Species distribution and antimicrobial susceptibility profile of gram-negative bacteria in hospitalized cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20730-e20730
Author(s):  
H. M. Ashour ◽  
A. El-Sharif
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Cancer Patients ◽  
Solid Tumor ◽  
Klebsiella Pneumonia ◽  
Gram Negative Bacteria ◽  
Isolation And Identification ◽  
Tumor Patients ◽  
Acinetobacter Species ◽  
Gram Negative

e20730 Background: Nosocomial infections pose significant threats to hospitalized patients, especially the immunocompromised ones, such as cancer patients. Methods: This study examined the microbial spectrum of gram-negative bacteria in various infection sites in patients with leukemia and solid tumors. The antimicrobial resistance patterns of the isolated bacteria were studied. Results: The most frequently isolated gram-negative bacteria were Klebsiella pneumonia (31.2%) followed by Escherichia coli (22.2%). We report the first-time isolation and identification of a number of less-frequent gram negative bacteria (Chromobacterium violacum, Burkholderia cepacia, Kluyvera ascorbata, Stenotrophomonas maltophilia, Yersinia pseudotuberculosis, and Salmonella arizona). Most of the gram-negative isolates from RTI, GITI, UTI, and BSI were obtained from leukemic patients. All gram-negative isolates from SI were obtained from solid-tumor patients. In both leukemic and solid-tumor patients, gram-negative bacteria causing UTI were mainly Escherichia coli and Klebsiella pneumoniae, while gram-negative bacteria causing RTI were mainly Klebsiella pneumoniae. Escherichia coli was the main gram-negative pathogen causing BSI in solid-tumor patients and GITI in leukemic patients. Isolates of Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, and Acinetobacter species were resistant to most antibiotics tested. There was significant imipenem-resistance in Acinetobacter (40.9%), Pseudomonas (40%), and Enterobacter (22.2%) species, and noticeable imipinem-resistance in Klebsiella (13.9%) and Escherichia coli (8%). Conclusions: This is the first study to report the evolution of imipenem-resistant gram-negative strains in Egypt. Mortality rates were higher in cancer patients with nosocomial Pseudomonas infections than any other bacterial infections. Policies restricting antibiotic consumption should be implemented to avoid the evolution of newer generations of antibiotic resistant-pathogens. No significant financial relationships to disclose.

scholarly journals National Surveillance of Antimicrobial Susceptibility of Bacteremic Gram-Negative Bacteria with Emphasis on Community-Acquired Resistant Isolates: Report from the 2019 Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART)

2020 ◽  
Vol 64 (10) ◽  
Author(s):  
Po-Yu Liu ◽  
Yu-Lin Lee ◽  
Min-Chi Lu ◽  
Pei-Lan Shao ◽  
Po-Liang Lu ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Gram Negative Bacteria ◽  
National Surveillance ◽  
Gram Negative ◽  
Content Type ◽  
E Coli ◽  
Carbapenem Resistant

ABSTRACT A multicenter collection of bacteremic isolates of Escherichia coli (n = 423), Klebsiella pneumoniae (n = 372), Pseudomonas aeruginosa (n = 300), and Acinetobacter baumannii complex (n = 199) was analyzed for susceptibility. Xpert Carba-R assay and sequencing for mcr genes were performed for carbapenem- or colistin-resistant isolates. Nineteen (67.8%) carbapenem-resistant K. pneumoniae (n = 28) and one (20%) carbapenem-resistant E. coli (n = 5) isolate harbored blaKPC (n = 17), blaOXA-48 (n = 2), and blaVIM (n = 1) genes.

scholarly journals A survey on gram-negative bacteria in saffron finches (Sicalis flaveola) from illegal wildlife trade in Brazil

