scholarly journals Prevalence and characterization of antimicrobial resistance among gram-negative bacteria isolated from febrile hospitalized patients in central Ethiopia

2022 ◽  
Vol 11 (1) ◽  
Author(s):  
Tafese Beyene Tufa ◽  
Colin R. Mackenzie ◽  
Hans Martin Orth ◽  
Tobias Wienemann ◽  
Tamara Nordmann ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Hospitalized Patients ◽  
Empiric Antibiotic Therapy ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Central Ethiopia ◽  
Empiric Treatment

Abstract Background Infectious diseases are among the leading causes of death in many low-income countries, such as Ethiopia. Without reliable local data concerning causative pathogens and antimicrobial resistance, empiric treatment is suboptimal. The objective of this study was to characterize gram-negative bacteria (GNB) as pathogens and their resistance pattern in hospitalized patients with infections in central Ethiopia. Methods Patients ≥ 1 year of age with fever admitted to the Asella Referral and Teaching Hospital from April 2016 to June 2018 were included. Blood and other appropriate clinical specimens were collected and cultured on appropriate media. Antibiotic susceptibility testing (AST) was performed using the Kirby–Bauer method and VITEK® 2. Species identification and detection of resistance genes were conducted using MALDI-ToF MS (VITEK® MS) and PCR, respectively. Results Among the 684 study participants, 54.2% were male, and the median age was 22.0 (IQR: 14–35) years. Blood cultures were positive in 5.4% (n = 37) of cases. Among other clinical samples, 60.6% (20/33), 20.8% (5/24), and 37.5% (3/8) of swabs/pus, urine and other body fluid cultures, respectively, were positive. Among 66 pathogenic isolates, 57.6% (n = 38) were GNB, 39.4% (n = 26) were gram-positive, and 3.0% (n = 2) were Candida species. Among the isolated GNB, 42.1% (16/38) were Escherichia coli, 23.7% (9/38) Klebsiella pneumoniae and 10.5% (4/38) Pseudomonas aeruginosa. In total, 27/38 gram-negative isolates were available for further analysis. Resistance rates were as follows: ampicillin/sulbactam, 92.6% (n = 25); cefotaxime, 88.9% (n = 24); ceftazidime, 74.1% (n = 20); cefepime, 74.1% (n = 20); gentamicin, 55.6% (n = 15); piperacillin/tazobactam, 48.1% (n = 13); meropenem, 7.4% (n = 2); and amikacin, 3.7% (n = 1). The blaNDM-1 gene was detected in one K. pneumoniae and one Acinetobacter baumannii isolate, which carried an additional blaOXA-51 gene. The ESBL enzymes were detected in 81.5% (n = 22) of isolates as follows: TEM, 77.2% (n = 17); CTX-M-1 group, 68.2% (n = 15); SHV group, 27.3% (n = 6); and CTX-M-9 group, 9.1% (n = 2). Based on the in vitro antimicrobial susceptibility results, empiric treatment initiated in 13 of 18 (72.2%) patients was likely ineffective. Conclusion We report a high prevalence of ESBL-producing bacteria (81.5%) and carbapenem resistance (7.4%), with more than half of GNB carrying two or more ESBL enzymes resulting in suboptimal empiric antibiotic therapy. These findings indicate a need for local and national antimicrobial resistance surveillance and the strengthening of antimicrobial stewardship programs.

scholarly journals High Rate of Multidrug-resistance Among Clinical Isolates of Gram-negative Bacteria in Hospitalized Patients With Febrile Diseases in Central Ethiopia

2021 ◽  
Author(s):  
Tafese B Tufa ◽  
Colin R Mackenzie ◽  
Hans Martin Orth ◽  
Tobias Wienemann ◽  
Tamara Nordmann ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Low Income ◽  
Hospitalized Patients ◽  
High Rate ◽  
Empiric Antibiotic Therapy ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Central Ethiopia

