scholarly journals Pediatric surgical sepsis: diagnostics and intensive therapy

2021 ◽  
pp. 34-42
Author(s):  
Elmira Satvaldieva ◽  
Gulchehra Ashurova ◽  
Otabek Fayziev ◽  
Abdumalik Djalilov
Keyword(s):  
Life Support ◽  
Intensive Therapy ◽  
Blood Gases ◽  
Tracheal Aspirate ◽  
Surgical Pathology ◽  
Diffusion Method ◽  
Infusion Therapy ◽  
Disk Diffusion Method ◽  
Surgical Interventions ◽  
Microbiological Monitoring

The aim: Optimization of diagnostics and schemes of pathogenetic intensive therapy of surgical sepsis in children based on clinical and laboratory criteria and bacteriological monitoring. Materials and methods: The research period is 2018-2020. The object of the study (n=73) – children with surgical pathology (widespread peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, abdominal trauma, etc.). Research methods: microbiological monitoring to determine the sensitivity of the microorganism to antibiotics was carried out before and at the stages of treatment (sputum, urine, wound, bronchoalveolar lavage, tracheal aspirate, blood, contents from drainages, wound surface). Determination of the sensitivity of the isolated strains to antibiotics was carried out by the disk-diffusion method. To determine predictors of sepsis in surgical patients, clinical (mean arterial pressure (mAP), heart rate (HR), respiratory rate (RR), SpO2, etc. and laboratory parameters on days 1–2 (up to 48 hours) of sepsis identification, days 4 and 8 of intensive therapy. Procalcitonin was determined by immunofluorescence on a Triage® MeterPro analyzer (Biosite Diagnostics, USA). Blood gases and electrolytes were analyzed using a Stat Profile CCX analyzer (Nova Biomedical, USA). Results: studies have shown the effectiveness of complex intensive care in 86.3 % of cases. Mortality was found in 13.7 % of cases. Patients with severe surgical pathology died: widespread peritonitis, severe TBI + coma with irreversible neurological disorders, urosepsis against the background of chronic renal failure, after repeated surgical interventions, due to the development of refractory septic shock (SS). Conclusions. Early diagnosis of sepsis, rational early ABT under the control of microbiological monitoring, non-aggressive infusion therapy with early prescription of vasopressors (SS) with constant monitoring of the child's main life support organs contribute to an improvement in sepsis outcomes and a decrease in mortality

scholarly journals Intensive therapy in patients with scar strictures of the esophagus

2018 ◽  
Vol 1 (1) ◽  
pp. 42-45
Author(s):  
V. O. Shaprynskyi ◽  
Y. V. Shaprynskyi ◽  
V. F. Kryvetskyi ◽  
Mustafa Bassam Hussein
Keyword(s):  
Postoperative Complications ◽  
Intensive Therapy ◽  
Diagnostic Algorithm ◽  
Infusion Therapy ◽  
Considerable Part ◽  
Plasma Albumin ◽  
Complete Obstruction ◽  
Surgical Interventions ◽  
Esophageal Strictures ◽  
Logistic Regression Method

The proposed medical tactics and intensive therapy of scar strictures of the esophagus we represent in this article. The causes of their occurrence: burns in the esophagus, surgical interventions on the esophagus, reflux esophagitis, and malignant genesis – esophageal cancer. A considerable part of patients with scar strictures of the esophagus is hospitalized at later stages of the stricture: with 4th and 5th degrees of obstruction. This leads to increasing of the number of exhausted patients and neglected cases, that contributes to increasing of levels of postoperative lethality and complications. The sults of surgical treatment of 116 patients with esophageal strictures at the period of 2003–2017 were analyzed. We used a logistic regression method to determine the risk factors for postoperative complications. It was established that the risk increases significantly with the presence of technical difficulties during operation, diabetes mellitus, blood plasma albumin levels less than 25 g/l, complete obstruction of the esophagus. The proposed program of treatment of patients with scar strictures of the esophagus reliably reduces the risk of postoperative complications. The diagnostic algorithm, the program of treatment of patients with preoperative infusion therapy and parenteral nutrition with “all in one” system were applied in patients of the main group. Due to the treatment program and intensive therapy, the number of postoperative complications has decreased from 27,27% to 12,0%, and mortality – from 6,06% to 2,0%.