2016 ◽  
Vol 53 (3) ◽  
pp. 286 ◽  
Author(s):  
Yamê Miniero Davies ◽  
Marta Brito Guimarães ◽  
Liliane Milanelo ◽  
Maria Gabriela Xavier de Oliveira ◽  
Vasco Túlio De Moura Gomes ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Klebsiella Oxytoca ◽  
Enterobacter Cloacae ◽  
Wildlife Trade ◽  
Gram Negative Bacteria ◽  
Citrobacter Freundii ◽  
Gram Negative ◽  
Illegal Wildlife Trade ◽  
Serratia Liquefaciens

No Estado de São Paulo, Brasil, os pássaros como os canários-da-terra têm sido uma das espécies mais frequentemente resgatadas do tráfico illegal e enviadas aos centros de vida selvagem. Em situações de estresse estas aves podem ser acometidas por infecções causadas por bactérias oportunistas. Este fato é de grande importância quando é planejada da reintrodução das aves na natureza. O presente trabalho foi delineado para avaliar o estado de saúde de canários-da-terra resgatados do tráfico ilegal. Foram colhidas soabes da traqueia e da cloaca de 100 aves resgatadas durante os anos de 2012 e 2013. Os resultados obtidos revelaram alta frequência de bactérias gram-negativas nas fezes e no orofaringe dos animais, com maior frequência para os membros da família Enterobacteriaceae (97,5%). Os gêneros mais frequentes foram Escherichia coli (46,55) e Klebsiella pneumoniae (10,4%). Outros microorganismos incluindo Enterobacter cloacae, Serratia liquefaciens, Serratia spp, Klebsiella oxytoca e Citrobacter freundii também foram isolados em menor frequencia de aves assintomáticas. A presença de estirpes de Escherichia coli enteropagênicas (EPEC) e as produtoras da toxina de Shiga confirmam o risco de zoonose e a importância para saúde pública deste tipo de ave. 

scholarly journals Isolasi dan Identifikasi Bakteri Gram Negatif pada Uterus Sapi Aceh yang Mengalami Repeat Breeding

2020 ◽  
Vol 20 (2) ◽  
Author(s):  
Indi Rafika ◽  
Cut Nila Thasmi ◽  
Herrialfian Herrialfian ◽  
Rosmaidar Rosmaidar ◽  
Hafizuddin Hafizuddin
Keyword(s):  
Escherichia Coli ◽  
Nutrient Broth ◽  
Gram Negative Bacteria ◽  
Pseudomonas Sp ◽  
Isolation And Identification ◽  
Gram Negative ◽  
E Coli ◽  
Identification Of Bacteria

ABSTRAK. Penelitian ini bertujuan mengetahui jenis bakteri Gram negatif pada uterus sapi Aceh yang mengalami kawin berulang. Dalam penelitian ini digunakan enam ekor sapi Aceh betina yang terdiri atas tiga ekor sapi fertil (K1) dan tiga ekor yang mengalami kawin berulang (K2, repeat breeding, RB). Pengambilan sampel bakteri dalam uterus sapi dilakukan dengan menggunakan swab steril yang disimpan dalam media nutrient broth (NB) untuk isolasi dan identifikasi jenis bakterinya. Berdasarkan hasil penelitian, baik K1 dan K2, positif terinfeksi bakteri dan diperoleh 16 isolat bakteri di antaranya enam isolat berasal dari K1 dan sepuluh isolat berasal dari K2. Dari 10 isolat bakteri Gram negatif yang ditemukan pada sapi RB terdiri atas Escherichia coli (E. coli) (30,00%), Pseudomonas sp. (30,00%), Enterobacter sp. (20,00%), Klebsiella sp. (20,00%). Disimpulkan bahwa bakteri yang paling banyak menginfeksi uterus sapi RB adalah E. coli dan Pseudomonas sp. (Isolation and identification of gram negative bacteria in uterine Aceh cow with repeat breeding) ABSTRACT. The study determined the type of Gram negative bacteria of the Aceh cattle uterus which has been diagnosed with repeat breeding. The study was conducted on six Aceh cows consists of 3 normal fertile cows (K1) and 3 repeat breeding cows (K2, RB). The bacteria in uterine samples were collected using sterile swab, kept into nutrient broth (NB) for further isolation and identification of bacteria. The result of the study showed that the total of 16 isolates of bacteria was observed in all cows : 6 isolates from group K1 and 10 isolates from group K2. A total of 10 isolates from cattle with repeat breeding consist of Escherichia coli (E. coli) (30.00%), Pseudomonas sp (30.00%), Enterobacter sp (20.0%), and Klebsiella sp (20.0%). It can be concluded that the most bacteria that infect uterine cows with repeat breeding are E. coli and Pseudomonas sp.

