scholarly journals A study on virulence factors and antimicrobial resistance pattern among enterococci isolated from various clinical specimens from a tertiary care hospital

2017 ◽  
Vol 5 (7) ◽  
pp. 2969
Author(s):  
Hemalatha G. ◽  
Bhaskaran K. ◽  
Sowmiya M. ◽  
Anusheela Howlader ◽  
Sethumadhavan K.
Keyword(s):  
Antimicrobial Resistance ◽  
Virulence Factors ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
Control Measures ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Drain Tube ◽  
Care Hospital

Background: Enterococci, adult faeces commensal are important nosocomial pathogens. E. faecalis is the most common cause of infection, followed by E. faecium. In the past two decades, they have developed resistance to many commonly used antimicrobial agents. Understanding virulence factors and monitoring antimicrobial resistance among Enterococci is essential for controlling the spread of bacterial resistance and important for epidemiological surveillance within the hospital environment. The aim of the study is to evaluate antibiotic resistance and virulence factors exhibited by Enterococcus sp.Methods: One hundred consecutive isolates of Enterococci isolated from different clinical samples of patients attending AVMC and H, a tertiary care center at Pondicherry in a period of 20 months were included in the study. Enterococcus sp were identified as per standard conventional bacteriologic methods and detected for the production of virulence factors such as Hemolysin production, Gelatinase production. Antimicrobial susceptibility testing was carried out by disc diffusion method and MIC of vancomycin and teicoplanin was determined by E-test strips.Results: Among 100 Enterococcal isolates included in the study, 81% were E. faecalis and 19% were E. faecium which were isolated from urine (44%), Pus (51%) and others specimen (5%, which includes blood 80% and drain tube 20%). In this study, overall 15% of E. faecalis and 1% of E. faecium showed hemolysin production and Gelatinase was produced by 6% of E. faecalis and 4% of E. faecium. Majority of E. faecalis and E. faecium strains isolated in our study, had increased sensitivity were to be exhibited for Linezolid, Vancomycin followed by high level gentamycin and high degree of resistance to penicillin, ciprofloxacin and cotrimoxazole. Analyzing the results of MIC of vancomycin and teicoplanin, 5 isolates were classified phenotypically as VanB phenotype that possess only moderate to high levels of vancomycin resistance and one isolate obtained from drain tube which showed MIC of vancomycin as 120µg/ml and teicoplanin 16µg/ml was grouped into VanA.Conclusions: Though the prevalence of vancomycin resistant Enterococcci (VRE) is very low in our study, yet regular monitoring of vancomycin resistance is very crucial for early detection, treatment, application of preventive and control measures and most importantly to check the spread of virulent multidrug resistant Enterococcus species.

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

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.

scholarly journals PREVALENCE AND ANTIBIOTIC SUSCEPTIBILITY PATTERN OF PSEUDOMONAS SPECIES ISOLATED FROM CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 50-53
Author(s):  
M. ABDUR RAHMAN ◽  
POOJA NAIR
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Control Measures ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Pseudomonas Species

Objective: Pseudomonas aeruginosa is the commonest agent causing opportunistic nosocomial infections, contributing to mortality and morbidity worldwide. Along with its intrinsic and acquired resistance mechanisms, infections caused by Pseudomonas species further lead to treatment failure. This study was done to determine the prevalence and antimicrobial susceptibility pattern of different species of Pseudomonas isolated from various clinical samples by phenotypic methods. Methods: This study involved the examination of clinical samples for various species of Pseudomonas by using different standard biochemical tests. Their antimicrobial susceptibility profile was performed by the Kirby Bauer disc diffusion method. Analysis of the antibiogram pattern was done to study the multi-drug resistance among Pseudomonas species. Results: Out of the 1249 bacterial isolates, Pseudomonas species accounted for 12.9%. Pseudomonas species showed maximum resistance to gentamicin (31.4%), followed by ciprofloxacin (30.2%. and showed the least resistance tocolistin and polymyxin B. 46 isolates out of the 162 (28%) were found to be Multi-Drug Resistant (MDR) Pseudomonas aeruginosa. Conclusion: The present study highlights that Pseudomonas species remains a major cause of hospital-acquired infections. Multidrug resistance was observed in most of the strains, which makes the therapeutic options more difficult. Surveillance of antimicrobial resistance and strict infection control measures are essentially to be practiced in managing and control of infections caused by Pseudomonas.

scholarly journals Characterization, speciation and antimicrobial resistance pattern of Enterococcus species isolated from clinical specimens at a rural tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3484
Author(s):  
Shweta Jaiswal ◽  
Amit Singh ◽  
Rajesh K. Verma ◽  
Dharmendra P. Singh ◽  
Sunita Kumari
Keyword(s):  
Tertiary Care ◽  
Vancomycin Resistance ◽  
High Rate ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
Resistance To Penicillin