Abstract Background Infectious diseases are among the leading causes of death in many low-income countries such as Ethiopia. Without reliable local data concerning causative pathogens and antimicrobial resistance, empirical treatment is suboptimal. The objective of this study was the characterization of Gram-negative bacteria (GNB) as pathogens and their resistance pattern in hospitalized patients with infections in Central Ethiopia. MethodsPatients ≥1 year of age with fever admitted to the Asella Referral and Teaching Hospital from April 2016 to June 2018 were included. Blood and other appropriate clinical specimens were collected and cultured on appropriate media. Antibiotic susceptibility testing (AST) was performed using the Kirby-Bauer method and VITEK® 2. Species identification and detection of resistance-genes were conducted using MALDI-ToF-MS (VITEK® MS) and PCR respectively. ResultsOf 684 study participants, 54.2% were male and median age was 22.0 (IQR: 14-35) years. Blood cultures were positive in 5.4% (n=37). In other clinical samples, cultures were positive in 60.6% (20/33), 20.8% (5/24), and 37.5% (3/8) in swabs/pus, urine and other body fluids, respectively. Of 66 pathogenic isolates, 57.6% (n=38) were GNB, (39.4% (n=26) Gram-positive and 3.0% (n=2) were candida species. Among the isolated GNB, 42.1% (16/38) were E. coli, 23.7% (9/38) K. pneumoniae and 10.5% (4/38) P. aeruginosa. In total, 27/38 Gram-negative isolates were available for further analysis. Resistance rates were: ampicillin/sulbactam 92.6% (n=25), cefotaxime 88.9% (n=24), ceftazidime 74.1% (n=20), cefepime 74.1% (n=20), gentamicin 55.6% (n=15), piperacillin/tazobactam 48.1% (n=13), meropenem 7.4% (n=2), and amikacin 3.7% (n=1). The NDM-1 gene was detected in one K. pneumoniae and one A. baumannii isolate, which carried an additional OXA-51 gene. Genes for ESBLs were detected in 81.5% (n=22) isolates as follows: TEM 77.2% (n=17), CTX-M-1-group 68.2% (n=15), SHV-group 27.3% (n=6) and CTX-M-9-group 9.1% (n=2). Clinical treatment data revealed ineffective antimicrobial treatment in 13 of 18 (72.2%) patients.ConclusionWe report a high prevalence of ESBL-producing bacteria (81.5%) and carbapenem-resistance (7.4%), with more than half of the GNB carrying two or more ESBL genes resulting in sub-optimal empiric antibiotic therapy. These findings indicate a need for local and national antimicrobial resistance surveillance and strengthening of antimicrobial stewardship programs.

scholarly journals Antimicrobial Susceptibility Pattern of Gram-Negative Bacterial Isolates from Raw Chicken Meat Samples

2019 ◽  
Vol 6 ◽  
pp. 89-95
Author(s):  
Neha Gautam ◽  
Rojan Poudel ◽  
Binod Lekhak ◽  
Milan Kumar Upreti
Keyword(s):  
Antimicrobial Resistance ◽  
Pathogenic Bacteria ◽  
Chicken Meat ◽  
Food Microbiology ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Kathmandu Valley ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Meat Samples

Objectives: This research aims to study the microbial quality of chicken meat available in retail shop of Kathmandu Valley. Methods:  This Study was conducted from June to December 2018 in three different districts of Kathmandu Valley. Samples were collected in sterile plastic bags, labeled properly and stored in an icebox and transported to the Food Microbiology laboratory of Golden Gate International College.  During sample preparation, 25 grams of each sample was taken and transferred to sterile flasks containing 225 ml of buffered peptone water. Potential pathogenic Gram-negative bacteria were isolated by using respective selective media and identified by biochemical test. Antibiotic susceptibility profile of isolates was carried out by Kirby-Bauer disc diffusion method according to CLSI 2017 guideline. Results: Of total 81 chicken meat samples processed; 201 Gram negative bacteria were isolated.  E. coli (100%) was the dominant Gram-negative isolates, followed by Citrobacter spp (62.96%), Pseudomonas spp (40.74%), Proteus spp (19.75%), Salmonella spp (16.04%) and Klebsiella spp (8.64%) respectively. No any multidrug isolates were detected. Conclusion: The study showed that the raw chicken meat samples of Kathmandu valley was highly contaminated with Gram negative potential pathogenic bacteria. Antimicrobial resistance pattern shown by the isolates may indicates that there is not overuse of drug in animals and the less chance of risk of increasing antimicrobial resistance.