scholarly journals Determination of Patulin By TLC From Mouldy Apples

2010 ◽  
Vol 34 (1) ◽  
pp. 201-207
Author(s):  
Omar J. Al saree
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Inhibitory Effect ◽  
Gram Negative Bacteria ◽  
Zone Of Inhibition ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Tlc Plates

Analysis of the decayed apples (van. Starking delicious), collected from the localmarket, for patulin mycotoxin, using column chromotography and TLC Plates showedthat the presence of the amount of patulin mycotoxin in the mouldy tissues (1.3 , 2.5 ,3.4 , 4.2, 5.5, and 6.4 ) cm in diameters were (5.1, 5.8, 6.3, 10.5, 12.3, and 14 ) μgpatulin/g moldy tissues respectively. According to this research also, Patulinmycotoxin could diffused to the surrounding mouldy tissues. It is found that (0.5and0.2), (1.0 and 0.5), and (1.5 and 0.5) μg patulin/g tissues in the first and secondcentimeters after mouldy tissues 4.2, 5.5 and 6.4 cm respectively, this phenomenondue to the presence of intracellular spaces in the tissues which allow to patulin todiffuse from mouldy to the healthy tissues there was no patulin found in the othersurrounding healthy tissues. Gram positive bacteria found to be more susceptible topatulin, the zone of inhibition against Staphyllococcus aureus was 10 to 11 mm indiameter at concentration 10 and 30 mg /ml respectively when compared with 0.3μg/ml streptomycin and 0.06 μg/ml ciprofloxacin while no inhibitory effect foundagainst Gram negative bacteria Klebsiella pneumoniae and Escherichia coli

scholarly journals Bacteriological Profile, Antibiotic Susceptibility Pattern and Predictors of bacteremia among Children with Bloodstream Infection

2021 ◽  
Author(s):  
Samina Nazir Chaki ◽  
Levina Msuya ◽  
Deborah Mchaile ◽  
Michael Johnson Mahande ◽  
Ronald Mwitalemi Mbwasi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Bloodstream Infection ◽  
Antibiotic Susceptibility ◽  
Klebsiella Pneumonia ◽  
Gram Negative Bacteria ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative

Abstract Background: Bloodstream infections are major causes of morbidity and mortality among children in Sub-Saharan countries. This study aimed to determine the prevalence of bacteremia, etiological agents’ antibiotic susceptibility pattern and predictors of bacteremia among children with bloodstream Infection.Methodology: This hospital-based cross-section study involved children aged two months to thirteen years. All children meeting the inclusion criteria during the study period were enrolled. All consenting parents were interviewed via a questionnaire to collect data, followed by a thorough physical assessment and venipuncture was done to collect blood samples. Data were analysed using SPSS version 23.Results: Among 242 study participants, 154(63.6%) were male and blood cultures were positive in 37(15.3%). Gram-positive and gram-negative bacteria constituted 32(80%) and 8(20%), respectively. The frequent pathogen found was Staphylococcus aureus 25(62.5%), followed by Enterococcus spp. 4(10%), Escherichia coli 4(10%), Pseudomonas aeruginosa 3(7.5%), Streptococcus pyogenes 3(7.5%) and 1(2.5%) Klebsiella pneumonia. The majority of bacterial isolates showed high resistance to commonly used antibiotics in the study area. Predictors of bacteremia were severe malnutrition, hydrocephalus, hyperglycemia, lethargy and BSI with no foci of infection. Conclusion: Prevalence of bacteremia was 15.3%. Gram-positive bacteria were more prevalent than gram-negative bacteria. Staphylococcus aureus and Escherichia coli were the prevalent isolates causing BSI. Effective antibiotics for both gram-negative & gram-positive organisms are imipenem, meropenem and piperacillin-tazobactam followed by amikacin; vancomycin & clindamycin for gram-positive organisms. To curb the growing antimicrobial resistance that we see in this and other studies, continuous antimicrobial stewardship is necessary, else we risk failing to treat BSI.