Background: Enterococci have attracted much attention in recent years due to their increased recognition as a cause of nosocomial infection. They exhibit vancomycin resistance with increasing frequency so that determination of antimicrobial susceptibility pattern is necessary. Aim of present study is to determine the prevalence and susceptibility pattern of Enterococci in rural tertiary care hospital.Methods: Total of 100 Enterococcus isolated from various clinical samples were identified and speciated by Vitek®2 compact system (BIOMERIEUX). Antibiotic susceptibility was determined by modified Kirby Bauer disc diffusion method. Results were interpreted as per CLSI guidelines and vancomycin MIC was determined by E-test method.Results: Out of 100 Enterococcus strains 47 were E. faecalis, 51 were E. faecium, 02 were E. gallinarum and 01 was E. cassaliflavus. Resistance to penicillin, ampicillin, ciprofloxacin, elevated level gentamycin and high-level streptomycin were observed. All isolates were sensitive to linezolid and teicoplanin, 6% strains showed vancomycin resistance by E-test.Conclusions: High rate of resistance to penicillin, ciprofloxacin and aminoglycosides is observed and emergence of VRE has further worsened this situation. So, there is an urgent need for more rational use of antimicrobials and infection control.

DETECTION AND CHARACTERISATION OF VANCOMYCIN RESISTANT ENTEROCOCCAL ISOLATES OF CLINICAL SAMPLES FROM A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 76-79
Author(s):  
R.Beaula Lilly ◽  
V.K.M. Banu
Keyword(s):  
Multiple Drug Resistance ◽  
Tertiary Care ◽  
Vancomycin Resistance ◽  
Therapeutic Options ◽  
Hospital Environment ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Care Hospital ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

The emergence of Vancomycin resistant enterococci (VRE) has posed serious threats to the community because they exhibit multiple drug resistance, thus limiting the therapeutic options for the clinicians. As Vancomycin resistant enterococci (VRE) also have ampicillin resistance and high level aminoglycoside resistance, they are the most difcult to treat. The therapeutic options are limited by elimination of the synergy between aminoglycoside and the beta lactum drugs which is the treatment of choice for enterococcal infections which is of great concern. More antibiotic resistance makes these pathogens excellent survivors in hospital environment and cause nosocomial infections. Atotal of 142 enterococcal isolates from various clinical samples were identied to their species level and subjected to antimicrobial susceptibility testing to various antibiotics. Initial screening for Vancomycin resistance was done using the Vancomycin Screen Agar and the isolates showing resistance were subjected to Vancomycin and Teicoplanin MIC and later these isolates showing resistance were conrmed by genotypic methods for Vancomycin resistant genes.Total VRE isolates as per Vancomycin MIC value were 19 and the prevalence rate was 13.3% (19/142).In PCR assay, a total of 16 isolates including 13 E.faecium and 3 E.faecalis were found to be of Van B genotype and the remaining 3 isolates including 2 E.faecium and 1 E.faecalis were found to be of Van A genotype. In this study, the prevalence of Vancomycin resistance in Enterococcal species is 13.3% as per vancomycin MIC by Micro broth dilution technique. The phenotypic detection of Vancomycin resistance by MIC of Vancomycin and Teicoplanin correlates with the genotypic method of detection of Vancomycin resistant genes (VanA, VanB).

scholarly journals The Usage of Antibiotics by COVID-19 Patients with Comorbidities: The Risk of Increased Antimicrobial Resistance

Antibiotics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 35
Author(s):  
Basit Zeshan ◽  
Mohmed Isaqali Karobari ◽  
Nadia Afzal ◽  
Amer Siddiq ◽  
Sakeenabi Basha ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Surgical Intensive Care ◽  
E Coli ◽  
Tract Infections

Antimicrobial resistance (AMR) is a global health issue that plays a significant role in morbidity and mortality, especially in immunocompromised patients. It also becomes a serious threat to the successful treatment of many bacterial infections. The widespread and irrelevant use of antibiotics in hospitals and local clinics is the leading cause of AMR. Under this scenario, the study was conducted in a tertiary care hospital in Lahore, Pakistan, from 2 August 2021 to 31 October 2021 to discover the prevalence of bacterial infections and AMR rates in COVID-19 patients admitted in surgical intensive care units (SICUs). Clinical samples were collected from the patients and we proceeded to identify bacterial isolates, followed by antibiotic susceptibility testing (AST) using the Kirby Bauer disk diffusion method and minimum inhibitory concentration (MIC). The data of other comorbidities were also collected from the patient’s medical record. The current study showed that the most common pathogens were E. coli (32%) and Klebsiella pneumoniae (17%). Most E. coli were resistant to ciprofloxacin (16.8%) and ampicillin (19.8%). Klebsiella pneumoniae were more resistant to ampicillin (13.3%) and amoxycillin (12.0%). The most common comorbidity was chronic kidney disease (CKD) and urinary tract infections (UTIs). Around 17 different types of antibiotic, the carbapenem, fluoroquinolones, aminoglycoside, and quinolones, were highly prevalent in ICU patients. The current study provides valuable data on the clinical implication of antibiotics consumed by COVID-19 patients in SICUs and the AMR rates, especially with different comorbidities.

