were collected  for Gram staining, culture, biochemical test from clinically diagnosed  patients of cervicitis for presumptive identification of Neisseria gonorrhoeae. The isolates with presumptive identification were confirmed by rapid carbohydrate utilization test (RCUT), which differentiates  N.gonorrhoeae from other Neisseria. Antimicrobial susceptibility test was done according CLSI guideline. Result: A total 245 females were recruited of which N. gonorrhoeae were detected from 39(15.9%) cases. Among 39 positive cases of gonococcal cervicitis, 19 (48.71%) were detected in the age group of 21-30 years. 56.41% were sensitive and 30.76% were resistant to ceftriaxone. Similarly 51.28% were sensitive and 23.07% were resistant to cefuroxime; 23.07% sensitive, 30.76% moderately sensitive and 46.15% resistant to ciprofloxacin. Conclusion: Gonococcal cervicitis is found in a high frequency rate with a reduced sensitivity to antibiotics especially ciprofloxacin, second and third generation cephalosporins.Bangladesh J Infect Dis 2014;1(1):3-7

scholarly journals Anti-microbial sensitivity and resistance of organisms in blood-culture samples from prolonged fever cases: evidence from a tertiary care hospital in West Bengal, India

2018 ◽  
Vol 7 (11) ◽  
pp. 2173
Author(s):  
Somanjana Ghosh ◽  
Arista Lahiri ◽  
Siddhartha Bera ◽  
Soumyajyoti Bandyopadhyay
Keyword(s):  
Blood Culture ◽  
Tertiary Care ◽  
Systemic Infection ◽  
Cross Sectional Study ◽  
Background Information ◽  
Resistance Pattern ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Cross Sectional ◽  
High Level

Background: Currently there is a rise in resistance to anti-microbials which is a matter of concern in treatment of systemic infections. Blood culture is considered “gold standard” in diagnosis of suspected systemic infection. The susceptibility to antibiotics thereafter determine the future course of treatment. The current study aims to find out the sensitivity and resistance pattern of the blood culture isolates.Methods: A cross-sectional study was performed on the blood culture samples sent within 24hours of admission of the adult patients reporting fever for 7 days or more with no history of consumption of any antibiotics within last month. Total 134 blood samples were analysed. The proportion of sensitivity and resistance to anti-bacterial agents was calculated among those samples which showed growth in the culture. Background information of the patients in terms of age, sex and religion were also noted.Results: Mean age of the patients was 39.33 (±12.19) years. Overall 47.76% were female patients and remaining were male. Among the Hindu patients majority were male while among Muslims majority were female. Of the total number of blood cultures examined 46.27% showed growth of bacteria. Staphylococcus aureus was the most frequently found bacteria isolated in cultures, followed by coagulase negative Staphylococcus and Pseudomonas. Of the frequently used antibiotics, higher sensitivity was seen with vancomycin, amikacin, netilmycin, imipenem, gentamicin. High resistance was observed in use of antibiotics like cefixime, amoxicillin-clavulanic acid and azithromycin.Conclusions: High level of resistance to several commonly used advanced antibiotics warrant judicial and evidence-based use of these drugs. 

Fluoroquinolones Resistance Among Bacterial Uropathogens In A Tertiary Care Hospital Of Western Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1137-1141
Author(s):  
Dharm Raj Bhatta ◽  
Rajani Shrestha ◽  
Deependra Hamal ◽  
Supram HS ◽  
Niranjan Nayak
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Empirical Treatment ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Klebsiella Species ◽  
Cross Sectional ◽  
Gram Negative ◽  
Microbiological Techniques ◽  
Tract Infections

Introduction: Urinary tract infections are one of the most common clinical illnesses in developing countries. Most of the infections are treated empirically due to unavailability of laboratory facilities. Fluoroquinolones are frequently used for empirical treatment of UTIs. Objectives: This study was aimed to determine prevalence and antibiotic resistance pattern of bacterial uropathogens, especially to fluoroquinolones. Methodology: This hospital based cross sectional study was carried out at Manipal Teaching Hospital, Pokhara, Nepal. A total of 2450 mid stream urine samples were included in this study.  Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Results: Significant bacteriuria was detected in 258 (10.5%), insignificant bacteruria in 614 (25%), growth of multiple organisms in 238 (9.7%) while no growth was recorded in 1340 (54.7%) samples. E coli was the commonest isolate followed by Klebsiella species. Fluoroquinolones resistance among Gram negative isolates was high. Most of the Gram negative isolates were susceptible to amikacin, gentamicin, nitrofurantoin and imipenem. Conclusion: High resistance to fluoroquinolones, cotrimoxazole and cephalosporins dictates these to be unsuitable for empirical treatment of UTIs. Amikacin, gentamicin, nitrofurantoin and imipenem were the most effective antibacterials.

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