scholarly journals Bryndza cheese of Slovak origin as potential resources of probiotic bacteria

10.5219/1413 ◽  
2020 ◽  
Vol 14 ◽  
pp. 641-646
Author(s):  
Miroslava Kačániová ◽  
Petra Borotová ◽  
Margarita Terenjeva ◽  
Simona Kunová ◽  
Soňa Felsöciová ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Lactic Acid ◽  
Listeria Monocytogenes ◽  
Lactic Acid Bacteria ◽  
Klebsiella Pneumoniae ◽  
Enterococcus Faecalis ◽  
Yersinia Enterocolitica ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative

Bryndza cheese includes several predominant lactic acid bacteria. The aim of our study was the antagonistic effect of lactic acid bacteria supernatant isolated from ewes´ cheese bryndza against ten Gram-positive and Gram-negative bacteria. Isolated strains of bacteria were obtained from bryndza which were produced in five different regions of Slovakia. Isolated strains of lactic acid bacteria were identified with mass spectrometry MALDI-TOF MS Biotyper. A total of one hundred and thirty lactic bacteria include Enterococcus faecalis, Enterococcus faecium, Enterococcus hirae, Lactobacillus brevis, Lactobacillus harbinensis, Lactobacillus johnsonii, Lactobacillus plantarum, Lactobacillus paracasei ssp. paracasei, Lactobacillus paraplantarum, Lactobacillus suebicus, Lactococcus lactis ssp. lactis, Lactococcus lactis, and Pediococcus acidilactici were tested in this study against Gram-negative bacteria: Escherichia coli CCM 3988, Klebsiella pneumoniae CCM 2318, Salmonella enterica subsp. enterica CCM 3807, Shigella sonnei CCM 1373, Yersinia enterocolitica CCM 5671 and Gram-positive bacteria: Bacillus thuringiensis CCM 19, Enterococcus faecalis CCM 4224, Listeria monocytogenes CCM 4699, Staphylococcus aureus subsp. aureus CCM 2461, Streptococcus pneumonia CCM 4501 with agar diffusion method. Lactic acid bacteria showed activity 92% against Yersinia enterocolitica, 91% against Klebsiella pneumoniae, 88% against Escherichia coli, 84% against Listeria monocytogenes. The most effective bacteria against Gram-positive and Gram-negative bacteria tested was Lactobacillus paracasei ssp. paracasei.

MULTI-RESISTANT CARBAPENEM-INSENSITIVE GRAMNEGATIVE BACTERIA IN PATIENTS WITH SOLID TUMORS

2017 ◽  
Vol 63 (5) ◽  
pp. 780-784
Author(s):  
Anna Polishchuk ◽  
Yelena Yakubovich ◽  
Viktor Osovskikh ◽  
Vladimir Yevtushenko ◽  
O. Polukhina
Keyword(s):  
Cancer Patients ◽  
Solid Tumors ◽  
Antimicrobial Agents ◽  
Distinct Species ◽  
Multidrug Resistant ◽  
Klebsiella Pneumonia ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Wide Range ◽  
Genes Encoding

