scholarly journals Antimicrobial drug sensitivity pattern of Pseudomonas aeruginosa in respiratory infections

2017 ◽  
Vol 6 (7) ◽  
pp. 1591
Author(s):  
Syed S. Ameen ◽  
Shanmukananda Prakash ◽  
Laxminarayana Bairy K. ◽  
Shahabuddin Soherwardi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Respiratory Infections ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Mortality And Morbidity ◽  
Antimicrobial Susceptibility Pattern ◽  
Sensitivity Pattern ◽  
Male Preponderance

Background: Pseudomonas aeruginosa, a gram-negative pathogen commonly associated with nosocomial infections is the most widespread multidrug-resistant pathogen causing pneumonia in hospitalized patients. Inadequate empirical therapy has been associated with high mortality and morbidity. Objective: To evaluate and analyze the antimicrobial susceptibility pattern of P. aeruginosa in respiratory infections in a tertiary care hospital.Methods: The study was carried out at Kasturba Hospital, Manipal from Jan 2011 to Dec 2011. Specimens of 63 in-patients were analyzed who were culture positive for P. aeruginosa.Results: Majority of patients were aged above 40yrs with a male preponderance. Specimens were taken from patients who were diagnosed with bronchiectasis, pneumonia, COPD, bronchial asthma etc. Overall the organism was most sensitive to carbapenems (87.3%) followed by cefoperazone-sulbactam combination (85.7%). Sensitivity to ceftazidime and cefepime was equal (82.5%) and was more when compared to piperacillin-tazobactam (81.5%). Overall resistance rate was highest for fluoroquinolones (23.8%) followed by aztreonam (22.2%).Conclusions: Hence we would like to recommend cefoperazone-sulbactam as the preferred antipseudomonal agent and carbapenems as reserved drugs in treating pseudomonal lung infections. Use of fluoroquinolones and aztreonam as monotherapy in resistant P. aeruginosa infections should be restricted.

scholarly journals Bacteriological profile with antibiotic sensitivity pattern of burn wound infections in a peripheral tertiary care hospital

2021 ◽  
Vol 8 (4) ◽  
pp. 1253
Author(s):  
Arnab Mandal ◽  
Swapan Das
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Susceptibility ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Specific Pattern ◽  
Care Hospital ◽  
Wound Infections ◽  
Burn Wound ◽  
Mortality And Morbidity ◽  
Sensitivity Pattern

Background: India, has an estimated burn incidence of 6-7 million annually. Nearly 10% of these are life threatening and require hospitalization, and main cause of mortality and morbidity of these burn patients were wound infection and sepsis after 1st 24 hours. The present study was tried to determine specific pattern of burn wound infections, and antibiotic susceptibility of those isolates.Methods: After matching inclusion and exclusion criteria, total 55 patients were taken for this institution based, prospective observational study. Wound swabs were collected on day 7 and cultured aerobically in MacConkey agar and 5% blood agar and antibiotic susceptibility testing was done on Muller Hinton agar using Kirby-Bauer disc diffusion method.Results: Among study population 69.1% patients were female and majority (29.1%) of the patients belongs to age group from 21 to 30. It was found that 48 wound swabs were positive for microorganisms, of which Pseudomonas aeruginosa was most common isolated organism (23.6%), followed by Klebsiella pneumoniae (16.4%) and Staphylococcus aureus (14.5%). The most effective antibiotic found in this study was piperacillin/tazobactam, followed by imipenem/cilastatin.Conclusions: It was seen that gram-negative organisms were more prevalent. Pseudomonas aeruginosa was the most common microorganism and piperacillin/tazobactam was most effective antibiotic.

scholarly journals Dissemination of Plasmid-Mediated Aminoglycoside-Modifying Enzymes Among MDR Acinetobacter baumannii Isolates from a Tertiary Care Egyptian Hospital

2020 ◽  
Vol 14 (1) ◽  
pp. 98-106
Author(s):  
Mahmoud M. Tawfick ◽  
Hamada F. Rady ◽  
Mervat I. El-Borhamy ◽  
Anwar D. Maraqa
Keyword(s):  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Care Hospital ◽  
Aminoglycoside Resistance ◽  
Antimicrobial Susceptibility Pattern ◽  
Pcr Method ◽  
Resistance Rates ◽  
Encoding Genes

