Prevalence of extended-spectrum beta-lactamase producing gram negative isolates in Enterobacteriaceae group of bacteria in clinical samples from a tertiary care hospital

Introduction: Extended spectrum β-lactamases (ESBLs) are enzymes that intervene resistance to extended-spectrum (third generation) cephalosporins (e.g., ceftazidime, cefotaxime, and ceftriaxone) and but do not affect carbapenems (e.g., meropenem or imipenem). Though the number of ESBLs producing organism has been increasing day by day, the detection methods and treatment option for them are extremely limited. Objective: Objective of the study was to investigate the rate of ESBLs production and their antibiotic susceptibility pattern. Materials and method: A total 200 Gram negative isolates from various clinical samples received in microbiology laboratory, Sir Takhtsinhji General Hospital, Bhavnagar were studied and Antibiotic susceptibility test was done for commonly used antibiotics. A hospital-based study was conducted in microbiology laboratory, Sir Takhtsinhji General Hospital, Bhavnagar from February 2012 to August 2012. A total of 200 Gram negative isolates from various clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. Results: Among the total isolates 89(44.5%) were ESBLs producer, and the rate of ESBLs positivity was 39.8% for E. coli (33 out of 83), 10% for Proteus mirabilis (1 out of 10), 51.4% for Klebsiella spp (55 out of 107). ESBLs producing organisms were resistant to most of the antibiotics but 100% were sensitive to imipenem, meropenem, and cefoperazone + sulbactam. Conclusion: Screening for ESBLs production requires to be carried out regularly in all clinical diagnostic laboratories to direct clinicians in appropriate selection of antibiotics.

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Detection and Antimicrobial Susceptibility Pattern of Extended Spectrum Beta Lactamases (ESBLs) Producing Gram Negative Bacteria from Different Clinical Samples

Pulse ◽

10.3329/pulse.v8i1.28096 ◽

2016 ◽

Vol 8 (1) ◽

pp. 15-20

Author(s):

Suma Mita Biswas ◽

Nikhat Ara ◽

Nasreen Huda ◽

Sofia Andalib ◽

Mohammad Hefzur Rahman ◽

...

Keyword(s):

Antibiotic Susceptibility ◽

Tertiary Care ◽

Detection Methods ◽

Clinical Samples ◽

Care Hospital ◽

Clinical Diagnostic Laboratory ◽

Diagnostic Laboratory ◽

Gram Negative ◽

Extended Spectrum ◽

Antibiotic Susceptibility Test

Introduction: Extended spectrum ?-lactamases (ESBLs) are enzymes that mediate resistance to extended-spectrum (third generation) cephalosporins (e.g., ceftazidime, cefotaxime, and ceftriaxone) and monobactams (e.g., aztreonam) but do not affect cephamycins (e.g., cefoxitin and cefotetan) or carbapenems (e.g., meropenem or imipenem). Though the no. of ESBLs producing organism has been increasing day by day, the detection methods and treatment option for them are extremely limited.Aims & Objective: The present study was undertaken to investigate the rate of ESBLs production and their antibiotic susceptibility pattern.Materials & Method: A total 110 Gram negative isolates from various clinical samples from a tertiary care hospital were studied and ESBLs production was detected by double disc synergy test. Antibiotic susceptibility test was done for commonly used antibiotics.Results: Among the total isolates 66.36% (73) were ESBLs producer, and the rate of ESBLs positivity was 80.32% for E.coli (49 out of 61), 25% for Pseudomonas spp (6 out of 24), 71.42% for Klebsiella spp (10 out of 14), 80% for Enterobacter spp (4 out of 5), 100% for Acinetobacter spp (4 out of 4) and 0% for Proteus spp (0 out of 2). ESBLs producing organisms were resistant to most of the antibiotics but 100% were sensitive to imepenem.Conclusion: Screening for ESBLs production needs to be carried out routinely in every clinical diagnostic laboratory to guide clinicians in proper selection of antibiotics.Pulse Vol.8 January-December 2015 p.15-20

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Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

Tropical Medicine and Health ◽

10.1186/s41182-021-00313-3 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Aryatara Shilpakar ◽

Mehraj Ansari ◽

Kul Raj Rai ◽

Ganesh Rai ◽

Shiba Kumar Rai

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Polymyxin B ◽

Multidrug Resistant ◽

Confirmatory Test ◽

Clinical Samples ◽

Care Hospital ◽

Gram Negative ◽

Extended Spectrum ◽

Esbl Producers

Abstract Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile. Methods A cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers. Conclusion Multidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