Infections caused by multiresistant gram-negative bacteria are one of the major problems in the treatment of cancer patients. Strains with mechanisms of resistance mediated by carbapenemases represent a particular threat since they spread rapidly and are characterized by high frequency of occurrence of multiresistance to antimicrobial agents. Here we show that 14 out of 399 gram-negative bacteria (3,5 %), isolated from clinical specimens of 11 patients with solid tumors (n=581) in a hospital of federal level in January 2015-April 2016 were carbapenem-insusceptible. Among them 3 isolates of Klebsiella pneumonia, 2 Enterobacter cloacae, 2 Pseudomonas aeruginosa and 7 Acinetobacter baumannii. All 14 strains were resistant to a wide range of antimicrobial agents including beta-lactams, aminoglycosides, monobactams and fluoroquinolones. The only antimicrobial agent to which all but one Exloacae strain remained susceptible was colistin. This strain was insusceptible to all 10 antimicrobial agents tested in the study, including tigecycline. We observed two cases of infection of a single patient by 2-3 distinct species of multidrug-resistant gram-negative bacteria. In 79 % of the strains the genes encoding carbapenemases of OXA40/24, KPC, VIM and NDM types were detected. Despite the fact that multidrug-resistant car-bapenem-insusceptible strains of gram-negative bacteria were isolated from a relatively small number of cancer patients, the majority of these strains represent a particular epidemiological and clinical threat.

scholarly journals Genomic and Resistance Epidemiology of Gram-Negative Bacteria in Africa: a Systematic Review and Phylogenomic Analyses from a One Health Perspective

mSystems ◽  
2020 ◽  
Vol 5 (6) ◽  
Author(s):  
John Osei Sekyere ◽  
Melese Abate Reta
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Vibrio Cholerae ◽  
Salmonella Enterica ◽  
Animal Health ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Content Type

ABSTRACT Antibiotic resistance (AR) remains a major threat to public and animal health globally. However, AR ramifications in developing countries are worsened by limited molecular diagnostics, expensive therapeutics, inadequate numbers of skilled clinicians and scientists, and unsanitary environments. The epidemiology of Gram-negative bacteria, their AR genes, and geographical distribution in Africa are described here. Data were extracted and analyzed from English-language articles published between 2015 and December 2019. The genomes and AR genes of the various species, obtained from the Pathosystems Resource Integration Center (PATRIC) and NCBI were analyzed phylogenetically using Randomized Axelerated Maximum Likelihood (RAxML) and annotated with Figtree. The geographic location of resistant clones/clades was mapped manually. Thirty species from 31 countries and 24 genera from 41 countries were analyzed from 146 articles and 3,028 genomes, respectively. Genes mediating resistance to β-lactams (including blaTEM-1, blaCTX-M, blaNDM, blaIMP, blaVIM, and blaOXA-48/181), fluoroquinolones (oqxAB, qnrA/B/D/S, gyrA/B, and parCE mutations, etc.), aminoglycosides (including armA and rmtC/F), sulfonamides (sul1/2/3), trimethoprim (dfrA), tetracycline [tet(A/B/C/D/G/O/M/39)], colistin (mcr-1), phenicols (catA/B, cmlA), and fosfomycin (fosA) were mostly found in Enterobacter spp. and Klebsiella pneumoniae, and also in Serratia marcescens, Escherichia coli, Salmonella enterica, Pseudomonas, Acinetobacter baumannii, etc., on mostly IncF-type, IncX3/4, ColRNAI, and IncR plasmids, within IntI1 gene cassettes, insertion sequences, and transposons. Clonal and multiclonal outbreaks and dissemination of resistance genes across species and countries and between humans, animals, plants, and the environment were observed; Escherichia coli ST103, K. pneumoniae ST101, S. enterica ST1/2, and Vibrio cholerae ST69/515 were common strains. Most pathogens were of human origin, and zoonotic transmissions were relatively limited. IMPORTANCE Antibiotic resistance (AR) is one of the major public health threats and challenges to effective containment and treatment of infectious bacterial diseases worldwide. Here, we used different methods to map out the geographical hot spots, sources, and evolutionary epidemiology of AR. Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp., Neisseria meningitis/gonorrhoeae, Vibrio cholerae, Campylobacter jejuni, etc., were common pathogens shuttling AR genes in Africa. Transmission of the same clones/strains across countries and between animals, humans, plants, and the environment was observed. We recommend Enterobacter spp. or K. pneumoniae as better sentinel species for AR surveillance.

