Microbiological monitoring as a component of efficient prevention and treatment of purulent-septic infections in an orthopedics and traumatology department

Efficient monitoring of circulating purulent-septic infectious agents in a clinical setting and a study on antibiotic susceptibility of isolated strains of microorganisms allows identifying changes in the pathogen structure and trends in antibiotic resistance development, which helps to determine the tactics of antibacterial therapy and elaborate appropriate measures. The aim of the study. Retrospective analysis of the results of microbiological monitoring of purulent-septic infectious (PSI) agents in the Orthopedics and Traumatology Department (OTD) of the Zaporizhzhia Central Ambulance and Emergency Care Hospital over the period 2017–2020 to determine the main antibacterial drugs for empirical therapy. Materials and methods. We analyzed the bacteriological test results of 664 clinical material samples obtained from OTD patients using bacteriological examination statistical reporting and analytical data of the WHONET 5.6 software. Results. The main PSI pathogens in the OTD were from the ESKAPE group: E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa and S. epidermidis, P. mirabilis, C. amycolatum. Isolates of E. faecalis were sensitive to vancomycin, linezolid, S. aureus – to linezolid, tigecycline, netilmicin, A. baumannii – to tigecycline. All P. aeruginosa strains were resistant to ticarcillin/clavulanate, cefepime, chloramphenicol, imipenem, meropenem, aztreonam, ciprofloxacin. E. coli and K. pneumoniae were resistant to ampicillin, ticarcillin/clavulanate, aztreonam, ceftriaxone, cefepime. The number of isolates sensitive to piperacillin/tazobactam, carbapenems, levofloxacin, gentamicin, amikacin, chloramphenicol ranged from 37 % to 65 %. Conclusions. E. coli, S. aureus, K. pneumoniae, A. baumannii, E. faecalis, P. aeruginosa, S. epidermidis, P. mirabilis, C. amycolatum play an important role in the structure of PSI pathogens in the Orthopedics and Traumatology Department of Zaporizhzhia Central Ambulance and Emergency Care Hospital. The antibiotics of choice as the antibacterial empirical therapy for enterococcal infections are vancomycin, linezolid, for staphylococcal infections – vancomycin, linezolid, tigecycline, netilmicin. PSI pathogens continually evolve developing antibiotic resistance, and it is of particular importance to monitor antibiotic susceptibility of microorganisms within the OTD.

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Nitric oxide (NO) elicits aminoglycoside tolerance in Escherichia coli but antibiotic resistance gene carriage and NO sensitivity have not co-evolved

Archives of Microbiology ◽

10.1007/s00203-021-02245-2 ◽

2021 ◽

Author(s):

Cláudia A. Ribeiro ◽

Luke A. Rahman ◽

Louis G. Holmes ◽

Ayrianna M. Woody ◽

Calum M. Webster ◽

...

Keyword(s):

Nitric Oxide ◽

Antibiotic Resistance ◽

Antibiotic Susceptibility ◽

Bacterial Pathogens ◽

Antibiotic Resistance Gene ◽

Antibiotic Resistance Genes ◽

Resistance Mechanisms ◽

Current Work ◽

E Coli ◽

Respiratory Inhibitor

AbstractThe spread of multidrug-resistance in Gram-negative bacterial pathogens presents a major clinical challenge, and new approaches are required to combat these organisms. Nitric oxide (NO) is a well-known antimicrobial that is produced by the immune system in response to infection, and numerous studies have demonstrated that NO is a respiratory inhibitor with both bacteriostatic and bactericidal properties. However, given that loss of aerobic respiratory complexes is known to diminish antibiotic efficacy, it was hypothesised that the potent respiratory inhibitor NO would elicit similar effects. Indeed, the current work demonstrates that pre-exposure to NO-releasers elicits a > tenfold increase in IC50 for gentamicin against pathogenic E. coli (i.e. a huge decrease in lethality). It was therefore hypothesised that hyper-sensitivity to NO may have arisen in bacterial pathogens and that this trait could promote the acquisition of antibiotic-resistance mechanisms through enabling cells to persist in the presence of toxic levels of antibiotic. To test this hypothesis, genomics and microbiological approaches were used to screen a collection of E. coli clinical isolates for antibiotic susceptibility and NO tolerance, although the data did not support a correlation between increased carriage of antibiotic resistance genes and NO tolerance. However, the current work has important implications for how antibiotic susceptibility might be measured in future (i.e. ± NO) and underlines the evolutionary advantage for bacterial pathogens to maintain tolerance to toxic levels of NO.

