scholarly journals Prevalence and antimicrobial resistance of beta-lactamase-producing Gram-negative isolates from outpatient clinical and environmental samples in the Zenica-Doboj Canton, Bosnia and Herzegovina

2016 ◽  
Vol 6 (2) ◽  
pp. 94-99
Author(s):  
Amir Ibrahimagić ◽  
Emina Idrizović ◽  
Edita Divjan ◽  
Biljana Klimenta
Keyword(s):  
Environmental Samples ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Antibiotic Prescribing ◽  
High Morbidity ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Upper Respiratory Tract ◽  
Gram Negative ◽  
Klebsiella Spp

Introduction: Infections due to extended-spectrum beta-lactamase (ESBL)-producing isolates in patients are hard to treat and cause high morbidity and mortality. ESBL-producing bacteria have been increasingly detected in environmental samples in different countries since 2002, and have gained considerable attention worldwide.Methods: Antibiotic susceptibility of all isolates was determined using the disk diffusion method. The production of ESBLs was determined by the double-disk synergy test.Results: Among the outpatient clinical samples, out of 2857 Gram-negative bacteria, 184 (6.5%) ESBL-producing bacteria were isolated. In this group, 143 (77.7%) were from urine samples, 26 (14.1%) from surgical wounds, 6 (3.3%) from umbilical swabs, and 9 (4.9%) from other patients sites (upper respiratory tract, cannula, eyes, genital swabs). Escherichia coli was isolated in 62 (33.7%), and Klebsiella spp. in 50 (27.8%) cases. Among the environmental samples, out of 381 Gram-negative bacteria, 52 (13.6%) were ESBL-producing isolates. In this group, 37 (71.2%) were sampled from water, 7 (13.5%) from food, and 8 (15.4%) from environmental surfaces. The most prevalent ESBL-producing bacteria isolated from the environmental samples were E. coli (isolated from 26 samples), Klebsiella spp. (10), non-fermenters (9), and other bacteria isolated from 7 samples. The clinical outpatient ESBL-producing isolates showed resistance to all cephalosporins, ranging from 25% (cefepime) to 100% (cefuroxime). The environmental ESBL-producing isolates showed resistance to cefuroxime, aztreonam, cefpodoxime, amoxicillin/clavulanate, and cefoxitin in the range of 65-100%.Conclusions: Prevalence of antibiotic resistance of ESBL-producing strains is high and requires routine detection of ESBL-producing isolates in the laboratories, designing of appropriate antibiotic prescribing policies and control of the risk factors.

scholarly journals Phenotypic characterization of beta-lactamases producing Gram-negative bacteria in a tertiary hospital, Nepal

2019 ◽  
Vol 7 (1) ◽  
pp. 74-81
Author(s):  
Elina Maharjan ◽  
Pooja Shakya ◽  
Balkrishna Bhattachan ◽  
Bharat Prasad Baral ◽  
Dhiraj Shrestha
Keyword(s):  
Tertiary Hospital ◽  
Diffusion Method ◽  
Phenotypic Characterization ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Disk Method ◽  
Esbl Producers

Infections caused by beta-lactamases producing Gram-negative bacteria are increasing, thus posing a challenge to the management of such infections. The surveillance data of such bacteria is limited in Nepal so this study aimed to detect the beta-lactamase producing Gram-negative bacteria in a tertiary setting. A total of 604 clinical samples, including urine, blood, sputum and body fluids, were cultured and identified by the routine standard laboratory protocols. Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method following Clinical and Laboratory Standard Institute guidelines (2014). Extended-spectrum beta-lactamases (ESBL) producers were identified by combined disk method and metallo-beta-lactamases (MBL) producers were identified by Imipenem- EDTA combined disk method. Out of 604 samples, 282 (46.7%) samples showed significant growth, of which 229 (81.2%) were Gram-negative bacteria. Of 229 Gram-negative bacteria, 200 (87.3%) were multidrug resistant, 67 (29.3%) were ESBL producers and 16 (7.0%) were MBL producers. Klebsiella pneumoniae were among higher ESBL producers and Pseudomonas aeruginosa were among higher MBL producers. The findings suggest higher antibacterial resistance among Gram-negative bacteria with the added burden of beta-lactamase production. Imipenem was effective against 125 of 229 Gram-negative bacteria tested. Thus, imipenem can be the drug of choice for empirical management. The higher multidrug resistance and higher beta-lactamases production among Gram-negative bacteria warrant the continuous monitoring, surveillance, early detection, and infection control practices of such bacteria

scholarly journals Carbapenemase Producers among Gram Negative Bacteria from Environmental and Clinical Samples in Makurdi, Nigeria