89 Antimicrobial Resistance Pattern and Prevalence of Extended Spectrum Beta-lactamase in Non-fermenting Gram Negative Bacteria, Isolated from Burn Wounds: A Prospective Study from a Tertiary Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S59-S60 ◽  
Author(s):  
Niyousha Naderi ◽  
Armin Safdarpour ◽  
Mojdeh Hakemi-Vala ◽  
Hossein Masoomi
Keyword(s):  
Antimicrobial Resistance ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Gram Negative ◽  
Burn Wounds ◽  
Extended Spectrum Beta Lactamase ◽  
Burn Center ◽  
Thermal Injuries ◽  
New Strategies

Abstract Introduction Burn wound infections are one of the major causes for long-term hospitalization and mortality among patients with thermal injuries. Identifying the bacterial cause of infection and determining the appropriate antibiotic to treat these infections is an important stage in treatment. The aim of this study was to investigate antimicrobial drug resistance in non-fermenting gram-negative bacteria isolated from burn wounds in patients who were admitted to a tertiary burn center. Methods In this prospective study during a six-month period in 2018,100 isolates of non-fermenting gram-negative bacteria were collected from 100 patients with thermal injuries. Antibiotic susceptibility test was performed using the Kirby-Bauer method based on the clinical and laboratory standards institute guidelines. Double-disc synergy test, a phenotypic method, was used to identify strains producing extended-spectrum beta-lactamase (ESBL). Data analyses were performed using SPSS. Results A total of 100 wound samples were examined from 100 patients, 76% were male and 24% were female with a mean age of 33 years (range 1–89 years old). Mean total body surface area burned was 35% (range 1–95%) and mean length of hospital stay was 24 days (range 3–69 days). Eighty five percent of cases were under 50 years old. Overall mortality rate in this study was 17%. The major causes of burn were liquefied natural gas tank explosion (35%) and scalds (19%). Acinetobacter baumannii (A.baumannii) was the most common pathogen followed by Pseudomonas aeruginosa (P.aeruginosa) (60% and 40%, respectively). ESBL producing rate was significantly higher in P.aeruginosa isolates (27.5%) than A.baumannii isolates (3.3%) (P-value < 0.001). Antibiotic resistance pattern of P.aeruginosa showed the highest resistance to ciprofloxacin, amikacin and imipenem (95%), followed by gentamicin (92.9%),ceftazidime(87.50) and piperacillin-tazobactam(85%). Antibiotic resistance pattern of A.baumannii showed the highest resistance to ceftazidime(100%) followed by ciprofloxacin, amikacin, imipenem(98.3%), gentamicin and piperacillin-tazobactam (93.3%). Multiple drug resistance (MDR) rate among A.baumannii and P.aeruginosa was 98.3% and 92.5% respectively, which is higher than previous reports. Conclusions A.baumannii and P.aeruginosa were the most common pathogens identified in this cohort with a significant MDR rate (over 95%). New strategies to control expansion of antimicrobial resistance in burn centers are necessary. Applicability of Research to Practice This study shows the antimicrobial resistance pattern and prevalence of ESBL in burn wounds indicating that further studies requires to identify new strategies to control emerging antimicrobial resistance in burn centers.