Background: Acinetobacter baumannii is one of the most challenging multidrug-resistant (MDR) nosocomial pathogens worldwide. Aminoglycosides are used for the treatment of A. baumannii infections, however, resistance to aminoglycosides is currently emerging, limiting therapeutic choices. Objective: In this study, the prevalence of aminoglycoside resistance and plasmid-mediated mechanisms of aminoglycoside resistance were investigated in A. baumannii clinical isolates collected from ICU patients at a tertiary care hospital in Egypt. Methods: The automated Vitek 2 system was used to identify A. baumannii species and determination of the antimicrobial susceptibility pattern. The identification of A. baumannii was confirmed by the detection of the blaOXA-51-like gene intrinsic to this species. Minimum Inhibitory Concentration (MIC) of gentamicin was determined using E-test following the CLSI breakpoints. Isolates were screened for the prevalence and diversity of the plasmid-carried aminoglycoside-modifying enzymes encoding genes aacC1, aadA1, aadB and aphA6. For genetic diversity analysis, the ERIC-PCR method was performed. Results: All A. baumannii isolates were MDR with high resistance rates to tested antimicrobials. The resistance rate to gentamicin was 92.9% with elevated MICs (≥ 32 μg/mL). The gentamicin-resistant isolates harboured one or more of the studied genes with the prevalence of aphA6 (81%). ERIC-based genotyping revealed that there was no evidence of A. baumannii clonal dissemination among isolates. Conclusion: The study concluded that MDR A. baumannii isolates were highly resistant to gentamicin. The plasmid-carried aminoglycoside-modifying enzymes encoding genes were disseminated among isolates with the AphA6 gene, which was the most prevalent one. The acquisition of more than one aminoglycoside resistance gene was associated with an elevated MIC of gentamicin. Thus, regular surveillance studies of the emerging resistance to antimicrobials and strict measures to control the dissemination of resistance determinants genes are warranted.

scholarly journals Antibiogram of the Common Uropathogenic Bacteria among Yemeni Patients in Sana’a City: A Recent Report

2018 ◽  
pp. 1-10 ◽  
Author(s):  
Hafez Alsumairy ◽  
Tawfique K. AlZubiery ◽  
Talal Alharazi ◽  
Mufeed Baddah ◽  
Adel Al-Zubeiry
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Empirical Therapy ◽  
High Sensitivity ◽  
Resistance Rate ◽  
Beta Lactam ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Uropathogenic Bacteria

Aims: This study aimed to identify the prevalence and antimicrobial susceptibility of the commonly isolated uropathogens in Sana’a city, Yemen. Study Design:  A cross-sectional and descriptive study. Place and Duration of Study: The study was carried out at the hospitals and clinics of Sana'a city, Yemen between October 2016 and March 2017. Methodology: Clean-catch mid-stream urine samples were collected to detect the most common uropathogenic bacteria and their antibiotic susceptibility using Kirby Bauer standardized method. Results: Urine cultures yielded 170 significant bacterial growths of uropathogens. Escherichia coli was the most often isolated pathogen (43.5%), followed by Klebsiella pneumoniae (24.7%), Pseudomonas aeruginosa (20.0%) and Staphylococcus aureus (11.8%). The overall sensitivity was high to an excellent pattern for Carbapenems, Nitrofurantoin, Amikacin, and Piperacillin-Tazobactam. Escherichia coli shows an excellent sensitivity (88%) for Nitrofurantoin and Imipenem, followed by (85%) Ertapenem. Pseudomonas aeruginosa exhibited moderate resistance to Carbapenems, Moxifloxacin, and Piperacillin-Tazobactam in this study. Staphylococcus aureus was more vulnerable to all Quinolones except Nalidixic acid and it displays a high sensitivity pattern, 90% for both Nitrofurantoin and Gentamicin, 83% for Penicillin, 80% for both Minocycline. Antibiogram of isolated organisms revealed that there was resistance to two and more antimicrobials. Conclusion: In this study, we observe a high resistance rates to Beta-lactam, Quinolones, and Macrolides antibiotics. Nevertheless, most uropathogenic isolates were still sensitive to Nitrofurantoin, Imipenem, Ertapenem, and Amikacin, they considered as a proper antibiotics for empirical therapy of UTIs. Establishment of antibiogram of locally isolated organisms is necessary to avoid indiscriminating use of antibiotic and to decrease the resistance rate in our community.

scholarly journals Isolation, identification and antibiotic sensitivity pattern of aerobic bacteria from burn wound patient admitted in tertiary care hospital