2020 ◽  
pp. 11-20
Author(s):  
F. B. Omoregbe ◽  
O. E. Fagade
Keyword(s):  
Environmental Samples ◽  
University Teaching ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Gram Negative Bacteria ◽  
Disc Diffusion ◽  
Environmental Isolates ◽  
Biochemical Tests ◽  
Gram Negative

Carbapenem-resistant Gram negative bacteria in healthcare setting is an important medical problem and a major threat. These Gram negative bacteria are rapidly spreading worldwide. Clinical bacteria isolates were obtained from clinical samples Urine, High Vaginal Swab (HVS), Wound Swab (WS), Stools, Ear Swab (ES), Endocervical Swab (ECS), Sputum and Blood, from two tertiary hospitals. Environmental samples were also collected from both hospitals using standard sampling techniques. Multiple drug resistant (MDR) patterns were determined using disc diffusion technique. Biochemical tests were used in the identification. Antibiotics sensitivity of clinical and environmental isolates was verified using disc diffusion method. Detection of carbapenemase producing bacteria was done using double disc synergy test and modified Hodge test. Data obtained were analysed using descriptive statistics. Clinical bacteria (403) obtained were distributed 271 Federal Medical Centre(FMC) and 132 Benue State University Teaching Hospital (BSUTH) out of which 299 were confirmed Gram negative, 218 (FMC) and 81 (BSUTH), respectively. Thirty-nine Gram negative bacteria were also isolated from the environmental samples. A higher percentage of carbapenemase producers (12.8%) were found in environmental isolates compared to 2.7% in clinical isolates. Any levels of resistance to carbapenems calls for the need to reduce the indiscriminate use of this group of antibiotics and monitoring both in the hospitals and environment.

Prevalence and Antibiogram of Extended-Spectrum Beta-Lactamase Producing Gram-negative Bacteria Isolated from Septicemic Neonates in a Tertiary Care Hospital

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 171-175
Author(s):  
Tania Rahman ◽  
Momtaz Begum ◽  
Sharmeen Sultana ◽  
SM Shamsuzzaman
Keyword(s):  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Blood Samples ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

Background: In recent years, Extended-spectrum beta-lactamase (ESBL) producing microorganisms have complicated treatment of infections due to resistance of ESBL producing strains to a wide range of antimicrobials. Objective: Target of this study was to determine the prevalence of ESBL producing gramnegative bacteria in neonatal sepsis cases and to reveal the antimicrobial susceptibility pattern of those isolated ESBL producers. Materials and Methods: This cross sectional study was carried out in Dhaka Medical College Hospital (DMCH) over a period of 12 months from January to December in 2016. Following isolation and identification of gram-negative bacteria from blood samples of suspected septicemic neonates, antimicrobial susceptibility test was performed by Kirby Bauer disk-diffusion method and ESBL producers were detected by Double Disk Synergy (DDS) test. Results: Among 52 Gram-negative bacteria isolated from 106 blood samples, 34.61% ESBL producers were detected and Enterobacter spp. (45%) was predominant followed by Klebsiella pneumoniae (33.33%). None of the ESBL producers was resistant to colistin and tigecycline. All ESBL producing Acinetobacter baumannii, 77.78% and 66.67% of ESBL producing Enterobacter spp and Klebsiella spp. respectively showed resistance to meropenem. All ESBL producers were resistant to piperacillintazobactam. Conclusion: Appropriate measures should be taken to prevent the spread of ESBL producing strains by combining strategies for infection prevention, control and rational use of antibiotics. KYAMC Journal Vol. 11, No.-4, January 2021, Page 171-175

scholarly journals ESBL Producers in Gram Negative Isolates from Clinical Samples

