scholarly journals Study of aerobic and anaerobic bacterial profile of nosocomial infections and their antibiotic resistance in a referral center, Southwest Iran: A three year cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259512
Author(s):  
Nazanin Ahmadkhosravi ◽  
Azar Dokht Khosravi ◽  
Aram Asareh Zadegan Dezfuli ◽  
Mohammad Hashemzadeh ◽  
Morteza Saki ◽  
...  

Background The drug resistance is expected to be the most important challenge in infection control in Iran, where there is no local report or standard drug resistance monitoring system. Therefore, this study aimed to investigate the aerobic and anaerobic bacterial profile of nosocomial infections and their antibiotic resistance in Ahvaz, southwest Iran. Methodology The gram-positive and gram-negative bacteria were identified on the basis of conventional culture and biochemical tests. The antibiotic resistance of the bacterial isolates against antibiotics was determined by the disk diffusion method. Results Among total 1156 collected positive samples, E. coli and coagulase-negative staphylococci (CoNS) were the most frequent pathogenic gram negative bacteria (GNB) and gram positive bacteria (GPB) respectively. Drug susceptibility testing revealed that among GNB, P. aeruginosa was 100% resistant to amikacin, cefepime, ciprofloxacin and tetracycline. In the case of E. coli, the resistance rate was (98%) for trimethoprim sulfamethoxazole and cefepime. For GPB, S. aureus showed the highest resistance rates to amikacin (100%) and clindamycin (100%). In addition, CoNS strains showed a high level of resistance to doxycycline (100%), erythromycin (100%) and cefoxitin (97%). In Bacteroeides fragilis isolates, the highest resistance rate belonged to clindamycin (72%), and Clostridium perfringens strains showed high level of resistance to penicillin (46%). Conclusion The results highlighted that there are distinct factors leading to antimicrobial resistance in Ahvaz, southwest Iran. The primary contributors to the resistance development, include poor surveillance of drug-resistant infections, poor quality of available antibiotics, clinical misuse, and the ease of access to antibiotics. Moreover, similar factors such as self-medication and the lack of regulation on medication imports play a role in antibiotic resistance in the region.

Author(s):  
Amit Bhatia ◽  
Juhi Kalra ◽  
Saurabh Kohli ◽  
Barnali Kakati ◽  
Reshma Kaushik

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents. 


Author(s):  
N. Jyothsna ◽  
A. Ramya ◽  
K. Abhilash ◽  
Bathsa Liza Johnson

<p class="abstract"><strong>Background:</strong> Our study was done to determine the pattern of antibiotic resistance of various strains of bacteria causing acute tonsillitis.</p><p class="abstract"><strong>Methods:</strong> the study was a randomized cross sectional study. Patients matching the inclusion criteria were included. Duration of study was 6 months.</p><p class="abstract"><strong>Results:</strong> Out of 120 cases, 46 cases showed no bacterial growth (NBG) and 74 cases showed bacterial growth. 42 cases were gram-negative bacterial strain and 32 cases were positive bacterial strain out of 72 bacterial grown cases. A list of 25 antibiotic drugs in gram-negative and 31 drugs in gram-positive strain, their sensitivity and resistance were taken and noted. Among gram-negative bacteria imipenem (71.4%) showed highest sensitivity. Highest antibiotic resistance was seen in ampicillin (85.71%). Least sensitivity is observed in clindamycin, amoxicillin+clavulanic acid with 2.38%. Among gram-positive bacteria, highest sensitivity was noted in cefotaxime (75%). Highest antibiotic resistance was seen in cotrimoxazole (46.8%). Least sensitivity is observed in netilmicin, sulbactam with 3.12%.</p><p class="abstract"><strong>Conclusions:</strong> The number of drugs resistant to the gram-positive bacteria are lesser than number of drugs sensitive, which showed significant difference (p&lt;0.05). Significant difference of antibiotic drugs was not found in gram-negative bacteria. Our study findings helped in appropriate and guarded use of the antibiotic drugs in acute tonsillitis, minimizing the exposure of individuals to antibiotic resistance by choosing an appropriate sensitive drug, therefore improving the quality of therapy.</p>


2020 ◽  
Vol 65 (9) ◽  
pp. 562-566
Author(s):  
I. V. Shipitsyna ◽  
E. V. Osipova ◽  
O. A. Astashova ◽  
D. S. Leonchuk

