scholarly journals Prevalence and antibiogram of nonfermenting gram negative bacilli isolates obtained from various clinical samples in a tertiary care hospital, Bathinda, Punjab, India

2018 ◽  
Vol 6 (4) ◽  
pp. 1228
Author(s):  
Amandeep Kaur ◽  
Amarjit Kaur Gill ◽  
Satnam Singh
Keyword(s):  
Clinical Laboratory ◽  
Tertiary Care ◽  
Empiric Therapy ◽  
Species Level ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Gram Negative

Background: Non-fermenting gram-negative bacilli (NFGNB) have emerged as important healthcare associated pathogens in recent years. Infections caused by these bacteria are almost always secondary to some predisposing factors in patients such as burns, prolonged antimicrobial therapy, immunosuppression etc. The Objectives of the study was to be carried out with an objective to identify NFGNB upto genus and species level and study their antimicrobial sensitivity/ resistance pattern so that empiric therapy could be selected accordingly.Methods: A total of 2261 clinical samples were collected from patients admitted in ICU and different wards of the hospital. All samples were processed according to standard microbiological procedures. Identification of NFGNB upto genus and species level was done by various biochemical tests. Antimicrobial susceptibility testing was done by Kirby Bauer disc diffusion method results were interpreted in accordance with clinical laboratory standards institute guidelines.Results: In this study, 365 NFGNB were obtained accounting for their prevalence of 16.1%. P. aeruginosa was the commonest NFGNB isolated in this study accounting for 52.6%, A. baumannii was the second common NFGNB isolated (31.7%). Other NFGNB isolates were obtained with a lesser frequency. P. aeruginosa isolates were highly sensitive to polymyxin B and colistin followed by imipenem. Most of the A. baumannii isolates were multidrug resistant.Conclusions: This study gives an alarming sign towards high prevalence of multi drug resistant NFGNB in our hospital. Therefore, improved antibiotic stewardship and strict protocols for hand washing need to be implemented to prevent emergence and spread of multidrug resistant NFGNB in health care settings.

scholarly journals Antibiotic Susceptibility Pattern of Nosocomial Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nepal

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Bidya Shrestha ◽  
B M Pokhrel ◽  
T M Mohapatra
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Test Method ◽  
University Teaching ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Methicillin Resistant

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), the most common cause ofnosocomial infection has been a major cause of morbidity and mortality around the world. They arenormally resistant to most of the antibiotics used in clinical practice. This study has been carried outto fi nd out the resistance pattern among S. aureus.Methods: During November 2007 to June 2008, clinical samples from patients with nosocomialinfection were processed for culture and sensitivity following standard methodology in microbiologylaboratory, Tribhuvan University teaching hospital, Kathmandu, Nepal.Results: Among 149 Staphylococcus aureus isolates, highest resistance was observed against Penicillin(91.94%) followed by Fluoroquinolone (61.74%), Erythromycin (52.94%), Gentamicin (46.98%),Cotrimoxazole (42.95%), Tetracycline (40.94%) and others, whereas susceptibility was observedmaximum against Chloramphenicol (94.85%) followed by Rifampicin (92.61%), Tetracycline(59.06%), Cotrimoxazole (57.04%), and others. None of the isolates were resistant to Vancomycinand Teicoplanin. Of these isolates 44.96 % of the isolates were Methicillin resistant S. aureus (MRSA).Resistance to Penicillin, Fluoroquinolone, Erythromycin, Gentamicin, Co-trimoxazole and Tetracyclinewere associated signifi cantly with MRSA isolates (X2= 8.779, p<0.05, X2= 74.233, p<0.05, X2= 84.2842,p<0.05, X2= 108.2032, p<0.05, X2= 88.1512, p<0.05 and X2= 79.1876, p<0.05 respectively). Althoughmost of the Methicillin sensitive S. aureus (MSSA) isolates were susceptible to both Rifampicinand Chloramphenicol, only Rifampicin susceptibility was signifi cantly associated with them (X2=10.1299, p<0.05). Among three Biochemical tests for the detection of β lactamase detection namelychromogenic, iodometric and acidimetric test, chromogenic test method had highest sensitivity andspecifi city.Conclusions: Since MRSA comprised a greater part of S. aureus isolates and were multi-resistant,patients infected by such strains should be identifi ed and kept in isolation for hospital infectioncontrol and treated with second line of drug like vancomycin.Key Words: β lactamase, methicillin resistant Staphylococcus aureus,methicillin sensitive Staphylococcus aureus, resistance pattern

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 of carbapenemase-producing Klebsiella pneumoniae at a tertiary care hospital in Kathmandu, Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Susil Pyakurel ◽  
Mehraj Ansari ◽  
Smriti Kattel ◽  
Ganesh Rai ◽  
Prasha Shrestha ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Growth Media ◽  
Care Hospital ◽  
Drug Resistant ◽  
Biochemical Tests