scholarly journals Characterization and antimicrobial susceptibility of coagulase-negative staphylococci isolated from clinical samples

2018 ◽  
Vol 10 (04) ◽  
pp. 414-419 ◽  
Author(s):  
Prapti Bora ◽  
Priya Datta ◽  
Varsha Gupta ◽  
Lipika Singhal ◽  
Jagdish Chander
Keyword(s):  
Antibiotic Susceptibility ◽  
Tracheal Aspirate ◽  
Polymyxin B ◽  
Common Species ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Coagulase Negative Staphylococci ◽  
Disk Diffusion Method ◽  
In Vitro Susceptibility

ABSTRACT PURPOSE: This study has been done to speciate coagulase-negative staphylococci (CoNS) and also study their antibiotic susceptibility pattern isolated from clinical samples. MATERIALS AND METHODS: A total of 120 consecutive CoNS were isolated from various clinical samples such as blood, pus, wound swab, drain fluid, tracheal aspirate, peritoneal fluid, and pleural fluid over a period of 6 months. CoNS were identified by characteristic growth on media such as Blood agar and MacConkey agar. Speciation and identification were done by a range of biochemical testing such as PYR broth hydrolysis, novobiocin resistance, polymyxin B sensitivity, and then by matrix-assisted laser desorption ionization-time of flight. Antibiotic susceptibility of the isolates was done by Kirby-Bauer disk diffusion method as per CLSI 2017 guidelines. RESULTS: Among the 120 isolates, the most common species was Staphylococcus epidermidis (56.67%) followed by Staphylococcus haemolyticus (21.67%), Staphylococcus lugdunensis (11.67%), Staphylococcus caprae (5%), Staphylococcus cohnii (3.33%), and finally Staphylococcus vitulinus (1.67%). Good in vitro susceptibility was noted toward linezolid (100%), vancomycin (100%), teicoplanin (100%), and doxycycline (80.2%). The antibiotics to which resistance was seen were penicillin (96.5%), ciprofloxacin (57.1%), and oxacillin (45.5%). MR CoNS in our study ranged from 50% to 68.67%. CONCLUSION: Antibiotic resistance in CoNS is increasing toward penicillin, ciprofloxacin, and oxacillin as found in our study. The antibiotics such as vancomycin, teicoplanin, linezolid, and doxycycline which showed good in vitro susceptibility, therefore, should be kept as reserve drugs and used judiciously.

scholarly journals Prevalence of microorganism and emergence of bacterial resistance in ICU of Bangabandhu Sheikh Mujib Medical University of Bangladesh

2014 ◽  
Vol 26 (1) ◽  
pp. 20-26
Author(s):  
Montosh Kumar Mondal ◽  
Beauty Rani Roy ◽  
Sabina Yeasmeen ◽  
Faizul Haque ◽  
AK Qumrul Huda ◽  
...  
Keyword(s):  
Bacterial Resistance ◽  
Urine Culture ◽  
Positive Culture ◽  
Tracheal Aspirate ◽  
Diffusion Method ◽  
Resistant Organism ◽  
Disk Diffusion Method ◽  
Antibiotic Resistant ◽  
Microbiological Methods ◽  
Medical University