scholarly journals Path-Organism Burden and Antibiogram Outline of Pseudomonas aeruginosa Isolates in a Tertiary Care Hospital of Jamshedpur, Jharkhand, India

2021 ◽  
Vol 8 (11) ◽  
pp. 638-642
Author(s):  
Mohammad Mustaqueem ◽  
Vindeshwar Mahto ◽  
Chandan Kumar Poddar ◽  
Rita Chouhan ◽  
Prity Mohan Kumar ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Clinical Samples ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Growth ◽  
Medical College

BACKGROUND Pseudomonas aeruginosa is an opportunistic pathogen involved in a variety of nosocomial infections like pneumonia, bacteraemia, wound infection and urinary tract infection. It is also involved in infections of rigorous burns and infections in immunocompromised persons. This study was undertaken to determine the prevalence and antibiotic susceptibility patterns of pathogenic P. aeruginosa isolated from a variety of clinical specimens in a tertiary care hospital of Jamshedpur, Jharkhand, India. METHODS Pseudomonas aeruginosa was identified using standard methods from various clinical samples collected over a period of seven months. This was a descriptive cross-sectional study which was approved by the ethical committee. The study was conducted from January 2019 to January 2020 in the Department of Microbiology at MGM Medical College, Jamshedpur, Jharkhand, India. This hospital has ICUs, one emergency ward, surgical & medical wards and Out-Patient Departments. RESULTS Our study showed the prevalence of P. aeruginosa during the study period from January 2019 to January 2020 in the Department of Microbiology at MGM Medical College, Jamshedpur, Jharkhand, India. A total of 1389 clinical samples were aerobically cultured, out of which 758 (54.6 %) yielded significant growth and the rest 630 (45.4 %) samples were either sterile or showed non-significant growth. From 758 positive growth samples, 161 (21.20 %) P. aeruginosa were isolated CONCLUSIONS The high prevalence of P. aeruginosa as an opportunistic nosocomial pathogen and high frequency of antimicrobial resistance among the clinical isolates demand regular monitoring of antibiogram of P. aeruginosa isolates with proper implementation of antimicrobial policy. Antibiotics should be used appropriately with care. Antimicrobial therapy should not be started unless there is clear evidence of infection and infection to be handled with proper infection control measures. KEYWORDS Pseudomonas aeruginosa, Pus Samples, Antimicrobial Resistance

scholarly journals Detection Of Hypermucoviscous Klebsiella Pneumoniae And Phenotypic Comparison Of Their Virulence Factors With Classical Strains Among Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Tika Bahadur Thapa ◽  
Sujina Maharjan ◽  
Nisha Giri ◽  
Manisha Sapkota ◽  
Ojaswee Shrestha ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Virulence Factors ◽  
Tertiary Care ◽  
Test Method ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Serum Resistance ◽  
Care Hospital ◽  
Beta Lactamase ◽  
String Test

Abstract Background: Klebsiella pneumoniae, which is commonly recognized in the laboratory, are termed as classical K. pneumoniae (cKP ) . A new strain of Klebsiella pneumoniae named hypermucoviscous K. pneumoniae (hmvKP) emerging with a distinctive feature than classical strains. In many recent studies, infections due to hypermucoviscous strains have been increasing with significant mortality and morbidity. Our study aimed to determine the prevalence of hypermucoviscous Klebsiella pneumoniae in our hospital and phenotypic comparison of their virulence with the classical strains. Materials and Methods: This laboratory-based cross-sectional study done from February to July 2018 in the Department of Microbiology, Manmohan Memorial Teaching Hospital, Kathmandu, Nepal. One hundred and five clinical non-duplicative isolates of Klebsiella pneumoniae proceeded for the study. Hypermucoviscosity of isolated Klebsiella pneumoniae were tested by standard String test. Antibiotic susceptibility was determined by the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Further, β-lactamases (ESBL, MBL, and KPC) were detected by the phenotypic combination disk test method. Serum resistance and biofilm production were determined to assess their virulence. Results: A total of one hundred five non-repetitive pure and microbiologically identified Klebsiella pneumoniae were isolated from various clinical samples collected during the study period. Among the isolated Klebsiella pneumoniae, 29 (27.6%) were hypermucoviscous K. pneumoniae (hmvKP), and 76(72.4%) were classical K. pneumoniae (cKP) determined by string test. The majority of Klebsiella pneumoniae were resistant to ceftazidime (80%) and cefotaxime (78%), whereas 46.7% of isolates were resistant to both imipenem and meropenem. Various virulence factors, namely beta-lactamase production, biofilm, and serum resistance, were compared among classical and hypermucoviscos strains, and the hypermucoviscous strains revealed significantly higher expression of virulence than classical strains. Conclusion: The phenotypic comparison of virulence factors and Beta-lactamase production was found significantly higher among the hypermucoviscous strains . The prevalence of these hypermucoviscous strains in hospital settings may increase the risk of morbidity and mortality. Therefore, timely diagnosis and appropriate treatment strategies to limit these infections are crucial.