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Vibrio cholerae Triggers SOS and Mutagenesis in Response to a Wide Range of Antibiotics: a Route towards Multiresistance

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01549-10 ◽

2011 ◽

Vol 55 (5) ◽

pp. 2438-2441 ◽

Cited By ~ 107

Author(s):

Zeynep Baharoglu ◽

Didier Mazel

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Vibrio Cholerae ◽

Fluorescent Protein ◽

Resistance Development ◽

Content Type ◽

E Coli ◽

Wide Range ◽

Green Fluorescent ◽

Regulated Promoters

ABSTRACTAntibiotic resistance development has been linked to the bacterial SOS stress response. InEscherichia coli, fluoroquinolones are known to induce SOS, whereas other antibiotics, such as aminoglycosides, tetracycline, and chloramphenicol, do not. Here we address whether various antibiotics induce SOS inVibrio cholerae. Reporter green fluorescent protein (GFP) fusions were used to measure the response of SOS-regulated promoters to subinhibitory concentrations of antibiotics. We show that unlike the situation withE. coli, all these antibiotics induce SOS inV. cholerae.

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Evaluation of Immunocompetent Urinary Tract Infected Balb/C Mouse Model For the Study of Antibiotic Resistance Development Using Escherichia Coli CFT073 Infection

Antibiotics ◽

10.3390/antibiotics8040170 ◽

2019 ◽

Vol 8 (4) ◽

pp. 170 ◽

Cited By ~ 1

Author(s):

Ashok Chockalingam ◽

Sharron Stewart ◽

Lin Xu ◽

Adarsh Gandhi ◽

Murali K. Matta ◽

...

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Bladder Tissue ◽

Resistance Development ◽

Once Daily ◽

E Coli ◽

Low Levels ◽

Tract Infections

Urinary tract infections (UTI) are common worldwide and are becoming increasingly difficult to treat because of the development of antibiotic resistance. Immunocompetent murine models of human UTI have been used to study pathogenesis and treatment but not for investigating resistance development after treatment with antibiotics. In this study, intravesical inoculation of uropathogenic Escherichia coli CFT073 in immunocompetent Balb/c mice was used as a model of human UTI. The value of the model in investigating antibiotic exposure on in vivo emergence of antibiotic resistance was examined. Experimentally infected mice were treated with 20 or 200 mg/kg ampicillin, 5 or 50 mg/kg ciprofloxacin, or 100 or 1000 mg/kg of fosfomycin. Ampicillin and ciprofloxacin were given twice daily at 8 h intervals, and fosfomycin was given once daily. Antibiotic treatment began 24 h after bacterial inoculation and ended after 72 h following the initial treatment. Although minimum inhibitory concentrations (MIC) for the experimental strain of E. coli were exceeded at peak concentrations in tissues and consistently in urine, low levels of bacteria persisted in tissues in all experiments. E. coli from bladder tissue, kidney, and urine grew on plates containing 1× MIC of antibiotic, but none grew at 3× MIC. This model is not suitable for studying emergent resistance but might serve to examine bacterial persistence.

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Antibiotic susceptibility of bacterial strains isolated from urinary tract infections inPakistan

International Journal of Medicine ◽

10.14419/ijm.v9i1.31359 ◽

2021 ◽

Vol 9 (1) ◽

pp. 18

Author(s):

Sarmad Zahoor ◽

Naveed Shehzad Ahmad ◽

Sadia Asif ◽

Hafiz Muhammad Sajid Jehangir ◽

Asad Ali ◽

...

Keyword(s):