Occurrence of Multiple-Drug Resistance bacteria and their antimicrobial resistance patterns in burn infections from southwest of Iran

2021 ◽  
Author(s):  
Mohammad Hashemzadeh ◽  
Reza Heydari ◽  
Aram Asareh Zadegan Dezfuli ◽  
Morteza Saki ◽  
Hossein Meghdadi ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Multiple Drug Resistance ◽  
Bacterial Species ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Gram Negative Bacteria ◽  
Diverse Range ◽  
Gram Negative ◽  
Maximum Resistance ◽  
Resistance Patterns

Abstract Background Burn infection continues to be a major issue of concern globally and causes more harm to developing countries. This study aimed to identify the aerobic bacteriological profiles and antimicrobial resistance patterns of burn infections in three hospitals in Abadan, southwest Iran. Methods The cultures of various clinical samples obtained from 325 burn patients were investigated from January to December 2019. All bacterial isolates were identified based on the standard microbiological procedures. Antibiotic susceptibility tests were performed according to the CLSI. Results A total of 287 bacterial species were isolated burn patients.P. aeruginosa was the most frequent bacterial isolate in Gram-negative bacteria and S. epidermidis was the most frequent species isolated in Gram-positive bacteria. The maximum resistance was found to ampicillin, gentamicin, ciprofloxacin, while in Gram-negative bacteria, the maximum resistance was found to imipenem, gentamicin, ciprofloxacin, ceftazidime, and amikacin. The occurrence of multidrug resistance phenotype was as follows: P. aeruginosa (30.3 %), Enterobacter spp (11.1 %), Escherichia coli (10.5 %), Citrobacter spp (2.1 %), S. epidermidis (2.8 %), S. aureus, and S. saprophyticus (0.7 %). Conclusion Owing to the diverse range of bacteria that because burn wound infection, regular investigation, and diagnosis of common bacteria and their resistance patterns is recommended to determine the proper antibiotic regimen for appropriate therapy.

Bacteriological Profiles with Antibiotic Susceptibility Pattern in Different Clinical Specimens of Specialized Neuroscience Hospital of Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 82-86
Author(s):  
Uzzwal Kumar Mallick ◽  
Mohammad Abdullah Yusuf ◽  
Md Sirajul Islam ◽  
Abu Nayeem ◽  
Gurudas Mondal
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Main Challenge ◽  
High Dependency ◽  
General Wards

Background: Throughout the world multi-drug resistant hospital acquired infections (HAI) are one of the leading causes of deaths and morbidity amongst hospitalized patients. Objective: The aim of study was to identify prevalence and variations of predominant microorganisms and their drug sensitivity and resistance pattern in a tertiary care public hospital, Dhaka, Bangladesh. Methodology: The study was conducted in Intensive Care Unit (ICU), High Dependency Unit (HDU), Post-operative ward and general wards of a tertiary care publicNeuro- hospital in Dhaka during 1st January, 2017 to 31st December, 2018. Patients admitted in any of the four units (ICU, HDU, Post-operative and general wards) of the hospital who were clinically suspected of having acquired any infection after 48 hours of admission to the ICUs were included. Depending on the clinical suspicion laboratory samples were collected from the patients. Samples were subjected to the testing and antibiotic sensitivity. Results: A total number of total 1672 samples from these patients yielded clinically relevant microorganisms. Of these samples, 273 were respiratory specimens were tracheal aspirate; 537 were urine; 377 were blood; 396 were cerebrospinal fluids; and 82 were other clinical samples. More than two-third samples were growth negative (71.4%) and only one-thirdsamples (28.6%) were growth positive. Maximum growth negative in blood samples and about half of samples of urine and tracheal aspirates were growth negative. About 80% were Gram-negative bacteria like Escherichia coli, Pseudomonas spp., Klebsiella whereas gram-positive organisms were about 20%. Most of the pathogens were Multi-drug resistance. Conclusion: Among HAIs Multidrug-resistant Gram-negative bacteria are the main challenge. Regular updating resistance of microbial are needed to develop antibiotic guideline to combat these infections and reduce morbidity and mortality. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 82-86

scholarly journals Pattern of antimicrobial resistance of Gram-negative bacilli in surgical site infections in in-patients and out-patients at an apex trauma Center: 2013–2016