scholarly journals Susceptibility of Clinical Isolates of Staphylococcus aureus to Ceftaroline

2021 ◽  
Author(s):  
Harsha Sreedharan ◽  
KB Asha Pai
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
The United States ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital

Introduction: Methicillin-Resistant Staphylococcus aureus(MRSA) infection is a major global healthcare problem, the prevalence of which varies from 25-50% in India. It is known to cause Skin and Soft tissue Infections (SSI), endovascular infections, endocarditis, pneumonia, septic arthritis, osteomyelitis, and sepsis. Vancomycin is the drug of choice for treating severe MRSA infections. Ceftaroline, a fifth-generation cephalosporin has been approved by the United States Food and Drug Administration (US FDA) for treating acute bacterial SSI caused by susceptible micro-organisms including MRSA, Community acquired respiratory tract infection, MRSA bacteremia and endocarditis. Aim: To assess the susceptibility of clinical isolates of S. aureusto ceftaroline, in a Tertiary Care Hospital. Materials and Methods: This prospective study was conducted in the Department of Microbiology of a Tertiary Care Hospital over a period of two months from June 2019 to July 2019. S.aureus isolates from various clinical samples were screened for methicillin resistance by disc diffusion method using cefoxitin disc and ceftaroline susceptibility of these isolates was assessed by E-strip method. The isolates were classified as ceftaroline susceptible, Susceptibility Dose Dependent (SDD) and ceftaroline resistant respectively as per CLSI guidelines. A descriptive analysis of the data was done and the results were presented as frequencies and percentages. Results: All the S.aureus isolates were found to be susceptible to ceftaroline. Methicillin Sensitive Staphylococcus aureus(MSSA) isolates had lower Minimum Inhibitory Concentration (MIC) when compared to MRSA. The highest MIC among MRSA was 0.5 μg/mL. Conclusion: Ceftaroline can be considered as an effective alternative for treatment of infections caused by MRSA.

scholarly journals Epidemiology of carbapenem-resistant Enterobacteriaceae in a Tertiary Care Center in the Kingdom of Bahrain

2019 ◽  
Vol 11 (02) ◽  
pp. 111-117 ◽  
Author(s):  
Nermin Kamal Saeed ◽  
Safaa Alkhawaja ◽  
Nashawa Fawzy Abd El Moez Azam ◽  
Khalil Alaradi ◽  
Mohammed Al-Biltagi
Keyword(s):  
Control Measure ◽  
Care Center ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Control Measures ◽  
Clinical Samples ◽  
Common Source ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract PURPOSE: The purpose of the study is to estimate the rate of infection with carbapenem-resistant Enterobacteriaceae (CRE) in the main governmental tertiary care hospital in Bahrain. MATERIALS AND METHODS: All clinical samples with positive growth of CRE over 6-year period (January 2012–December 2017) were collected from the microbiology laboratory data. RESULTS: The CRE incidence was high in the first half of study period (2012–2014) and then decreased between 2015 and 2017, after implementation of intensified CRE control measure bundle. About 49.4% of CRE-positive samples were isolated from the elderly age group (above 65 years old), most of them were admitted in the intensive care unit (ICU). The most common isolated organisms were Klebsiella pneumoniae (87.0%), followed by Escherichia coli (7.9%). Isolates from deep tracheal aspirate and midstream urine specimens were the most common source of CRE isolates (27.3%) and (26.3%), respectively. Bacteremia was documented in 21.2% of cases. CRE isolates in the study showed high rates of resistance to aminoglycosides (72.2% resistant to amikacin and 67.3% to gentamicin). Alternatively, most isolates retained their susceptibility to colistin and tigecycline with sensitivity of 83.9% and 85.7%, respectively. Combined resistance to both colistin and tigecycline was observed in 0.06% of total isolates. CONCLUSION: Elderly population and ICU admission were important risk factors for CRE acquisition. Most of CRE isolates were sensitive to both colistin and tigecycline, which make them the best combination for empiric frontline therapy for suspected serious CRE infection in our facility. Implementing CRE-bundled infection control measures significantly reduced the incidence of CRE infection in our hospital.

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