2020 ◽  
Vol 8 (6) ◽  
pp. 2095
Author(s):  
Amit Kumar Sah ◽  
Varun Goel ◽  
Siddu Lagamappagol
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Infectious Complications ◽  
Aetiological Factor ◽  
Research Centre ◽  
Care Hospital ◽  
Burn Wound ◽  
Sensitivity Pattern

Background: Significant burn injuries induce a state of immunosuppression that predisposes patients to infectious complications, thus the rate of nosocomial infections are higher. Rapidly merging multidrug resistant among the various isolate in indoor burn patients are depending on time-line becoming serious threat for managing therapeutically. Objective of this study is to determine the aetiological factor, prevalence, antimicrobial susceptibility pattern and emerging nosocomial pathogens.Methods: A prospective study was carried in burn ward of K.L.E.’s Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum for the period of 1 year. Pair of wound swab were collected from patient having burnt more than 30% (RULE OF NINE) on 3rd day of stay. Sample were collected aseptically from 30 patients and processed by convectional culture and biochemical identification procedures and tested against commonly used antibiotics.Results: 30 patients that fall under inclusive criteria were enrolled in the study. The total burn surface area (TBSA) ranges from 30-82%. The ratio of female to male patient suffering burn wound in our study is 1.5:1. Aetiology of burn is heat (moist/dry) mostly. Depending upon degree of burn, most of patient suffered from 20 degree (superficial to deep) injury. From 30 swab cultures, 42 isolates were identified during the study in which mixed were 66.66% and one is fungi. The most commonly isolated is Pseudomonas aeruginosa (45.24%) then Klebsiella pneumoniae (19.04%), Acinetobacter spp. (14.28%), Staphylococccus aureus (11.90%). Among gram positive isolates, isolates are found to be most resistant to Erythromycin (100%) and Co-trimoxazole (100%) and sensitive to Vancomycin (71.42%). Among gram negative isolates are found to be most resistant to Gentamicin (91.65%), Ciprofloxacin (82.35%), Ceftazidime (82.35%) and sensitive to Meropenem (52.95%), Piperacillin (35.30%), Carbenicillin (29.41%).Conclusions: Pseudomonas aeruginosa was found to be the most common isolate. The nature of microbial wound colonization and flora changes with time should be taken into consideration in empirical antimicrobial therapy.

scholarly journals Phenotypic and Genotypic Detection of Methicillin Resistant Staphylococcus aureus in Health Care Workers and Its Containment in a Tertiary Care Hospital, in South India

2021 ◽  
Author(s):  
Shamim Rahman ◽  
Ragini Ananth Kashid
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Meca Gene ◽  
Control Measures ◽  
Care Hospital ◽  
Beta Lactam ◽  
Accurate Identification ◽  
Mortality And Morbidity ◽  
Sensitivity Pattern ◽  
Hospital Infection Control

MRSA causes nosocomial and community based infections. It is associated with significant mortality and morbidity. Resistance in MRSA is encoded by mecA gene. Anterior nares are the ecological niche of Staphylococcus aureus. HCWs who are colonized with MRSA, act as agents of cross contamination of hospital and community acquired MRSA. Treating MRSA infections is a therapeutic challenge as it is resistant to beta lactam group of drugs. Therefore, there is a need for rapid and accurate detection of MRSA carriage in HCWs and to understand its antibiotic susceptibility pattern.The objective of the present study is to estimate the occurrence of MRSA in HCWs, using phenotypic and genotypic methods. A prospective study for six months was conducted after obtaining Institutional Ethical Committee clearance. Anterior nasal swabs of those HCWs who gave informed consent were taken processed for culture and sensitivity as per standard protocol. To detect MIC for oxacillin, E-strip method was used. mecA gene detection was done by PCR. A total of 300 HCWs were sampled.14.66% (44/300) of the isolates were identified as Staphylococcus aureus, of which 10 isolates were detected as MRSA. The overall isolation rate of MRSA is 3.33 %(10/300). MRSA carriage was high amongst nurses (5/59, 8.47%), followed by doctors (4/105, 3.80%).Antibiotic sensitivity pattern showed that highest resistance was to penicillin (75%) followed by amoxiclav (70.45 %).9 MRSA isolates were detected as mecA gene positive by PCR. MRSA carriers were decontaminated successfully with 2% mupirocin ointment and 2% chlorhexidine shampoo. This study reiterates the need for rapid and accurate identification of HCWs who have nasal colonization with MRSA, for reinforcing hospital infection control measures and decontamination protocol. This will help prevent the spread of MRSA in our community.