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TO STUDY ANTIBIOTIC SENSITIVITY PATTERN OF NONFERMENTATIVE GRAM NEGATIVE BACILLI FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL, JAIPUR.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1132 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Kirti Hemwani ◽

P. S. Nirwan ◽

Preeti Shrivastava ◽

Abhiraj Ramchandani

Keyword(s):

Tertiary Care ◽

Antibiotic Sensitivity ◽

Polymyxin B ◽

Hospital Environment ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Pathogenic Potential ◽

Gram Negative ◽

Sensitivity Pattern

Background: Nonfermentative gram negative bacilli (NFGNB) frequently considered as commensals or contaminants but the pathogenic potential of nonfermenters has been proved beyond doubt. They are resistant to commonly used antimicrobials. Aim: This study was undertaken to identify the nonfermenters isolated from various clinical samples and to know their Antibiotic sensitivity pattern. Materials and Methods: The present study was carried out on 150 strains of Nonfermenters isolated from 1200 various non repetitive clinical samples received in Department of Microbiology, NIMS Jaipur. Nonfermenters were identified using a standard protocol and their antibiotic susceptibility testing was performed with the help of the modified Bauer disc diffusion method. Results: Out of 150 nonfermenters isolated, Pseudomonas aeruginosa was the most common isolate 134 (89.33%) followed by Acinetobacter baumannii 16 (10.67%). Among all clinical samples Pus and Wound Discharge yield maximum isolates of NFGNB i.e. 54 (36%) % followed by sputum (39.0%). Most sensitive drug against NFGNB was Polymyxin-B (100%) followed by Imipenem (86 %) and Amikacin (71.33 %). Conclusion: Nonfermenters have a great potential to survive in a hospital environment so implementation of antibiotic stewardship programs and strict infection control practices will be required to prevent or slow down their emergence and spread. Keywords: Nonfermenters, Polymyxin-B, Pseudomonas, Acinetobacter.

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Prevalence of MDR and ESBL producing Gram-negative isolates from various clinical samples from patients visiting a tertiary care hospital in Kathmandu, Nepal

10.21203/rs.3.rs-198444/v1 ◽

2021 ◽

Author(s):

Aryatara Shilpakar ◽

Mehraj Ansari ◽

Kul Raj Rai ◽

Ganesh Rai ◽

Shiba Kumar Rai

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Polymyxin B ◽

Confirmatory Test ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Severe Problem ◽

Gram Negative ◽

Esbl Producers

Abstract BackgroundThe existence of multi-drug resistance organisms, including extended-spectrum beta-lactamases (ESBLs), is on the rise and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile.MethodsA cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified by using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the Kirby Bauer disc diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test.ResultsOut of 92 isolates, 84 (91.3%) isolates were multidrug resistant, and 47 (51.1%) isolates were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers.ConclusionMultidrug resistance was very high, however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

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Prevalence of nonfermentative gram-negative bacilli and their antimicrobial susceptibility profiles in a tertiary care hospital of Eastern India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20181070 ◽

2018 ◽

Vol 5 (2) ◽

pp. 366 ◽

Cited By ~ 2

Author(s):

Mandira Sarkar ◽

Jagadananda Jena ◽

Dipti Pattnaik ◽

Bandana Mallick

Keyword(s):

Antimicrobial Susceptibility ◽

Nosocomial Infections ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Burkholderia Cepacia Complex ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Isolation And Identification ◽