scholarly journals Antibiotic resistance and detection of plasmid mediated colistin resistance mcr-1 gene among Escherichia coli and Klebsiella pneumoniae isolated from clinical samples

Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Deepa Karki ◽  
Binod Dhungel ◽  
Srijana Bhandari ◽  
Anil Kunwar ◽  
Prabhu Raj Joshi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Klebsiella Pneumoniae ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Drug Resistant ◽  
Colistin Resistance ◽  
Gram Negative ◽  
E Coli

Abstract Background The prevalence of antimicrobial resistance (AMR) among Gram-negative bacteria is alarmingly high. Reintroduction of colistin as last resort treatment in the infections caused by drug-resistant Gram-negative bacteria has led to the emergence and spread of colistin resistance. This study was designed to determine the prevalence of drug-resistance among beta-lactamase-producing strains of Escherichia coli and Klebsiella pneumoniae, isolated from the clinical specimens received at a tertiary care centre of Kathmandu, Nepal during the period of March to August, 2019. Methods A total of 3216 different clinical samples were processed in the Microbiology laboratory of Kathmandu Model Hospital. Gram-negative isolates (E. coli and K. pneumoniae) were processed for antimicrobial susceptibility test (AST) by using modified Kirby-Bauer disc diffusion method. Drug-resistant isolates were further screened for extended-spectrum beta-lactamase (ESBL), metallo-beta-lactamase (MBL), carbapenemase and K. pneumoniae carbapenemase (KPC) production tests. All the suspected enzyme producers were processed for phenotypic confirmatory tests. Colistin resistance was determined by minimum inhibitory concentration (MIC) using agar dilution method. Colistin resistant strains were further screened for plasmid-mediated mcr-1 gene using conventional polymerase chain reaction (PCR). Results Among the total samples processed, 16.4% (529/3216) samples had bacterial growth. A total of 583 bacterial isolates were recovered from 529 clinical samples. Among the total isolates, 78.0% (455/583) isolates were Gram-negative bacteria. The most predominant isolate among Gram-negatives was E. coli (66.4%; 302/455) and K. pneumoniae isolates were 9% (41/455). In AST, colistin, polymyxin B and tigecycline were the most effective antibiotics. The overall prevalence of multidrug-resistance (MDR) among both of the isolates was 58.0% (199/343). In the ESBL testing, 41.1% (n = 141) isolates were confirmed as ESBL-producers. The prevalence of ESBL-producing E. coli was 43% (130/302) whereas that of K. pneumoniae was 26.8% (11/41). Similarly, 12.5% (43/343) of the total isolates, 10.9% (33/302) of E. coli and 24.3% of (10/41) K. pneumoniae were resistant to carbapenem. Among 43 carbapenem resistant isolates, 30.2% (13/43) and 60.5% (26/43) were KPC and MBL-producers respectively. KPC-producers isolates of E. coli and K. pneumoniae were 33.3% (11/33) and 20% (2/10) respectively. Similarly, 63.6% (21/33) of the E. coli and 50% (5/10) of the K. pneumoniae were MBL-producers. In MIC assay, 2.2% (4/179) of E. coli and 10% (2/20) of K. pneumoniae isolates were confirmed as colistin resistant (MIC ≥ 4 µg/ml). Overall, the prevalence of colistin resistance was 3.1% (6/199) and acquisition of mcr-1 was 16.6% (3/18) among the E. coli isolates. Conclusion High prevalence of drug-resistance in our study is indicative of a deteriorating situation of AMR. Moreover, significant prevalence of resistant enzymes in our study reinforces their roles in the emergence of drug resistance. Resistance to last resort drug (colistin) and the isolation of mcr-1 indicate further urgency in infection management. Therefore, extensive surveillance, formulation and implementation of effective policies, augmentation of diagnostic facilities and incorporation of antibiotic stewardship programs can be some remedies to cope with this global crisis.

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