Background Antibiotic resistant bacterial nosocomial infections are a leading problem in intensive care units (ICU). Objective To study the pattern of microorganism and bacterial resistant to antibiotic in ICU of Bangabandhu sheikh Mujib Medical University of Bangladesh. Methods This retrospective study was conducted in ICU of Bangabandhu Sheikh Mujib Medical University, Bangladesh from January 2010 to December 2012. Total number of samples were 448. The samples of tracheal aspirate, blood and urine for culture and sensitivity was collected from the patient admitted in ICU. Analysis of tracheal aspirate, blood and urine culture was done from hospital record. All bacteria was identified by standard microbiological methods, and their antibiotic sensitivity was performed using disk diffusion method. Results Total number of samples 448. Samples of tracheal aspirate was 159, positive culture 121(76%), most frequent identified organism was acenetobacter 45.45%, followed by pseudomonas 32.23%, proteus 11%, klebsiella 10% and E.coli 3%, samples of blood culture was 148, positive culture 22(14.86%), most frequent identified organism was pseudomonas 63.63%, followed by acenetobacter 22.72%, salmonella 4.54% and E.coli 4.54% and samples of urine culture was 141, positive culture 36 (25.53% ) most frequent identified organism was enterococcus 22.22%, followed by acenatobacter 19.44%, candida16.66%, klebsiella 13.88% and E.coli 13.88%. Drug resistant organism of tracheal aspirate was 12(20.33%) in 2010, 2(20%) in 2011 and 13(25%) in 2012. only collistin sensitive organism identified was 28(23.14%). Conclusion From this study we concluded that most common site of infection was respiratory tract and most prevailing organism was acinetobacter & pseudomonas and antibiotic resistant infection is increasing and at present around one fourth organisms were resistant to all antibiotics. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19811 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 20-26

scholarly journals Prevalence and molecular epidemiology of ceftaroline non-susceptible methicillin-resistant Staphylococcus aureus isolates, first clinical report from Iran

2020 ◽  
Author(s):  
Amin Khoshbayan ◽  
Aref Shariati ◽  
Ehsanollah Ghaznavi-Rad ◽  
Alex van Belkum ◽  
Davood Darban-Sarokhalil
Keyword(s):  
Staphylococcus Aureus ◽  
Tracheal Aspirate ◽  
Generation Cephalosporin ◽  
Diffusion Method ◽  
Type I ◽  
Clinical Report ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Novel Approach ◽  
Mrsa Strains

AbstractBackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens in Iran with a high prevalence and a high level of antibiotic resistance. Ceftaroline is a fifth generation cephalosporin binding and inhibiting penicillin binding protein (PBP2a).MethodsIn the present study, 228 clinical MRSA isolates were collected from four cities of Iran and their susceptibility to ceftaroline was evaluated by E-test and the disk diffusion method.ResultsOur results showed a high susceptibility rate (97.3%) to ceftaroline in MRSA strains from Iran. Six isolates were found to be ceftaroline non-susceptible (CPT-NS) with Minimum inhibitory concentration (MIC) ≥2 µg/mL. All CPT-NS isolates were isolated from blood and tracheal aspirate and belonged to SCCmec type III as well as agr type I and were all susceptible to vancomycin. Out of six isolates, three, two and one belonged to spa type t030, t4864, and t969, respectively. Vancomycin, quinupristin/dalfopristin, linezolid, chloramphenicol, and tigecycline were the most active agents against CPT-NS isolates.ConclusionDue to the broad-spectrum activity and low toxicity of ceftaroline as well as the increased rate of vancomycin resistance among MRSA strains in recent years, ceftaroline can be considered as a novel approach to treat MRSA-induced infections.

Prevalence of SHV-extended spectrum β-lactamase producing carbapenem –resistantKlebsiellapneumoniae among patients with lower respiratory tractinfections in Babylon Province-Iraq.