Gram Negative

Background: Nonfermentative gram-negative bacilli (nonfermenters) have emerged as a major concern for nosocomial infections. They exhibit resistance not only to the beta-lactam and other group of antibiotics but also to carbapenems. This study was undertaken to know the prevalence of nonfermenters from clinical samples along with their antimicrobial susceptibility profile.Methods: A cross-sectional study over a period of 21 months in the microbiology laboratory of a tertiary care hospital was done. Clinical samples were processed by conventional bacteriological methods for isolation and identification. Susceptibility testing was done by Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute.Results: 411 nonfermenters (13.18%) were isolated from 3116 culture positive clinical samples. Out of these nonfermenters, most were Acinetobacter baumannii (51.34%) followed by Pseudomonas aeruginosa (42.09%), Burkholderia cepacia complex (4.38%) and others (2.19%). Others included Burkholderia pseudomellei, Acinetobacter lwoffii and Stenotrophomonas maltophilia. Highest sensitivity to gentamicin and amikacin were shown by A. baumannii and P. aeruginosa respectively while both were mostly resistant to ceftriaxone. Burkholderia and Stenotrophomonas species showed 100% sensitivity to cotrimoxazole. A. baumannii was the most prevalent nonfermenter in intensive care units.Conclusions: Timely identification of nonfermenters and monitoring their susceptibility patterns will help in proper management of infections caused by them. Improved antibiotic stewardship and infection control measures should be implemented to prevent nosocomial infections and spread of drug resistant nonfermenters.

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Frequency and susceptibility pattern of metallo-beta-lactamase producers in a hospital in Pakistan

The Journal of Infection in Developing Countries ◽

10.3855/jidc.1050 ◽

2010 ◽

Vol 4 (12) ◽

pp. 810-813 ◽

Cited By ~ 11

Author(s):

Fatima Kaleem ◽

Javaid Usman ◽

Afreenish Hassan ◽

Aslam Khan

Keyword(s):

Tertiary Care ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Gram Negative ◽

Medical College ◽

Strip Method ◽

Carbapenem Resistant ◽

Microbiological Methods ◽

National University

Introduction: The rapid spread of acquired metallo-beta-lactamases (MBLs) among major Gram-negative pathogens is an emerging threat and a matter of particular concern worldwide. Methodology: This descriptive study was conducted between January and August 2009 in the department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, to determine the frequency and susceptibility patterns of MBL-producers among carbapenem-resistant Gram-negative rods (GNRs) from clinical isolates of a tertiary care hospital. All clinical samples were processed according to standard microbiological methods. Isolated GNRs were subjected to susceptibility testing against various antibiotics by disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Carbapenem-resistant isolates were subjected to the detection of MBL production by the E-test MBL strip method. Results: Out of 50 carbapenem resistant isolates, 39 (78%) of were confirmed to be MBL producers by the E-strip method. Acinetobacter baumannii were the most frequent MBL producers, followed by Pseudomonas aeruginosa. A total of 19 (37%) of the MBL producers were susceptible to cefoperazone-sulbactam. Conclusion: The findings strongly suggest that there is a need to track the detection of MBL producers and that judicious use of carbapenems is necessary to prevent the further spread of these organisms.

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

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v21i1.56341 ◽

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

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Prevalence of Asymptomatic Bacteriuria during Pregnancy at a Tertiary Care Hospital of Province No. 2, Nepal

Tribhuvan University Journal of Microbiology ◽

10.3126/tujm.v6i0.26576 ◽

2019 ◽

Vol 6 ◽

pp. 32-38

Author(s):

Khushbu Yadav ◽

Satyam Prakash

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Pregnant Women ◽

Antibiotic Susceptibility ◽

Tertiary Care ◽

Asymptomatic Bacteriuria ◽

Diffusion Method ◽

Care Hospital ◽

Antibiotic Susceptibility Test

Objectives: The objective of this study was to determine the prevalence of asymptomatic bacteriuria in pregnant women, identify the causative agent responsible for urinary tract infection (UTI) and its antibiotic susceptibility. Methods: The mid-stream urine sample was streaked on the MacConkey agar (MA) and Blood agar (BA) medium by the semi-quantitative culture technique. Identification of significant isolates was done by standard microbiological techniques. Antibiotic susceptibility test of the isolated organisms was done by modified Kirby Bauer disc diffusion method. Results: The prevalence rate of asymptomatic urinary tract infection (AUTI) among pregnant women was found to be 42%. The highest number of UTI cases found during pregnancy was in between age 21-25 years (52.22%), in second gravida (51.59%), during 3rd trimester of pregnancy (49.68%) and in winter with 52.22%. E. coli was principal organism to cause AUTI (35.48%) during pregnancy. Amikacin, imipenem and nalidixic acid were effective towards Gram negative bacilli whereas vancomycin, tetracycline and amoxyclav were effective towards Gram positive cocci. Conclusion: All pregnant women visited for antenatal checkups should be advised for the culture and sensitivity test of their urine specimens which will reduce the maternal and child health complications. Different screening test and awareness programme should be conducted at regular interval of time for prevention of AUTI during pregnancy.

