scholarly journals Antimicrobial susceptibility pattern of pus culture in a tertiary care hospital of Jharkhand, India

Author(s):  
Rajiv Kumar ◽  
Akhilesh Kumar ◽  
Umashanker Prasad Keshri ◽  
Manju Gari ◽  
Sumit Kumar Mahato ◽  
...  

Background: Antimicrobial resistance is developing day by day leading to increase not only in health care cost but also severity and death rate from certain infection that could have been avoided by rational use of existing and new antimicrobial agents. Present study is undertaken for this purpose to analyse the types of pathogens involved and their antibiotic sensitivity isolated from pus culture reports in a tertiary care hospital.Methods: Observational study was conducted using pus culture and sensitivity reports collected retrospectively from the records maintained in the Department of Microbiology over a period of 5 months from August 2016 to December 2016 in tertiary care hospital.Results: 85 percent pus samples were found culture positive of which microorganism isolated in decreasing order were Staphylococcus aureus, Pseudomonas, Klebsella and E. coli. Staphylococcus aureus was sensitive to fixed drug combination of piperacillin with tazobactam, linezolid, ceftriaxone with sulbactum, levofloxacillin and ciprofloxacin and resistance to cefotaxime, cloxacillin and ampicillin. Pseudomonas was highly sensitive to fixed drug combination of cefoperazone with sulbactum, piperacillin with tazobactum, ceftriaxone with sulbactum and resistance to cloxacillin and cefotaxime. Klebsiella showed high sensitivity to piperacillin with tazobactum, cefoperazone with sulbactum, ceftriaxone with sulbactum and was found resistant with norfloxacin and amoxycillin. E. coli showed high sensitivity in decreasing order with amikacin and gentamycin and resistance in increasing order with cefotaxime, cloxacillin, ampicillin and norfloxacin.Conclusions: The sensitivity patterns were different for each isolated microorganism but high sensitivity was found with fixed antimicrobial drug combination and resistance to frequently used drugs.

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 74-77
Author(s):  
Dipak Bhargava ◽  
Bijay Raj Pandit ◽  
Amarullah Shidiki ◽  
Ravi Shankar Gupta

Urinary tract infection is the second most common infection following respiratory tract infection. Among the outdoor and the indoor patients it is one of the common clinical state of affairs. For the effective management of this common clinical condition isolation of the common bacterial uropathogens and their antibiotic sensitivity profile is obligatory. In this present brief work an effort has been made to isolate the common bacterial uropathogen and their susceptibility pattern to the regularly used antimicrobial agents. We carried out this work in the Microbiology department of National Medical College from June 2016 to December 2016. In our study beside clean catched mid stream urine sample, catheterized urine sample and suprapubic aspirates are also collected. In our study we included a total of 516 UTI samples of patients. In our work 319 (62%) culture positive urine samples were from outpatient patient department while 197 (38%) were from inpatient department. Among both the outdoor and the indoor patient E. coli was the predominant organism followed by Klebsiella, Staphylococci, Enterococci and Pseudomonas. In our present work we found that the common bacterial isolates from the indoor patient showed higher degree resistance towards Aminopenicillin, Piperacillin, Nitrofurantoin, Ciprofloxacin and Nalidixic acid. Common bacterial uropathogens were found to be sensitive against Norfloxacin, Nitrofurantoin and Cephalosporins like Cefuroxime and Ceftazidime. It has also been found that beside E. coli other bacterial uropathogens were effective against third generation Cepahalosporins and Amikacin. This study clearly denotes that antibiotic sensitivity test should be carried out for determination of optimal treatment regimen against UTI.Med Phoenix Vol.2(1) July 2017, 74-77


2017 ◽  
Vol 7 (2) ◽  
pp. 101-105
Author(s):  
Jamal Uddin Ahmed ◽  
Mohammad Delwar Hossain ◽  
Muhammad Abdur Rahim ◽  
Farhana Afroz ◽  
AKM Musa