Antibiotic Resistance ◽

Urinary Tract ◽

Antibiotic Susceptibility ◽

Infectious Agent ◽

Genomic Research ◽

Susceptibility Pattern ◽

Bacterial Strains ◽

Dominant Type ◽

E Coli ◽

Tract Infections

Background: Urinary track infection (UTI) is a common infection in Pakistan. Poor knowledge about personal hygiene and lack of awareness are major reasons of this infection. All over the world and in Pakistan E. coli and K. pneumonia are main causative agents of UTI.Objectives:To analyze Antibiotic susceptibility pattern of bacterial strains isolated from urinary tract infections.Methods: In present study total 227 samples from Genomic Research Lab and Diagnostic Center Rawalpindi, Pakistan were tested for presence of different microbial infectious agents and their antibiotic resistance and susceptibility pattern. Biochemical test such as Gram staining, Lactose fermentation test, Motility test, Catalase test and Colony formation on MacConkey agar, Indole test, and Citrate utilization test were applied. The antibiotic susceptibility and resistance pattern was evaluated by using fourteen different antibiotics on MullarHigton agar. Top ten antibiotics were selected at a cut off value of 100 samples for E. coli and 20 samples for Klebsiella.Results: Against E. coli and K. species the most susceptible antibiotic was Imipenam with 97.5% and Amikacin with 94.9% susceptibility respectively. Moreover, against E. coli and K. species the most resistance antibiotic was Ciprofloxacin 81.7% and Tobramycin with 76.1% resistance respectively. The comparison of present study with pervious studies had shown an increase in resistance against various antibiotics.Conclusion: It is concluded from the present study that antibiotic resistance is on raise in Pakistan and the effect of each antibiotic was different with respect to type of infectious agent so it is recommended that the doctor should determine the dominant type of infectious agent and its susceptibility response before prescription of any antibiotic.

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BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF STROKE PATIENT’S URINARY CATHETER ISOLATES AT BETHESDA HOSPITAL, YOGYAKARTA

Berkala Ilmiah Kedokteran Duta Wacana ◽

10.21460/bikdw.v4i2.146 ◽

2019 ◽

Vol 4 (2) ◽

pp. 58

Author(s):

Christofer Sathya Wijaya Budi Sarwono

Keyword(s):

Antibiotic Resistance ◽

Urinary Tract ◽

Antibiotic Susceptibility ◽

Biofilm Formation ◽

Urinary Catheter ◽

Cross Sectional Study ◽

Stroke Patients ◽

Plate Method ◽

Cross Sectional ◽

E Coli

Background: Antibiotic resistance currently challenges infectious disease management, specifically in combating biofilm formation. Biofilm might be developed on urinary catheter, in which stroke patients with urinary tract problem have higher risk of catheter associated urinary tract infection and problems related to antibiotic resistance. Aim: This study describes the microbe types from catheter isolates, measuring the antibiotic susceptibility and biofilm formation, especially in stroke patients at Bethesda Hospital, Yogyakarta. Method: This is a cross-sectional study, describing findings of specimens from stroke patients at Bethesda Hospital, since December 2018 to January 2019. The isolates were identified with standard method, the antibiotic susceptibility were tested with antibiotic disc on MHA medium, and the biofilm formation were assessed using tissue culture plate method. All procedure were done in Microbiology Laboratorium, FK UKDW. Result: Thirty three microbes were isolated from 30 specimens of urinary catheter (63,3% male, 36,3% female). There is 76% isolates incapable of developing biofilm, while 15% is moderate biofilm producer and 9% is strong biofilm producer. The susceptibility test showed 100% resistancy of ampicillin-sulbactam, tetracyclin, ketoconazole, itraconazole, and terbinafine. Around 50% of E. coli and 57% of K. pneumonias isolates is MDR, and 75% of A. baumanii is XDR. Conclusion: Isolated microbes from urinary catheter of stroke patients at Bethesda Hospital is dominated by E. coli, K. pneumoniae, and A. baumanii. Some of the microbes could form strong biofilm, and some of the antibiotics could not be used in the future due to their 100% resistancy on all specimens.

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Incidence and antibiotic susceptibility of methicillin resistant Staphylococcus aureus in pus samples of patients of Bastar region, Central India

South Asian Journal of Experimental Biology ◽

10.38150/sajeb.2(5).p204-208 ◽

2012 ◽

Vol 2 (5) ◽

pp. 204-208

Author(s):

Mohammad Fareed Khan ◽

Arvind Neral ◽

Vikas Chandra Yadav ◽

Farah Aziz Khan ◽

Sarfaraz Ahmed

Keyword(s):