scholarly journals Evaluation of antimicrobial resistance, biofilm forming potential, and the presence of biofilm-related genes among clinical isolates of Pseudomonas aeruginosa

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Esmat Kamali ◽  
Ailar Jamali ◽  
Abdollah Ardebili ◽  
Freshteh Ezadi ◽  
Alireza Mohebbi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
Infection Prevention And Control ◽  
Beta Lactam ◽  
Antimicrobial Susceptibility Pattern ◽  
Combination Strategies ◽  
High Standards ◽  
And Control ◽  
Genotypic Characteristics

Abstract Objectives Pseudomonas aeruginosa is known as a leading cause of nosocomial infections worldwide. Antimicrobial resistance and biofilm production, as two main virulence factors of P. aeruginosa, are responsible for the persistence of prolonged infections. In this study, antimicrobial susceptibility pattern and phenotypic and genotypic characteristics of biofilm of P. aeruginosa were investigated. Results A total of 80 clinical P. aeruginosa isolates were obtained. Isolates showed resistance to all antibiotics with a rate from 12.5% (n = 10) against amikacin and piperacillin/tazobactam to 23.75% (n = 19) to levofloxacin. Multidrug-resistant P. aeruginosa accounted for 20% (n = 16). 83.75% (n = 67) of isolates showed biofilm phenotype. All three biofilm-related genes were found simultaneously in 87.5% (n = 70) of P. aeruginosa and 13.5% (n = 10) of the isolates had none of the genes tested. From the results of the present study, combination therapy including an anti-pseudomonal beta-lactam (piperacillin/tazobactam or ceftazidime) and an aminoglycoside or carbapenems (imipenem, meropenem) with fluoroquinolones in conjunction with an aminoglycoside can be used against Pseudomonas infections. However, reasonable antimicrobial use and high standards of infection prevention and control are essential to prevent further development of antimicrobial resistance. Combination strategies based on the proper anti-pseudomonal antibiotics along with anti-biofilm agents can also be selected to eradicate biofilm-associated infections.

A Bundle of Measures to Control an Outbreak of Pseudomonas aeruginosa Associated With P-Trap Contamination

2018 ◽  
Vol 39 (2) ◽  
pp. 164-169 ◽  
Author(s):  
Houssein Gbaguidi-Haore ◽  
Amélie Varin ◽  
Pascal Cholley ◽  
Michelle Thouverez ◽  
Didier Hocquet ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
High Risk ◽  
Bacterial Load ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Pipe System ◽  
Infection Control Measures ◽  
Cross Transmission ◽  
Proactive Measures

OBJECTIVETo describe an outbreak of multidrug-resistant Pseudomonas aeruginosa in which the hospital waste-pipe system was the likely source of contamination and to report the bundle of measures that facilitated the long-term control of the outbreak.DESIGNOutbreak investigation.SETTINGThe hematology unit of a tertiary-care referral center.PATIENTSPatients who were colonized or infected with P. aeruginosa belonging to the clonal outbreak.METHODSPatients admitted to our 15-bed stem-cell transplantation hematology unit were screened for P. aeruginosa carriage. Pseudomonas aeruginosa isolates were also obtained from diagnostic samples. We assessed the microbiological contamination of P-traps, water and toilets for 42 months. Extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) were screened and identified by polymerase chain reaction (PCR) and sequencing. Molecular typing of ESBL- or MBL-producing isolates was carried out using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).RESULTSFrom 2009 to 2013, a biclonal outbreak of IMP-19–producing ST235 (11 cases) and IMP-29–producing ST111 (10 cases) of P. aeruginosa occurred. The environmental investigation strongly suggested that P-traps were the reservoirs for the outbreak strains. A bundle of infection control measures, including engineering interventions on water outlets and disinfection of P-traps, controlled the outbreak.CONCLUSIONSWe report a prolonged outbreak of IMP-producing high-risk clones of P. aeruginosa, for which P-traps seems to play a major role in cross-transmission. It appears essential to implement proactive measures to limit the bacterial load in water fittings of high-risk units.Infect Control Hosp Epidemiol 2018;39:164–169

scholarly journals Drug Resistance and Biofilm Production among Pseudomonas aeruginosa Clinical Isolates in a Tertiary Care Hospital of Nepal