2020 ◽  
Vol 14 (3) ◽  
pp. 2027-2032
Author(s):  
Mita D. Wadekar ◽  
J.V. Sathish ◽  
C. Pooja ◽  
S. Jayashree
Keyword(s):  
Treatment Options ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Beta Lactam Antibiotics ◽  
Esbl Producers

Resistance to beta lactam antibiotics is the most common cause for beta-lactamase production. Increasing number of extended spectrum beta-lactamase (ESBL) producers has reduced the treatment options which resulted in emergence of multidrug resistant strains, treatment failure and hence increased mortality. To detect phenotypically, ESBL producers in Gram negative isolates from different samples and to know their susceptibility pattern. A retrospective study of Gram negative isolates was conducted. Total of 521 isolates were isolated from various samples. They were processed and identified by standard procedures. The antibiotic susceptibility testing was performed by Kirby- Bauer disc diffusion method using CLSI guidelines. ESBL was detected by combination disk test. A total of 521 Gram negative isolates were isolated which included E. coli, Klebsiella pneumoniae, Citrobacter spp., Enterobacter spp., Proteus spp. and Acinetobacter spp. Pseudomonas aeruginosa. Of 521 isolates tested, ESBL was detected in 329 (63.1%) isolates. These isolates showed maximum susceptibility to piperacillin- tazobactam (86%) followed by imipenem (78.4%), amikacin (63.5%), cotrimoxazole (54.4%), ciprofloxacin (51%), amoxi-clav (44.9%), cefepime (44.1%), gentamicin (38.9%), cefoxitin (34.9%) and ampicillin (19.1%). ESBL producers which are resistant to beta lactam antibiotics have become a major problem. Detection of these beta-lactamase enzymes by simple disk method and its reporting will help clinicians in prescribing proper antibiotics.

scholarly journals Extended Spectrum Beta Lactamase (ESBL) Producing Klebsiella pneumoniae , a therapeutic challenge.

2015 ◽  
Vol 13 (1) ◽  
pp. 22-25
Author(s):  
Raina Chaudhary ◽  
Sabita Bhatt Bhatt ◽  
Eva Piya
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Esbl Producer ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Sensitivity Pattern

Introduction: Klebsiella pneumoniae is one of the most common Gram negative bacteria encountered byclinicians worldwide as a cause of infections in human. Most of the infections are acquired in hospital settingtherefore, it is reported to be the amongst the 10 most common nosocomial pathogen in various studies. Nowadays,Klebsiella pneumoniae infections are complicated by increase in Extended Spectrum Beta Lactamase (ESBL)producing isolates. Therefore, this study is being conducted with the objective to fi nd out the prevalence ofESBL producing Klebsiella pneumoniaein various clinical samples and to fi nd out there sensitivity pattern.Methods: A total of 100 Klebsiella pneumoniae were isolated from various samples during the period of April2013 to November 2013 in Microbiology Unit of Shree Birendra Hospital. All the isolates were identifi ed withtheir sensitivity pattern according to standard methodology. Combination disc diffusion method was followedfor identifi cation of ESBL.Results: Out of total 100 isolates of Klebsiella pneumoniae21% were ESBL producer.ESBL producer isolatesshowed 100% sensitivity to Imepenem followed by Amikacin 57.1% and Chloramphenicol 47.6%. All theESBL isolates were resistant to both Cefotaxime and Ceftazidime.Conclusions: ESBL producer Klebsiella pneumoniae isolates were multidrug resistant. Continuous surveillanceand timely intervention with discouraging the use of cephalosporin group of antibiotics is mandatory.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12996 

scholarly journals Prevalence of imipenem resistant gram-negative bacteria in a tertiary care hospital of Dhaka, Bangladesh

2022 ◽  
Vol 21 (1) ◽  
pp. 145-150
Author(s):  
Rabeya Nahar Ferdous ◽  
Md Atikur Rahman ◽  
Md Anowar Hussain ◽  
Nasrin Akhter ◽  
Palash Chandra Banik ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Health Concern ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative

Objective: Imipenem resistant gram-negative bacteria (GNB) have become a major public health concern worldwide, including Bangladesh. The present study was performed to determine the frequency of imipenem resistant gram-negative bacteria (GNB), their antimicrobial susceptibility pattern. Materials and Methods: A total of three hundred and fifty clinical samples were collected from Bangladesh Institute of Health Sciences hospital (BIHS), Dhaka, Bangladesh, over a period of 12 months. Among 350 samples, 171 (48.86%) were from indoor patients, and 179 (51.14%) were from outdoor patients. The pathogens were isolated and identified by conventional methods and were screened for antibiotic susceptibility using the Kirby–Bauer disc diffusion method, including imipenem discs. A Chi-square test was employed for statistical analysis. Results and Discussion: Out of 350 clinical isolates, 246 showed resistance to imipenem (70.28%). Almost all of the imipenem resistant gram-negative bacteria showed the highest resistant pattern to cefepime (88.57%), amoxicillin (88.29%), cephalosporin (88.14%), cefoxitin (86%), tetracycline (84.42%), and the majority were resistant to levofloxacin (70.85%), doxycycline (70.57%), netilmicin (59.71%). But cotrimoxazole (13.42%) and tigecycline (11.43%) showed a lower resistance pattern. Statistical analysis exhibited imipenem resistant gram-negative isolates most commonly found in pus and urine samples, while Klebsiella spp (30.49%), Pseudomonas spp (26.83%) and E. coli (23.17%) were the most predominant pathogens. Conclusion: This is a retrospective study which study indicates a noteworthy rate of clinical isolates were imipenem resistant gram-negative bacteria in a well-defined tertiary care hospital, and most of these bacteria were also multidrug-resistant. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 145-150

scholarly journals In vitro Antibacterial Effect of Medicinal Plants Against Multidrug Resistant Gram Negative Bacteria

2018 ◽  
Vol 5 ◽  
pp. 25-31
Author(s):  
Bishnu Thapa ◽  
Anjana Singh ◽  
Reshma Tuladhar
Keyword(s):  
Antibacterial Activity ◽  
Medicinal Plants ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Ocimum Sanctum ◽  
Clinical Samples ◽  
Acorus Calamus ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Herbal Plants

Objectives: The aim of this work was to determine the antibacterial activity of methanol extract of herbal plants against the Multidrug resistant (MDR) Gram negative bacteria isolated from clinical samples. Methods: Gram negative bacteria isolated from various clinical samples were processed for antibiotic susceptibility test by modified Kirby-Bauer disc diffusion method and MDR bacteria were selected. Methanol extracts of six different medicinal plants Acorus calamus (bojho), Ocimum sanctum (tulsi), Azadirachta indica (neem), Cinnamomum tamala (tejpatta), Aloe vera and Zanthoxylum alatum (timur), were tested for antibacterial activity against the selected MDR bacteria by agar well diffusion method. Results: From clinical samples, 8 different MDR Gram negative bacteria isolated were Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Citrobacter spp., Proteus mirabilis, Proteus vulgaris, Acinetobacter spp. and Pseudomonas spp. with E. coli dominated the number. Out of six medicinal plants extracts, Z. alatum, C. tamala and Ocimum sanctum were found to be effective with zones of inhibition ranging from 9-13 mm. The medicinal plants with antibacterial activity can be an alternative source of medicine against MDR Gram negative bacteria. Conclusion: Several herbal plants extracts exhibit antibacterial activity against MDR Gram negative bacteria. Antibacterial activity of plant extracts can vary with type of plant and extraction methods. Thus, for optimal benefit of plant extract, an appropriate extraction method and use of purified product is essential.

Phenotypic Characterisation of Klebseilla pneumoniae Carbapenemase and Metallo Beta-lactamase in Carbapenem Resistant Gram-negative Bacteria

2021 ◽  
Author(s):  
Thresia . ◽  
Surya Sankar ◽  
Siju Joseph ◽  
V.R. Ambily ◽  
Anu Bosewell ◽  
...  
Keyword(s):  
Confirmatory Test ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Disc Diffusion ◽  
Beta Lactam ◽  
Disc Diffusion Method ◽  
Gram Negative ◽  
E Coli ◽  
Carbapenem Resistant