Antibiotic Susceptibility ◽

Tertiary Care ◽

Central India ◽

Empirical Therapy ◽

Disk Diffusion ◽

Antibiotic Prescribing ◽

Care Hospital ◽

Diffusion Test ◽

Disk Diffusion Test ◽

Methicillin Resistant

Increasing prevalence of methicillin resistant S. aureus (MRSA) and resistanceto multiple antibiotic classes is a global issue. Regional surveillance of antibiotic susceptibility of the organism is a necessary step to overcome the issues of antimicrobial resistance and treatment failure in MRSA infections. The study was conducted to find the pattern of antibiotic susceptibility in MRSA isolated from the pus samples of patients attending a tertiary care hospital in Bastar tribal region in Central India. The study was performed on 215 MRSA isolates cultured from pus samples of patients over a period of two years and five months. In the methicillin resistant organisms selected by oxacillin screen agar test and cefoxitin disk diffusion test, antibiotic susceptibility was determined by Kirby Baur disk diffusion test with CLSI guide lines. Of the total S. aureus isolates, the incidence of MRSA was 34.1% of which 82.8% were resistant to coâ€trimoxazole, 77.2% to tetracycline, 68.8% to gentamycin, 66% to erythromycin, 64.2% to ciprofloxacin, 1.4% to vancomycin, and 0.9% to linezolid. All these isolates were resistant to the ßâ€lactam antibiotics tested. Emergence of linezolid resistance and relatively higher vancomycin resistance in the MRSA isolates is a worrisome finding of this study. The antibiotic prescribing must rely on both initial empirical therapy and microbiological antibiotic susceptibility result.

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Antimicrobial Susceptibility Pattern of Escherichia coli Isolated from Uninary Tract Infected Patients Attending Bir Hospital

Nepal Journal of Science and Technology ◽

10.3126/njst.v14i1.8938 ◽

2013 ◽

Vol 14 (1) ◽

pp. 177-184 ◽

Cited By ~ 8

Author(s):

Amit Raj Sharma ◽

Dwij Raj Bhatta ◽

Jyotsna Shrestha ◽

Megha Raj Banjara

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Antimicrobial Susceptibility ◽

Public Health Problem ◽

Empirical Therapy ◽

Culture Method ◽

Diffusion Method ◽

Coagulase Negative Staphylococci ◽

E Coli ◽

Significant Growth

Correction: on 23/08/2014, the spelling of 'Uninary' in the title was changed to 'Urinary'.Antibiotic resistance among uropathogens is emerging public health problem. This study was done for assessing antibiotic and multidrug resistance (MDR) patterns of Escherichia coli at Bir Hospital, Kathmandu, among suspected urinary tract infection (UTI) patients from January to March, 2011. Altogether, 739 urine samples were analysed by semi-quantitative culture method and uropathogens were identified by conventional methods. E. coli was tested (109 samples) for antimicrobial susceptibility by Kirby Bauer disc diffusion method as per Clinical and Laboratory Standard Institute (CLSI) guidelines. Out of 739 samples, 27.3% gave significant growth of E. coli while 3.1% and 29.2% samples gave mixed and non-significant growth respectively. E. coli was found to be most predominant isolate (54.0%) followed by coagulase negative Staphylococci (CoNS) (21.3%) and Enterococcus spp. (7.3%). Nitrofurantoin was found to be the most effective antibiotic followed by ciprofloxacin and ofloxacin while cephalexin was least effective. Out of 109 E. coli isolates, 90.8% were MDR strains and most of the isolates had a very high multiple antibiotic resistance (MAR) index, suggesting the origin of the isolates to be of high antibiotic usage. E. coli showed higher rate of resistance towards commonly used oral antibiotics. However, nitrofurantoin is still active against organisms. Thus, nitrofurantoin could be the choice for empirical therapy of UTI. Nepal Journal of Science and Technology Vol. 14, No. 1 (2013) 177-184 DOI: http://dx.doi.org/10.3126/njst.v14i1.8938

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Current and Emerging Methods of Antibiotic Susceptibility Testing

Diagnostics ◽

10.3390/diagnostics9020049 ◽

2019 ◽

Vol 9 (2) ◽

pp. 49 ◽

Cited By ~ 37

Author(s):

Zeeshan A. Khan ◽

Mohd F. Siddiqui ◽

Seungkyung Park

Keyword(s):

Antibiotic Resistance ◽

Bacterial Infection ◽

Economic Burden ◽

Antibiotic Susceptibility ◽

Historical Perspective ◽

Susceptibility Testing ◽

Empirical Therapy ◽

Pivotal Role ◽

Disk Diffusion ◽

Antibiotic Susceptibility Testing

Antibiotic susceptibility testing (AST) specifies effective antibiotic dosage and formulates a profile of empirical therapy for the proper management of an individual patient’s health against deadly infections. Therefore, rapid diagnostic plays a pivotal role in the treatment of bacterial infection. In this article, the authors review the socio-economic burden and emergence of antibiotic resistance. An overview of the phenotypic, genotypic, and emerging techniques for AST has been provided and discussed, highlighting the advantages and limitations of each. The historical perspective on conventional methods that have paved the way for modern AST like disk diffusion, Epsilometer test (Etest), and microdilution, is presented. Several emerging methods, such as microfluidic-based optical and electrochemical AST have been critically evaluated. Finally, the challenges related with AST and its outlook in the future are presented.