2019 ◽  
Vol 21 (2) ◽  
pp. 110-116
Author(s):  
Rajani Shrestha ◽  
N. Nayak ◽  
D.R. Bhatta ◽  
D. Hamal ◽  
S.H. Subramanya ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Drug Resistance ◽  
Biofilm Formation ◽  
Tertiary Care ◽  
Clinical Problem ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Care Hospital ◽  
Microbiological Methods

Clinical isolates of Pseudomonas aeruginosa often exhibit multidrug resistance due to their inherent ability to form biofilms. Drug resistance in Ps. aeruginosa is a major clinical problem, especially in the management of patients with nosocomial infections and those admitted to ICUs with indwelling medical devices. To evaluate the biofilm forming abilities of the clinical isolates of Ps. aeruginosa and to correlate biofilm formation with antibiotic resistance. A total of 90 consecutive isolates of Ps. aeruginosa obtained from various specimens collected from patients visiting the Manipal Teaching Hospital, Pokhara, Nepal between January 2018 - October 2018 were studied. Isolates were identified by standard microbiological methods. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method. All the isolates were tested for their biofilm forming abilities by employing the tissue culture plate assay. Of the 90 Ps. aeruginosa isolates, maximum i.e 42 (46.6%) were from patients in the age group of > 50 years. Majority (30; 33.3%) of the isolates were obtained from sputum samples. However, percentage isolation from other specimens like urine, endotracheal tube (ETT), pus, eye specimens and blood were 18.9%, 16.7%, 16.7%, 7.8% and 6.7% respectively. All the isolates were sensitive to polymixin B and colistin, 91.1% of the organisms were sensitive to imipenem, and more than 80% to aminoglycosides (80% to gentamicin, 83.3% to amikacin). A total of 29 (32.2%) organisms were biofilm producers. Maximum numbers of biofilm producing strains were obtained from ETT (8 of 15; 53.3%), pus (8 of 15; 53.3%) and blood (2 of 6; 33.3%) i.e from all invasive sites. None of the isolates from noninvasive specimens such as conjunctival swabs were biofilm positive. Significantly higher numbers of biofilm producers (23 of 29; 79.3%) were found to be multidrug resistant as compared to non-biofilm (6 of 61; 9.8%) producers (p=0.000). Ps. aeruginosa colonization leading to biofilm formation in deep seated tissues and on indwelling devices is a therapeutic challenge as majority of the isolates would be recalcitrant to commonly used antipseudomonal drugs. Effective monitoring of drug resistance patterns in all Pseudomonas clinical isolates should be a prerequisite for successful patient management.

scholarly journals Increasing frequency of Pseudomonas aeruginosa infections during tigecycline use

2015 ◽  
Vol 9 (03) ◽  
pp. 309-312 ◽  
Author(s):  
Aysegul Ulu-Kilic ◽  
Emine Alp ◽  
Dilek Altun ◽  
Fatma Cevahir ◽  
Gamze Kalın ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Care Facility ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Control Group ◽  
Case Group ◽  
Icu Patients ◽  
Thoracic Drainage ◽  
Tertiary Care Facility

Introduction: The widespread use of tigecycline raises the question of increasing infection rates of Pseudomonas aeruginosa (PA) in ICUs which are not affected by this antibiotic. Objective:  The aim of this study was to determine if treatment with tigecycline is a risk factor for PA infection in ICU patients. Methodology: A retrospective and observational study was conducted at Erciyes University Hospital, Turkey, between 2008 and 2010. The Erciyes University Hospital is a 1300-bed tertiary care facility. The patients included in this study were hospitalized in four adult ICUs. Patients with PA infections (case group) were compared with patients with nosocomial infection other than PA (control group). Results: A total of 1,167 patients with any nosocomial infections were included in the study. Two hundred and seventy eight (23.8%) of the patients had PA infection during their ICU stay. Fifty nine patients (21.2%) in the case group received tigecycline before developing PA infections, which were found to be significantly more frequent than in the controls (p < 0.01). Multivariate analysis showed that risk factors for PA infection were previous tigecycline use (4 times), external ventricular shunt (4.2 times), thoracic drainage catheter (2.5 times) and tracheostomy (1.6 times). Conclusion: Our results contribute to the need for new studies to determine the safety of tigecycline use, especially for the treatment of critically ill patients. Since tigecycline seems to be an alternative for the treatment of multidrug resistant (MDR) microorganisms, rational use of this antibiotic in ICU patients is essential.

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