Background: Diabetes mellitus (DM) is an immunosuppressive condition and uncontrolled diabetes is associated with increased susceptibility to various infections like pneumonia. Community acquired pneumonia (CAP) in diabetic patients is often caused by more virulent or atypical organisms and associated with increased resistance to conventional antibiotics. The aims of this study were to identify the bacterial etiology of CAP in patients with DM and to see their antibiotic sensitivity pattern.Methods: This was a cross-sectional, observational study conducted in the Department of Internal Medicine & Pulmonology of BIRDEM General Hospital, Dhaka, Bangladesh, from January 2013 to December 2015. A total of 120 hospitalized diabetic patients diagnosed with CAP and with a positive sputum culture growth of any bacteria were included in the study.Results: Majority (67%) of the patients were male. Mean age of the patients was - 55.69 ±10.5 years. Mean duration of diabetes was - 7.35 ±1.3 years. Mean HbA1c was - 8.6 ±1.89%. Sputum for culture showed that out of 120 (100%) patients, Klebsiella pneumoniae was detected in 53 (44.2%) patients, Staphylococcus aureus in 18 (15.0%), Pseudomonas species in 16 (13.3%) patients, Acinetobacter in 10 (8.3%), Escherichia coli in 9 (7.5%) patients and 14 (11.7%) patients had growth of other organisms. Sensitivity pattern of different bacterial growth in sputum to commonly used antibiotics like ceftriaxone, ciprofloxacin, amikacin and imipenem were as follows – Klebsiella (19%, 47%, 74%, 96% respectively), Staph aureus (11%, 33%, 78%, 67% respectively), Pseudomonas (19%, 75%, 81%, 88% respectively), Acinetobacter (0%, 0%, 20%, 50% respectively), E. coli (22%, 22%, 100%, 100% respectively). All (100%) of the Pseudomonas and Acinetobacter were sensitive to colistin. Most of the growth of all the bacteria (Klebsiella 94%, Staphylococcus 78%, Pseudomonas 81%, Acinetobacter 100%, E. coli 100%) occurred in patients with poor glycemic control (HbA1c ? 7.0%).Conclusion: This study results suggest that CAP in diabetic patients are more frequently due to Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas species and mostly they are less sensitive to commonly used antibiotics like ceftriaxone and ciprofloxacin. So, whenever possible, treatment of CAP should be guided by sputum culture and sensitivity test and for empirical treatment of CAP in diabetic patients, alternative antibiotics like imipenem and amikacin should be considered.Birdem Med J 2017; 7(2): 101-105


Author(s):  
Kxitiza Pandey ◽  
Sulekha Nautiyal

Background: Achromobacter is a ubiquitous, non-fermenting, Gram-negative bacterium that lives in soil and aquatic environments. In recent years, many studies have shown its potential as opportunistic pathogen. It can colonize various items used in hospital and can survive various disinfectants. The infections get complicated due to its vast spectrum of intrinsic and extrinsic resistance to antimicrobial agents and disinfectants. Achromobacter spp. is an emerging pathogen and is becoming a reservoir for horizontal genetic transfer elements involved in spreading antibiotic resistance. This study was conducted to assess the extent of the Achromobacter related infection in our hospital setting and to set a baseline for future studies.Methods: This study was conducted over a period of one year (January to December 2018) in our tertiary care hospital. All specimens submitted for aerobic culture and sensitivity were analyzed and the bacterial identification and antibiotic sensitivity of the isolates was carried out using automated method (Vitek 2 Compact, bioMerieux).Results: Achromobacter species was reported from 0.46% (63/13831) specimens, 40% of them were isolated from suction tips. Achromobacter denitrificans amounted for 47/63 (74.6%) while Achromobacter xylosoxidans was identified in 16/63 (25.4%).Conclusions: Studying the organisms in order to observe their changing trends


Author(s):  
Avneet Kaur Heyar ◽  
Kamaldeep Kaur ◽  
Amarjit Kaur Gill ◽  
Prabhjot Kaur Gill

Nowadays in Staphylococcus aureus isolates resistant to lincosamide, macrolide and streptogramin B (MLSB) group of antibiotics are expanded. Therefore, clindamycin is preferred drug for the treatment of infections caused by S. aureus, but due to change in sensitivity patterns of clindamycin it is leading to treatment failure. The three resistance phenotypes of MLSB antibiotics are iMLSB (inducible resistance) and cMLSB (constitutive resistance) that are resistant to macrolides, lincosamides and streptogrammins B antibiotics, whereas MS resistance that is sole resistant to macrolides and streptogramins B antibiotics. Erythromycin ribosome methylase (erm) genes are responsible for expressing inducible clindamycin resistance among S. aureus. In the present investigation, a Double disc approximation/Disc induction test (D-test) and PCR were used. Out of 428 strains the prevalence of iMLSB, cMLSB and MS phenotypes were 36 (8.41%), 47 (10.98%) and 48(11.21%) respectively. It is concluded that D-test should be routinely done to avoid treatment failure due to clindamycin resistance. In addition, PCR is a simple, quick, reliable and sensitive method that could also be used in the detection of inducible clindamycin resistance. The reason for the lower prevalence of iMLSB phenotype in the present study could be due to the reason that samples included in this study were mostly from the rural areas as the exposure of antimicrobial agents is less. Keywords: Clindamycin resistance, D-test, ermA, ermC, iMLSB, S. aureus