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ISOLATION OF UROPATHOGENS AND THEIR ANTIBIOTIC SUSCEPTIBILITY PATTERN AT A TERTIARY CARE HOSPITAL IN NORTHERN INDIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i12.35692 ◽

2019 ◽

pp. 84-86

Author(s):

HARIT KUMAR ◽

VARSHA A SINGH ◽

SHAVI NAGPAL ◽

DIPANKAR BISWAS

Keyword(s):

Antibiotic Susceptibility ◽

Tertiary Care ◽

Care Hospital ◽

Susceptibility Pattern ◽

Candida Spp ◽

Antibiotic Susceptibility Pattern ◽

E Coli ◽

Northern India ◽

Predominant Pathogen ◽

Klebsiella Spp

Objective: The objective of the study was to know the isolation rate and antibiotic susceptibility pattern of pathogens causing urinary tract infection (UTI). Methods: A total of 500 urine samples of clinically suspected UTI were collected from January 2019 to June 2019. The samples were inoculated on Cystine Lactose Electrolyte-Deficient agar and incubated at 37°C for 24 h. Results: In our study, 303 (60.6%) samples showed growth of isolates. Among 303 isolates, 31 were Candida spp. which was not included in the study. Out of 272 isolates, Escherichia coli was 31.68%, followed by Klebsiella spp. (27.72%), Enterococcus faecalis (22.44%), Citrobacter spp. (3.96%), Staphylococcus aureus (2.64%), and Pseudomonas spp. (1.32%). For Gram-negative and Gram-positive isolates, the most effective antibiotic was nitrofurantoin. Conclusion: The study shows E. coli as the predominant pathogen that causes UTI. Nitrofurantoin and fosfomycin showed very high susceptibility to uropathogens and can be used to treat primary or uncomplicated UTI.

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Avaliação do Perfil de Sensibilidade aos Antibióticos na Infeção Urinária da Comunidade

Acta Médica Portuguesa ◽

10.20344/amp.5352 ◽

2014 ◽

Vol 27 (6) ◽

pp. 737 ◽

Cited By ~ 2

Author(s):

Rui Passadouro ◽

Raquel Fonseca ◽

Felícia Figueiredo ◽

Andreia Lopes ◽

Cristina Fernandes

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Clavulanic Acid ◽

Urinary Tract Infections ◽

Antibiotic Susceptibility ◽

Empirical Therapy ◽

Activity Level ◽

E Coli ◽

Amoxicillin Clavulanic Acid ◽

Tract Infections

Introduction: The urinary tract infections, after respiratory infections, are the most common in the community. The knowledge about the prevalence of microbial strains and their antibiotic susceptibility is crucial to establish an effective empirical therapy. The aim of this study was to determine the antibiotic susceptibility patterns of bacterial strains isolated from positive urine cultures performed in patients from the central region of Portugal. Material and Methods: We carried out a documental analysis of 6008 urine bacteriological exams, to be made available to physicians, most of which run through the automated system VITEK 2, bioMérieux. The majority (80%) of the urine bacteriological exams were from female. Escherichia coli was the most prevalent bacterial pathogen (65.9%), followed by Klebsiella spp (12%). Results: Nitrofurantoin showed high levels of activity (96%) for Escherichia coli, as well as Fosfomycin (96.6%). Amoxicillin-clavulanic acid presents an activity level of only 81.1% for the same germ. Quinolones exhibit efficacy to only 78% of the strains of Escherichia coli, below the Fosfomycin and Nitrofurantoin. Nitrofurantoin showed high levels of activity (96%) for E. coli as well as Fosfomycin (96.6%). Amoxicillin-Clavulanic Acid presents a level of activity of only 81.1% for the same germ. The quinolones have a efficacy for only 78% of strains of E. coli, lower than Fosfomycin. Discussion: Escherichia Coli was the most prevalent uropathogen (65.9%). High efficacy against this pathogenic agent was found for Fosfomycin (96.6%) and Nitrofurantoin (96%). Conclusion: Further antimicrobial surveillance studies should be developed, in order to formulate local empirical therapy recommendations for optimized therapeutical choices. Keywords: Urinary Tract Infections; Drug Resistance, Bacterial; Anti-Bacterial Agents; Community-Acquired Infections.

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