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Fatima Moeen Abbas
Keyword(s):  
Resistance Rate ◽  
Combination Method ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Carbapenem Resistant ◽  
Extended Spectrum ◽  
Pcr Method ◽  
Polymerase Chain ◽  
Tract Infections ◽  
Positive Results

This study was carried out to screen the prevalence of Klebsiella pneumoniae isolated from patients with lower respiratory tract infections in Babylon province.From December,2015 to the end of March,2016,a total of 100 sputum samples were collected from patients visited or hospitalized Merjan Teaching Hospital and Al- Hashimya General Hospital. Fifteenth (65%) isolates were identified as Klebsiellapneumoniae. All bacterial isolates were evaluated for extended spectrum β-lactamase (ESBL) production phenotypically using disk combination method. Eleven (73.3%) isolates were detected as ESBL-producers. Kirby-Bauer disk diffusion method was employed to determine resistance profile of ESBLs-positive isolates. Higher rates of resistance were observed for ampicillin and piperacillin antibiotics with (81.8%) and (72.7%) resistance rate, respectively, while the lowest rate was noticed for imipenem antibiotic (14.28%). Carbapenem-resistant isolates were investigated for blaSHV gene by Polymerase Chain Reaction (PCR) method, 2 (100%) isolates gave positive results.

Antibiotic Susceptibility Evaluation of Bacterial Agents Causing Infection in Children with Acute Tonsillopharyngitis

2020 ◽  
Vol 20 ◽  
Author(s):  
Hamidreza Sherkatolabbasieh ◽  
Majid Firouzi ◽  
Shiva Shafizadeh ◽  
Iman Amiri
Keyword(s):  
Sore Throat ◽  
Predictive Value ◽  
Positive Culture ◽  
Clinical Score ◽  
Streptococcal Pharyngitis ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Clinical Sensitivity ◽  
Group A

Background: The aim of this study is to evaluate the prevalence of group A beta-hemolytic pharyngitis by assessing the outcome of the culture and the resistance and sensitivity of group A beta hemolytic streptococcus to antibiotics. Methods: This cross-sectional study was conducted on 170 patients, aged 3-15 years, referred to the clinic with complaints of sore throat. Patients’ history was collected and physical examination was performed and were score based on clinical findings. Patients with other underlying pathologies and those taking antibiotics prior to the study were excluded from our study. Antimicrobial susceptibility test was performed by disk diffusion method against cephalexin, cefazolin, erythromycin and amoxicillin. Results: A total of 170 patients were reported with sore throat. Patients with positive culture results were 60% male and 40% female. Amoxicillin resistance was the greatest (5%) in the culture. All isolated bacteria were sensitive to amoxicillin, cephalexin, cefazolin and erythromycin. Patients with McIssac score ≥ 6 showed clinical sensitivity 75% specificity 61% negative predictive value 94.8% and positive predictive value 20.3% for Group A beta-hemolytic streptococcal pharyngitis. Conclusion: The results showed the higher the clinical score, the greater the chance of positive throat culture.

scholarly journals Predominance of PVL-negative community-associated methicillin-resistant Staphylococcus aureus sequence type 8 in newly diagnosed HIV-infected adults, Tanzania

2021 ◽  
Author(s):  
Joel Manyahi ◽  
Sabrina J. Moyo ◽  
Said Aboud ◽  
Nina Langeland ◽  
Bjørn Blomberg
Keyword(s):  
Staphylococcus Aureus ◽  
Hiv Infection ◽  
Diffusion Method ◽  
Molecular Characteristics ◽  
People Living With Hiv ◽  
Newly Diagnosed ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