2017 ◽  
Vol 4 (6) ◽  
pp. 2103
Author(s):  
Rekha Thaddanee ◽  
Gurudas Khilnani ◽  
Nupur Shah ◽  
Ajeet Kumar Khilnani

Background: This prospective observational study was conducted in a tertiary care hospital in Kachchh, over a period of 6 months, to know the antibiotic sensitivity pattern of pathogens in children less than 18 years old with Urinary Tract Infection (UTI).Methods: Between December 2016 to June 2017, 186 children met the inclusion criterion. Urine samples were collected and processed for urine routine microscopy, culture and antibiotic sensitivity as per the standard laboratory guidelines. Urine culture was positive in 50 cases, which were further evaluated to find out any renal disease. All patients were given 10-14 days antibiotics course and follow-up urine reports were done. Patients were considered cured when the follow-up urine reports were normal.Results: E. coli was the commonest organism (34%) isolated, found mainly in 1-5 years age group (20%). Enterococci were isolated in 32% cases, most of which were less than 5 years of age (28%). Klebsiella (12%), Methicillin Resistant Staphylococcus Aureus (MRSA) (10%), Coagulase negative staphylococci (6%), Pseudomonas (2%) and Budding yeast cell (4%) were the less frequent organisms isolated. E. coli were found to be less sensitive to different Aminoglycosides (11.7% - 23.5%), Cephalosporins (11.7% - 52.9%), Fluoroquinolones (5.8% - 11.7%), Co-trimoxazole (17.6%) and Piperacillin (17.6%), but were more sensitive (70.6%) to Imipenems. Enterococci were also partially sensitive to Aminoglycosides (6.2-18.7%), Cephalosporins (25-37.5.7%), Fluoroquinolones (6.25-12.5%), Penicillin-G (50%), Piperacillin (31.25%) and Co-trimoxazole (43.75%), but had good sensitivity for Imipenems (68.7%), Linezolid (75%) and Vancomycin (81.2%). Similarly, MRSA was 100% sensitive to Linezolid and Imipenem but partially sensitive (20-60%) to other antibiotics. Klebsiella showed 16.65-33.3% sensitivity to all antibiotics except Imipenem (83.3%) and was 100% resistant to Co-trimoxazole. Coagulase negative Staphylococci (CONS) remained 100% sensitive to all antibiotics and Pseudomonas was resistant to all antibiotics.Conclusions: The study concludes that pathogens for UTI in children have developed resistance, even to the newer generation antibiotics, probably due to the irrational use of antibiotics. In view of emergence of multi drug resistant pathogens, which carry considerable morbidity and mortality, every effort must be taken to use antibiotics judiciously.


2016 ◽  
Vol 5 (1) ◽  
pp. 20-23
Author(s):  
Raziur Rahman ◽  
Muhammad Abdur Rahim ◽  
Samira Rahat Afroze ◽  
Palash Mitra ◽  
Tabassum Samad ◽  
...  

Background and Aims: Urinary tract infection (UTI) is a common illness. The spectrum of bacteria causing UTI and their antibiotic sensitivity is not uniform. This study was designed to describe the bacteriological spectrum causing UTI and their antibiotic sensitivity.Methods: This cross-sectional study was done in the Department of Internal Medicine, BIRDEM General Hospital from January to June, 2013.Results: Total number of patients was 103 with females predominance (F:M ratio 2:1). Mean age was 57.5 years. Most (91.3%) of the study population were diabetic with poor glycaemic control (mean HbA1c 9.9%). Common symptoms were fever, dysuria, increased urinary frequency, suprapubic pain, vomiting and loin pain. Neutrophilic leukocytosis was common (94.2%). E. coli (79.6%) was the commonest aetiological agent followed by Klebsiella (9.7%), Citrobacter (3.9%), Acinetobacter (1.9%), Enterobacter (1.9%), Enterococcus (1.9%) and Pseudomonas (0.9%). Imipenem (100%), aminoglycosides e.g. amikacin and gentamycin and nitrofurantoin were among the most sensitive antibiotics.Conclusion: E. coli is the commonest organism causing UTI and imipenem, amikacin and nitrofurantoin are the most sensitive antibiotics.Birdem Med J 2015; 5(1): 20-23


2020 ◽  
Author(s):  
Vijayalaxmi V Mogasale ◽  
Prakash Saldanha ◽  
Vidya Pai ◽  
Rekha PD ◽  
Vittal Mogasale