The annual monitoring of the species composition of the causative agents of osteomyelitis, the identification of antibiotic-resistant strains, the study of the species composition of associations of microorganisms, their adhesive activity will prevent the spread of infection. Analyze the spectrum of the leading causative agents of osteomyelitis, their antibiotic sensitivity, and also the adhesive activity of the identified bacterial associations. A microbiological analysis of 2197 smears of adult patients with various etiological forms of osteomyelitis who were treated in the departments of the purulent center of the FSBI «NMRCTO» of the RF Ministry of Health in 2019. The spectrum of pathogenic microflora, sensitivity to standard antibacterial drugs used in the clinic was studied. The biofilm-forming ability of associations of microorganisms was investigated. According to the conducted microbiological monitoring for 2019, the microflora spectrum for osteomyelitis is diverse, the main pathogens are S. aureus, S. epidermidis, P. aeruginosa, K. pneumoniae, Enterococcus sp. A high percentage of isolation of microbial associations was noted, most often mix cultures of gram-positive and gram-negative bacteria. Bacterial associations: S. aureus + P. aeruginosa, S. aureus + S. marcescens, S. aureus + A. baumannii, S. epidermidis + E. cloacae - actively formed a biofilm on the surface of polystyrene plates, and the adhesive potential depended on interstrain relations in the composition of the formed biofilm. Among Gram-negative microflora, multiresistant strains prevail, among Gram-positive microflora - a high percentage of methicillin-resistant Staphylococci. When analyzing the antibiotic sensitivity of the isolated microorganisms, a high percentage of resistant strains is noted. So, with respect to enterobacteria, β-lactam antibiotics, drugs from the group of aminoglycosides, turned out to be ineffective. Among non-fermenting gram-negative bacteria, A. baumannii strains had multiple antimicrobial resistance. Among gram-positive microorganisms, a high percentage of isolation of methicillin-resistant staphylococci was noted. The specificity of the course of the disease and measures aimed at eliminating the pathogen depend on the species composition in the focus of infection. The study of the etiological structure of osteomyelitis, the monitoring of the antibiotic resistance of pathogens and their persistent potential, makes it possible to adopt sound tactics of conservative and surgical treatment.


2003 ◽  
Vol 376 (3) ◽  
pp. 801-805 ◽  
Author(s):  
Monique MALLÉA ◽  
Abdallah MAHAMOUD ◽  
Jacqueline CHEVALIER ◽  
Sandrine ALIBERT-FRANCO ◽  
Pierre BROUANT ◽  
...  

Over the last decade, MDR (multidrug resistance) has increased worldwide in microbial pathogens by efflux mechanisms, leading to treatment failures in human infections. Several Gram-negative bacteria efflux pumps have been described. These proteinaceous channels are capable of expelling structurally different drugs across the envelope and conferring antibiotic resistance in various bacterial pathogens. Combating antibiotic resistance is an urgency and the blocking of efflux pumps is an attractive response to the emergence of MDR phenotypes in infectious bacteria. In the present study, various alkylaminoquinolines were tested as potential inhibitors of drug transporters. We showed that alkylaminoquinolines are capable of restoring susceptibilities to structurally unrelated antibiotics in clinical isolates of MDR Gram-negative bacteria. Antibiotic efflux studies indicated that 7-nitro-8-methyl-4-[2´-(piperidino)ethyl]aminoquinoline acts as an inhibitor of the AcrAB–TolC efflux pump and restores a high level of intracellular drug concentration. Inhibitory activity of this alkylaminoquinoline is observed on clinical isolates showing different resistance phenotypes.


Molecules ◽  
2021 ◽  
Vol 26 (7) ◽  
pp. 1954
Author(s):  
Charlotte M. J. Wesseling ◽  
Thomas M. Wood ◽  
Kristine Bertheussen ◽  
Samantha Lok ◽  
Nathaniel I. Martin

The continued rise of antibiotic resistance threatens to undermine the utility of the world’s current antibiotic arsenal. This problem is particularly troubling when it comes to Gram-negative pathogens for which there are inherently fewer antibiotics available. To address this challenge, recent attention has been focused on finding compounds capable of disrupting the Gram-negative outer membrane as a means of potentiating otherwise Gram-positive-specific antibiotics. In this regard, agents capable of binding to the lipopolysaccharide (LPS) present in the Gram-negative outer membrane are of particular interest as synergists. Recently, thrombin-derived C-terminal peptides (TCPs) were reported to exhibit unique LPS-binding properties. We here describe investigations establishing the capacity of TCPs to act as synergists with the antibiotics erythromycin, rifampicin, novobiocin, and vancomycin against multiple Gram-negative strains including polymyxin-resistant clinical isolates. We further assessed the structural features most important for the observed synergy and characterized the outer membrane permeabilizing activity of the most potent synergists. Our investigations highlight the potential for such peptides in expanding the therapeutic range of antibiotics typically only used to treat Gram-positive infections.