Abstract Aim Although carbapenem is the last-resort drug for treating drug-resistant Gram-negative bacterial infections, prevalence of carbapenem-resistant bacteria has substantially increased worldwide owing to irrational use of antibiotics particularly in developing countries like Nepal.  Therefore, this study was aimed to determine the prevalence of carbapenemase-producing K. pneumoniae and to detect the carbapenemase genes (blaNDM-2 and blaOXA-48) in at a tertiary care hospital in Nepal. Materials and methods A hospital-based cross-sectional study was carried out from June 2018 to January 2019 at the Microbiology Laboratory of Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal. Different clinical samples were collected and cultured in appropriate growth media. Biochemical tests were performed for the identification of K. pneumoniae. Antibiotic susceptibility testing (AST) was performed by the Kirby–Bauer disc diffusion method. The modified Hodge test (MHT) was performed to detect carbapenemase producers. The plasmid was extracted by the modified alkaline hydrolysis method. Carbapenemase-producing K. pneumoniae were further confirmed by detecting blaNDM-2 and blaOXA-48 genes by PCR using specific forward and reverse primers followed by gel electrophoresis. Results Out of the total 720 samples, 38.9% (280/720) were culture positive. K. pneumoniae was the most predominant isolate 31.4% (88/280). Of 88 K. pneumoniae isolates, 56.8% (50/88) were multi-drug resistant (MDR), and 51.1% (45/88) were MHT positive. Colistin showed the highest sensitivity (100%; 88/88), followed by tigecycline (86.4%; 76/88). blaNDM-2 and blaOXA-48 genes were detected in 24.4% (11/45) and 15.5% (7/45) of carbapenemase-producing K. pneumoniae isolates, respectively. Conclusion The rate of MDR and carbapenemase production was high in the K. pneumoniae isolates. Colistin and tigecycline could be the drug of choice for the empirical treatments of MDR and carbapenemase-producing K. pneumoniae. Our study provides a better understanding of antibiotic resistance threat and enables physicians to select the most appropriate antibiotics.

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

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.

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

2018 ◽  
Vol 5 (2) ◽  
pp. 366 ◽  
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.

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

2010 ◽  
Vol 4 (12) ◽  
pp. 810-813 ◽  
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.

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

2021 ◽  
Vol 9 (3) ◽  
pp. 162-168
Author(s):  
Parmar M ◽  
Halpati A ◽  
Desai K
Keyword(s):  
General Hospital ◽  
Antibiotic Susceptibility ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Microbiology Laboratory ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Antibiotic Susceptibility Test

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.

scholarly journals Pseudomonas aeruginosa Infection and Antibiotic Sensitivity Pattern Isolated from a Tertiary Care Hospital in Dhaka City

2021 ◽  
pp. 23-29
Author(s):  
Mousumi Karmaker ◽  
Md. Abul Khair ◽  
Una Jessica Sarker ◽  
Rabeya Nahar Ferdous ◽  
Sa’dia Tasnim ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Health Sciences ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Sensitivity Pattern

Pseudomonas aeruginosa is one of the most widespread gram-negative microorganisms identified in the clinical samples and most common causes of hospital acquired infection. P. aeruginosa is affecting both indoor and outdoor patients throughout the world. Due to frequent mutation in          P. aeruginosa highly resistant strain developed rapidly. The aim of the study to determine the prevalence of P. aeruginosa species in different samples isolated from a Tertiary care Hospital as well as determination their diverse antibiotic resistance pattern. This cross-sectional study was carried out to determine in-vitro resistance pattern of P. aeruginosa isolates to common antimicrobial agents by disc diffusion method. Various clinical samples were collected from Bangladesh Health Sciences Hospital (BIHS) General Hospital, Dhaka. This research was carried out in the Department of Microbiology of Bangladesh University of Health Sciences (BUHS). Isolation, identification and antibiogram were performed for P. aeruginosa following standard microbiological laboratory procedure. A total of 218 P. aeruginosa were isolated from 3062 different clinical specimens which are statistically significant (p<0.0001). Among the highest number of P. aeruginosa were isolated from outdoor patients 140 compare to Indoor patients which are significantly higher (p <0.013). In this study Male (68.3%) are more vulnerable to P. aeruginosa infection compare to females (31.7%) which is also statistically significant. Young people (less than 35 years) were more susceptible to P. aeruginosa infection which is also statistically significant (p< 0.01). The highest number of P. aeruginosa was isolated from wound (43.12%), followed by pus (40.33%), sputum (8.71%) urine (7.80%). The maximum number of P. aeruginosa in various samples was resistant to aztreonam and co-tromoxazole followed by cephalosporins, aminoglycosides, carbapenems. The most sensitive antibiotic was colistin of followed by gentamycin and tetracycline. To control the spread of resistant bacteria, it is disparagingly vital to have stringent antibiotic guidelines. The antibiotic susceptibility pattern of P. aeruginosa requires to be continuously monitored in specialized clinical units and the results readily made available to the clinicians to minimize the resistance.

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

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