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Detection and genetic characterization of extended-spectrum beta-lactamases producers in a tertiary care hospital

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_31_19 ◽

2019 ◽

Vol 11 (03) ◽

pp. 253-258 ◽

Cited By ~ 1

Author(s):

Suryarashmi Sahoo ◽

Sarita Otta ◽

Bichitrananda Swain ◽

Subrat Kumar Kar

Keyword(s):

Klebsiella Oxytoca ◽

Tertiary Care ◽

Conventional Polymerase Chain Reaction ◽

Diffusion Method ◽

Care Hospital ◽

Beta Lactam ◽

Gram Negative ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Esbl Producers

Abstract BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing organisms inactivate extended beta-lactam antibiotics and monobactams and also exhibit coresistance to many other classes of antibiotics. The present study was carried out to assess the prevalence of the ESBLs and to determine the most prevalent genotype in our hospital. MATERIALS AND METHODS: All clinically significant Gram-negative isolates were identified, and their antimicrobial susceptibility testing was done by Kirby–Bauers' disc diffusion method. ESBL detection was confirmed by minimal inhibitory concentration method using agar dilution technique for those who screened positive by ceftazidime (30 μg) disc. Further, the established ESBL-positive isolates were subjected to genotyping for bla TEM, bla CTX-M, and bla SHV genes by using conventional polymerase chain reaction. RESULTS: Escherichia coli was the most common (28.84%) Gram-negative bacillus followed by Klebsiella pneumoniae (18.07%), while Pseudomonas spp. (9.61%) was the most commonly identified nonfermenter. ESBL production was detected in 160 (30.8%) isolates. Klebsiella oxytoca (46.7%) followed by E. coli (44%) were the common ESBL producers. Most predominant ESBL gene was bla TEM, found in 122 (76.25%) isolates. Combinations of two genes were seen in 109 (68.1%) isolates, the most common (43.12%) combination being blaTEM and blaCTX-M. In this study, 16 (10%) strains had all the three types of genes. Most of the isolated Gram-negative bacilli (GNB) were sensitive to amikacin, imipenem, and colistin. CONCLUSION: In our study, the 30.8% of GNB were ESBL producers. This is the only study that shows that TEM is the most prevalent ESBL genotypes in our area. Of concern is a good number of isolates showing all three patterns of genes (TEM, SHV, and CTX-M). Amikacin, imipenem, and colistin were the most useful antibiotics in our setup.

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Detection of Gram Negative Bacilli Producing Extended Spectrum Beta Lactamase on Intensive Care Unit at Tertiary Care Hospital

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i23b31413 ◽

2021 ◽

pp. 15-21

Author(s):

M. Nishanthy ◽

Chitralekha Saikumar

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Tertiary Care ◽

Clinical Samples ◽

Care Hospital ◽

Beta Lactamase ◽

Principal Mechanism ◽

Gram Negative ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum

Antimicrobial resistance is a budding threat worldwide. The every class of antibiotic agents must have resistance mechanisms.The principal mechanism for resistance to the β-lactam antibiotics in gram-negative bacteria is the production of β-lactamase. The creation of extended-spectrum β-lactamases (ESBLs) is a vital mechanism which is responsible for the resistance to the cephalosporins. During the last 2 decades, ESBL producing gram-negative bacilli have arose as a major problem in many settings. Resistance to 3rd generation cephalosporins by attainment and manifestation of extended spectrum beta lactamase (ESBL) enzymes among gram-negative bacilli is on a rise. To isolate the ESBL strains from various clinical samples in ICU. To find out the prevalence of ESBL producing gram negative bacilli during the period of December 2017 - December 2018 in the Intensive care unit of Sree Balaji Medical College and Hospital. Totally 27 out of 139 gram negative bacilli (19.42%) were found to be ESBL producers. ESBL triggering gram negative bacilli spiteful the biological sample like blood, urine, wound swab, sputum were 36.36%, 16.00%, 10.00%, 9.09% individually Though Meropenem is 100% sensitive to all ESBL beginning gram negative bacilli, but still sensitivity also witnessed with some cheaper drugs like Cotrimoxazole (33.33%), Amikacin (48.14%), Gentamicin (40.7%), Ciprofloxacin (22.22%). Hence we care and will provide an analysis and treatment for affected patients with Extended Spectrum Beta Lactamase producing organisms.

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