2013 ◽  
Vol 7 (2) ◽  
pp. 13-16
Author(s):  
Durdana Chowdhury ◽  
Sanya Tahmina Jhora ◽  
Mili Rani Saha ◽  
Najmun Nahar

Bacterial pathogens were isolated from  pus, wound swab, urine, blood and throat swab. A total  of 300 samples were collected from Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), BIRDEM and National Medical College (NMCH) and processed following standard microbiological methods. Antibiotic susceptibility testing were performed on pure culture isolates by employing Kirby-Bauer disc-diffusion method for the commonly used antibiotics. 326 (93.33%) bacterial pathogens were isolated from 300 patients. Single bacterial pathogen was present in 78% cases and mixed bacterial pathogens were in 15.40% cases.  Staphylococcus aureus was the predominant species (38.66%) followed by Escherichia coli (38%), Pseudomonas spp. (13.33%), Proteus spp. (8.33%), CoNS (7.66%), Serratia spp (2.85%), Klebsiella spp. (2.00%) and  Acinetobacter spp. (0.97%). Resistance rate towards amoxicillin, ciprofloxacin, co-trimoxazole and  ceftriaxone were high among both Gram-positive and Gram-negative isolates. However, both groups showed good susceptibility to gentamicin and levofloxacin. S. aureus and CoNS showed 100% sensitivity to vancomycin and all isolated Gram negative organisms showed 98-100% sensitivity to imipenem.These results indicate that gentamicin and levofloxacin may be convenient alternative antimicrobial agent for both Gram-positive and Gram-negative bacteria and vancomycin for Gram positive and imipenem for Gram negative bacteria as well.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19327 Bangladesh J Med Microbiol 2013; 07(02): 13-16


2018 ◽  
Vol 2 (1) ◽  

Background: The intensive care units are epicenters for the emergence of antibiotic resistant Gram-negative bacteria because of the high use of antibiotics, prolonged hospital stay, reduced patient immunity, use of medical devices, and the frequent contact between healthcare workers and patients. Surveillance of bacterial resistance is the key element to understand the size of the problem, drive interventions, and measures the effect of these measures. Several reports have linked the use of third generation cephalosporins with β-lactam resistance in gram-negative bacteria. Several strategies were introduced by the Antibiotic Stewardship Programs to reduce antibiotic resistance but the efficacies of these interventions are not well studied. Methods: The Microbiology Laboratory of Hamad Medical Corporation (HMC) monitors antimicrobial resistance by continuous surveillance using the National Committee for Clinical Laboratory Standards (NCCLS) - currently Clinical Laboratory Standards Institute interpretive criteria. Surveillance data were released annually and shared with clinicians and policy makers for review of the antibiotic policy and the antibiotic formulary. Results: Surveillance data in 2001 showed high level β-lactam antibiotics resistance and high level production of extended spectrum β-lactamases (ESBL) among gram-negative bacteria. As a result, the Hospital Antibiotic Policy Committee decided to withdraw ceftazidime a third –generation cephalosporin known to be a strong inducer of ESBL, from the hospital formulary. Subsequent resistance surveillance over the following three years in the Medical Intensive Care unit (MICU) demonstrated a gradual drop in the resistance of Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli; the commonest isolated gram negative bacteria from MICU), not only to third and fourth generation cephalosporins, but also to Piperacillin – Tazobactam in spite of the increased use of the later drug in the MICU. Discussion and conclusion: Antibiotic resistance is an increasing global problem. Surveillance studies are needed to monitor resistance development, to guide local empirical therapy, and to implement timely and adequate countermeasures. Since resistance development is an evolutionary process, constant surveillance is necessary to gain insight into the problem in a timely fashion. Several measures were taken including antibiotic cycling, antibiotic rotation and restriction. Restriction of the use of Ceftazidime resulted in a significant drop in the resistance of the common Gram-negative bacteria to the betalactam antibiotics. The sustainability and efficacy of these measures need to be monitored over time.


2021 ◽  
Author(s):  
Jignasha T. Thumar ◽  
Nisha Trivedi

The overuse of antibiotics has resulted in the development of drug resistant, a major problem in disease curing processes i.e. development of drug resistance. The World Health Organization (WHO) released its first list of the most concerning pathogens for human health in 2017 which suggested that there are total 12 bacterial families which have developed multiple drug resistance and for which novel antibiotics are required immediately (WHO 2017). There is a requirement to explore some novel compounds to overcome this issue. Thus our study aimed at exploration of marine actinomycetes as a valuable resource for novel products with antimicrobial properties. The halophilic actinomycete Nocardiopsis_sp. Al-H10-1 (KF384482) was isolated from saline water (20 m away from shore) of Alang coast (Gulf of Khambhat), Bhavnagar, Gujarat, India. The isolate Al-H10-1 was identified as Nocardiopsis sp. through rigorous morphological and cultural characteristics; the species was confirmed through 16s rRNA phylogenetic analysis. The antimicrobial potential of Nocardiopsis sp. Al-H10-1 was assessed against a range of Gram-positive and Gram-negative bacteria as well as three fungi, there it demonstrated antimicrobial activity against four Gram negative bacteria and one Gram positive bacteria. Further active antimicrobial compounds present in ethyl acetate extract was identified using Gas Chromatography-Mass Spectroscopy (GC-MS). GC-MS analysis showed the presence of 17 compounds which included antimicrobial compounds like 2, 4-bis (1, 1-dimethylethyl)-Phenol, Dibutyl phthalate as well as various types of alkanes and their derivatives.


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