Background: Antibiotic resistance is an emerging concern in the therapy of clinical infections worldwide. Previous studies conducted in our laboratory have confirmed an increase in the prevalence of extended spectrum beta-lactamase (ESBL) among the Gram-negative bacterial pathogens associated with dogs, which could act as a potential source for the transfer of these resistant pathogens or their genetic determinants to human. Since carbapenems are the last resort drugs against these resistant pathogens, the study was aimed to isolate and characterise carbapenem resistance among Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae) and Pseudomonas aeruginosa (P. aeruginosa) associated with common clinical infections in dogs.Methods: A total of 100 samples were collected from lesional skin, urine and anterior vagina of dogs presented to the Veterinary Hospitals of Kerala Veterinary and Animal Sciences University at Mannuthy and Thrissur. The samples were cultured onto Brain Heart Infusion Agar (BHIA), Eosin Methylene Blue (EMB) and Mac Conkey (MAC) for isolation of bacteria. Identification of the isolates was performed based on cultural, morphological and biochemical characteristics. The isolates were subjected to antimicrobial susceptibility test (ABST) against the 12 commonly used beta-lactam and non–beta-lactam group of antibiotics by disc diffusion method and further subjected to screening for ESBL double disc diffusion method. Carbapenem-resistant isolates were subjected to phenotypic confirmatory test for carbapenemase production employing Imipenem-EDTA and Ertapenem-boronic acid minimum inhibitory concentration (MIC) strip method.Result: Forty four Gram-negative bacterial isolates obtained were viz., E. coli (30), K. pneumonia (11) and P. aeruginosa (3) from the 100 samples. Apart from these, other isolates obtained were Staphylococcus spp. (53) and Bacillus spp. (2). All the Gram-negative isolates were subjected to ABST employing 12 common antibiotics belonging to beta-lactam and non-beta-lactam groups. Multidrug resistance (MDR) could be observed in 28 E. coli, 11 K. pneumoniae and three P. aeruginosa isolates. All the 42 MDR isolates showed positive results for ESBL production. A total of 14 isolates out of the 44 Gram-negative bacilli were found to be resistant to carbapenem either to imipenem, meropenem or ertapenem. Among the 14 Gram-negative isolates, nine turned out to be positive for metallo-beta-lactamase (MBL) and none for K. penumoniae carbapenemase (KPC) on phenotypic confirmatory test for detecting major carbapenemase enzymes. The present study documented that Gram- negative bacteria like E. coli, K. pneumoniae and P. aeruginosa isolated from dogs are showing an increase rate of resistance against carbapenems which are the last resort drugs against ESBL producers. Hence, there is an urgent need to curb the irrational and excessive use of antibiotics in veterinary sector.

Antimicrobial Activity of Herbal Mixture Extract Combination on Microorganisms Isolated from Urinary Tract infection

Bionatura ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 1346-1351
Author(s):  
Risala H Allami ◽  
Raghad S. Mouhamad ◽  
Sura A. Abdulateef ◽  
Khlood abedalelah al-Khafaji
Keyword(s):  
Urinary Tract Infection ◽  
Antibacterial Activity ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pathogenic Bacteria ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Klebsiella Spp

Urinary tract infection (UTI) is the second most common infection after respiratory tract infection. Its prevalence is more in women as compared to men. Approximately 50% of women have an infection of the Urinary tract in their life-time. The bacterial infection is one of the most important bioactivity; using their ability to imitate evanish then distributes international fitness problems into the 21st centenary. Thus a recent study was undertaken to investigate the antibacterial activity of a mixture of three medicinal plants against UTI infectious isolates. The three considered plants were (Aloe vera, Artemisia herba alba and Teucrium polium), which were used in Iraqi medicine for many centuries. The effectiveness of this combination was investigated using in vitro well diffusion method. The extract was tested against four isolated pathogenic bacteria (Staphylococcus aureus, Klebsiella spp, and Proteus spp). The aqueous extract exhibited antibacterial activity against gram-positive and gram-negative bacteria. The mixture extract had the highest effect against S. aureus and Proteus spp, followed by a lower effect on Klebsiella spp. In conclusion, the antibacterial effect of the tested plant extracts confirmed a higher impact on Gram-positive bacteria as compared to Gram-negative bacteria. Therefore, it can be concluded that the usage of these plants as a traditional medicine form can be considered as a strong assistant to regular medicine drugs and treatments.

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