AbstractDifficult-to-treat infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are of concern in people living with HIV infection as they are more vulnerable to infection. We aimed to identify molecular characteristics of MRSA colonizing newly diagnosed HIV-infected adults in Tanzania. Individuals newly diagnosed with HIV infection were recruited in Dar es Salaam, Tanzania, from April 2017 to May 2018, as part of the randomized clinical trial CoTrimResist (ClinicalTrials.gov identifier: NCT03087890). Nasal/nasopharyngeal isolates of Staphylococcus aureus were susceptibility tested by disk diffusion method, and cefoxitin-resistant isolates were characterized by short-reads whole genome sequencing. Four percent (22/537) of patients carried MRSA in the nose/nasopharynx. MRSA isolates were frequently resistant towards gentamicin (95%), ciprofloxacin (91%), and erythromycin (82%) but less often towards trimethoprim-sulfamethoxazole (9%). Seventy-three percent had inducible clindamycin resistance. Erythromycin-resistant isolates harbored ermC (15/18) and LmrS (3/18) resistance genes. Ciprofloxacin resistance was mediated by mutations of the quinolone resistance-determining region (QRDR) sequence in the gyrA (S84L) and parC (S80Y) genes. All isolates belonged to the CC8 and ST8-SCCmecIV MRSA clone. Ninety-five percent of the MRSA isolates were spa-type t1476, and one exhibited spa-type t064. All isolates were negative for Panton-Valentine leucocidin (PVL) and arginine catabolic mobile element (ACME) type 1. All ST8-SCCmecIV-spa-t1476 MRSA clones from Tanzania were unrelated to the globally successful USA300 clone. Carriage of ST8 MRSA (non-USA300) was common among newly diagnosed HIV-infected adults in Tanzania. Frequent co-resistance to non-beta lactam antibiotics limits therapeutic options when infection occurs.

scholarly journals Evaluation of the in vitro antibacterial activity of some essential oils and their blends against Staphylococcus spp. isolated from episodes of sheep mastitis

2021 ◽  
Author(s):  
Filippo Fratini ◽  
Margherita Giusti ◽  
Simone Mancini ◽  
Francesca Pisseri ◽  
Basma Najar ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Essential Oils ◽  
Diffusion Method ◽  
Minimal Bactericidal Concentration ◽  
Coagulase Negative Staphylococci ◽  
Disk Diffusion Method ◽  
In Vitro Antibacterial Activity ◽  
High Concentrations ◽  
Thymus Serpyllum

AbstractStaphylococcus aureus and coagulase-negative staphylococci are among the major causes of mastitis in sheep. The main goal of this research was to determine the in vitro antibacterial activity of several essential oils (EOs, n 30), then five of them were chosen and tested alone and in blends against staphylococci isolates. Five bacteria were isolated from episodes of ovine mastitis (two S. aureus and three S. xylosus). Biochemical and molecular methods were employed to identify the isolates and disk diffusion method was performed to determine their antimicrobial-resistance profile. The relative percentage of the main constituents in the tested essential oils and their blends was detected by GC-EIMS analysis. Antibacterial and bactericidal effectiveness of essential oils and blends were evaluated through minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). All of them showed sensitivity to the used antimicrobials. The EOs with the highest antibacterial activity were those belonging to the Lamiaceae family characterized by high concentrations of thymol, carvacrol and its precursor p-cymene, together with cinnamon EO, rich in cinnamaldehyde. In terms of both MIC and MBC values, the blend composed by Thymus capitatus EO 40%, Cinnamomum zeylanicum EO 20%, Thymus serpyllum EO 20% and Satureja montana EO 20% was found to be the most effective against all the isolates. Some essential oils appear to represent, at least in vitro, a valid tool against ovine mastitis pathogens. Some blends showed a remarkable effectiveness than the single oils, highlighting a synergistic effect in relation to the phytocomplex.

scholarly journals Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria

2021 ◽  
Vol 11 (01) ◽  
pp. e28-e34
Author(s):  
Kevin B. Edem ◽  
Enobong E. Ikpeme ◽  
Mkpouto U. Akpan
Keyword(s):  
Primary School ◽  
School Children ◽  
Antimicrobial Susceptibility ◽  
Group A Streptococcus ◽  
Latex Agglutination ◽  
Sub Saharan Africa ◽  
Primary School Children ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional

AbstractSurveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross-sectional study of 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer's exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were susceptible to penicillin. None of the tested isolates was susceptible to co-trimoxazole. The prevalence of streptococcal throat carriage in the study area was low. There were no Group A Streptococcus isolates suggesting an evolving epidemiology of BHS disease in the study area.

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