2018 ◽  
Vol 10 (04) ◽  
pp. 432-436 ◽  
Author(s):  
Nidhi Bhardwaj ◽  
Surbhi Khurana ◽  
Minu Kumari ◽  
Rajesh Malhotra ◽  
Purva Mathur
Keyword(s):  
Antimicrobial Resistance ◽  
Hospital Stay ◽  
Surgical Site Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
Resistance Patterns ◽  
Mueller Hinton Agar

ABSTRACT INTRODUCTION: Antimicrobial resistance is an increasing problem worldwide especially among the surgical site infections (SSIs). SSI is becoming more serious due to hospital-acquired infections/nosocomial infections, which further leads to the overuse of broad-spectrum antibiotics. To investigate the antimicrobial resistance patterns among Gram-negative bacteria in SSI in in- and out-patients the present study was designed. METHODOLOGY: During the 4 years (January 2013–December 2016), the antimicrobial resistant pattern was studied in the admitted patients and in the patients who were followed up to the outpatients department (OPD) after discharge. Antimicrobial resistance pattern testing was done by the disk diffusion method on Mueller-Hinton agar and by E-test for ten antibiotics according to The Clinical and Laboratory Standards Institute guidelines for Gram-negative bacilli. RESULTS: A total of 2,447 strains were isolated from the studied population on over the period of 4 years. Of 2447, 1996 (81%) were isolated from patients who had SSI during the hospital stay, and 451 (18%) were from patients who attended the OPD after discharge. In the outpatients, who followed up in the OPD for the SSI, Escherichia coli (148), and Pseudomonas aeruginosa (93), whereas in the patients who develop SSI during their hospital stay, Acinetobacter baumannii (622), E. coli (424), and Klebsiella pneumoniae (315) were found to be common. A very high resistance pattern was observed in both the studied groups; however, a higher resistance pattern was seen in in-patients as compared to outpatients. CONCLUSION: In our study, we have reported resistance pattern in Gram-negative bacteria isolated from the patients who were came for the follow as well as in the inpatients. For the outpatients, it can be concluded that it could be a community-acquired infection which is also an alarming condition for our society.

scholarly journals 2018-2019 Antimicrobial Resistance Pattern in Bacterial Pneumonia at Dr. Soedarsono Hospital Pasuruan

2020 ◽  
Vol 2 (1) ◽  
pp. 41-48
Author(s):  
Felicia Susanto ◽  
◽  
Catur Purnamawati ◽  
Devvi Riasari ◽  
◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Bacterial Pneumonia ◽  
Sputum Culture ◽  
World Health ◽  
Resistance Pattern ◽  
Common Disease ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative

Pneumonia is the ninth most common disease in dr. Soedarsono Pasuruan Region General Hospital. The resistance of Klebsiella pneumoniae to third-generation Cephalosporins and Streptococcus pneumonia to Penicillin were the topics discussed on World Health Organization’s (WHO) global report for antimicrobial resistance. This study purpose is to analyze the microbial pattern and antimicrobial resistance of bacterial pneumonia from sputum culture. This is a descriptive retrospective study with a total of 59 requests for sputum culture which included a clinical diagnosis of pneumonia. There are 37 male (63%) and 22 female (37%) with the most age group was adult (18-59 years) 39 people (66%) included in this study. Gram-negative bacteria are more common as the cause of pneumonia than gram-positive. Gram-negative bacteria that caused pneumonia in this study are Klebsiella pneumoniae (25.4%), Acinetobacter baumannii (15.3%), dan Enterobacter cloacae complex (15.3%). Gram-positive are Staphylococcus haemolyticus (11.9%), Staphylococcus aureus (8.5%), and Staphylococcus epidermidis (8.5%). The most antimicrobial resistance in gram-negative bacteria is Ampicillin (94.3%) and gram-positive bacteria are Benzylpenicillin (94.1%). The number resistance of Penicillin in gram-negative and gram-positive was high; therefore empirical therapy for pneumonia still uses broad-spectrum antimicrobial like beta-lactam.

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