Abstract Background There is global consensus that Antimicrobial Resistance (AMR) poses an unprecedented challenge to modern medicine as we know it today; and the lack of new antibiotics in the pipeline is compounding the threat to contain emerging drug-resistant infections. In 2017, the World Health Organization (WHO) has articulated a priority pathogens list (PPL) to provide strategic direction to research and development of new anti-microbials. Anti-microbial resistance patterns of selected ‘drug-bug’ combinations based on the WHO-PPL in one tertiary health care facility in India are explored in this paper. Methods Culture reports of laboratory specimens, collected between 1st January 2014 and 31st October 2019 from paediatric patients in a tertiary care hospital in India, were retrospectively extracted. The antimicrobial susceptibility patterns for selected antimicrobials based on the WHO-PPL are analysed and reported. Results Of 12,256 culture specimens screened, 2,335 (19%) showed culture positivity; of which 1,556 were organisms from the WHO-PPL. E. coli was the most common organism isolated (37%) followed by Staphylococcus aureus (16%). Total 72% of E. coli were extended-spectrum beta-lactamases producers, 55% of Enterobacteriaceae were resistant to 3rd generation cephalosporins, and 53% of Staphylococcus aureus were Methicillin resistant. Time-trend analysis of the data showed continued high resistance to carbapenem in E coli, Klebsiella pneumoniae and Enterobacter cloacae. Conclusions The AMR trends and prevalence patterns are likely to be different, across various local settings, than as defined at the national level or the WHO-PPL. This difference needs to be recognised in decision and policy making. It is critical, that the evidence used at national and global levels, have reasonable geographical and population representation through standardised and more granular AMR surveillance, in order to improve the effectiveness of the overall national AMR response.


2010 ◽  
Vol 2 (02) ◽  
pp. 078-081 ◽  
Author(s):  
Shilpa Arora ◽  
Pushpa Devi ◽  
Usha Arora ◽  
Bimla Devi

ABSTRACT Aim: The emergence of Methicillin-resistant Staphylococcus aureus (MRSA) has posed a serious therapeutic challenge. We report the prevalence and antibiotic susceptibility pattern of MRSA in the hospitals attached to GMC, Amritsar, Punjab. Materials and Methods: The study comprised of 250 coagulase-positive staphylococci (COPS) isolated from a total of 6743 clinical specimens (like pus, blood, urine, high vaginal swab, sputum, etc.) of patients admitted in hospitals attached to Government Medical College, Amritsar from January 2008−February 2009. Routine antibiotic susceptibility testing was performed and interpreted as per standard guidelines. Methicillin resistance was detected using oxacillin and cefoxitin disc diffusion method, oxacillin screen agar method, and minimum inhibitory concentration using broth macrodilution method. Results: A total of 115 (46%) strains were found to be methicillin resistant. Multidrug resistance was observed in 73% MRSA strains. However, no strain was resistant to vancomycin. Conclusion: Regular surveillance of hospital-associated infection and monitoring of antibiotic sensitivity pattern is required to reduce MRSA prevalence.


2020 ◽  
Vol 7 (1) ◽  
pp. 23-29
Author(s):  
Gunjal P. N. ◽  
Gunjal S. P.

Urinary tract infection (UTI), is defined as a disease caused by invasion of urinary tract by microorganisms. Majority of UTI cases are due to bacterial infection constitute about 95% of total UTI cases. About 80% of UTI cases are caused by E.coli producing extended spectrum ?-lactamase (ESBL) producing isolates. In recent years limitations in treating infections caused by multidrug resistant organisms has increased. This study aims to determine ESBL production of E. coli cases from a tertiary care hospital. Methodology: A total 358 midstream urine samples were collected by random sampling method during March 2015 to June 2018. Identification, antibiotic sensitivity testing, performed according to standard protocol following Clinical and Laboratory Standard Institute (CLSI) guidelines, 2013. Screening for ESBL producing E.coli isolates performed using ceftazidime further confirmation done by phenotypic disc diffusion test using combined disc method using ceftazidime (30µg) & ceftazidime/ clavulanic acid (30/10 µg) as per CLSI guidelines. Results: Total 358 specimens processed for urine culture. Gram negative bacilli isolated from 123(34.35 %), out of which 68 (55.28%) were E.coli, 19 (15.44%) K. pneumoniae, 15 (12.19%), Pseudomonas spp. 08 (6.50%), Citrobacter spp and Acinetobacter spp, 03 (2.43%), Proteus mirabilis, 01 (0.81%) Proteus vulgaris and Enterobacter respectively. Out of 68 isolates of E.coli, 65 (95.58%) were MDR, ESBL was detected in 31 (47.69%) out of these 65 isolates. Out of these 31 cases 19 (61.29%) were female and 12 (38.70%) were male cases. Conclusion: This study concludes 47.69% ESBL producing MDR E. coli were isolated from UTI cases with female predominance.


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