scholarly journals Evaluation of Sphingomonas paucimobilis as an emerging nosocomial pathogen in a teaching hospital in Uttarakhand

Author(s):  
Ranjana Rohilla ◽  
Dimple Raina ◽  
Malvika Singh ◽  
Ajay Kumar Pandita ◽  
Shiwang Patwal

Background and Objectives: Sphingomonas paucimobilis is an opportunistic pathogen and was rarely encountered in clin- ical specimens previously. This study aimed to investigate the clinical features, associated co-morbidities, and antimicrobial susceptibility patterns of S. paucimobilis infection in a tertiary hospital in Uttarakhand. Materials and Methods: S. paucimobilis isolates cultured from various sections of hospital and OPDs were identified and an- alyzed for their antibiograms in the microbiology laboratory for a duration of one year from January 2020 to December 2020. Results: S. paucimobilis was isolated from 49 samples (0.01%) out of 3792 samples processed in VITEK 2 Compact auto- mated ID/AST instrument. The maximum number of isolates were obtained from urine samples (31%), followed by blood (24%). Septicemia (41%), meningitis (17%), lower respiratory tract infections and ventilator associated pneumonia (14%) constituted a major portion of infections caused by this organism. Diabetes mellitus (22%) and steroid usage (16%) were major associated co-morbid conditions. Third and Fourth generation cephalosporins like ceftriaxone (81%) and cefepime (86%) were found to be the most susceptible drugs whereas 61% of isolates were resistant to colistin. Conclusion: This organism is an up-and-coming pathogen and should not be simply labeled as a contaminant. Although the organism is not grossly virulent and still might not be associated with serious life-threatening infections; however their evolving resistance patterns and increased spectrum of infections should be seriously taken into account.

2019 ◽  
Vol 7 (2) ◽  
pp. 49-54
Author(s):  
Alka Hasani ◽  
Nasim Asadi Faezi ◽  
Mohammad Ahangarzadeh Rezaee ◽  
Elham Sheykhsaran ◽  
Narges Darabi ◽  
...  

Background: Bloodstream infections are considered a significant medical concern associated with high morbidity and mortality rates. Therefore, physicians should be guided to use antimicrobial susceptibility patterns in order to select appropriate empiric antimicrobial agents to treat the patients who suffer from bacteremia. Objective: The present study aimed to determine antimicrobial resistance and susceptibility patterns in isolates collected from bloodstream infections. Materials and Methods: To achieve this, a total of 710 bacterial blood culture isolates were collected from Sina hospital, and then susceptibility patterns to a number of antibiotics were analyzed according to Clinical and Laboratory Standards Institute guidelines. Results: The identified isolates included Staphylococcus aureus 14 (20.6%), Escherichia coli 14 (20.6%), Acinetobacter baumannii 12 (17.6%), Pseudomonas aeruginosa 11 (16.2%), Coagulasenegative Staphylococcus 8 (11.8%), Klebsiella pneumoniae 6 (8.8%), and Enterobacter spp. 3 (4.4%). The total resistance rate to co-trimoxazole, ceftriaxone, ceftazidime, cefotaxime, ofloxacin, gentamicin, ciprofloxacin, levofloxacin, amikacin, and imipenem was 44 (64.7%), 42 (61.8%), 39 (57.4%), 38 (55.9%), 35 (51.51%), 32 (47.1%), 31 (45.6%), 25 (36.8%), and 27 (39.7%), respectively. Finally, the susceptibility rate to amikacin and imipenem was 43 (63.2%) and 41 (60.3%), respectively. Conclusion: In general, A. baumannii strains isolated from blood cultures were resistant to most antibiotics and the greatest sensitivity was observed to gentamicin (58.3%) compared to other antibiotics. Therefore, gentamicin was found as the most effective antibiotic for treating bloodstream infections caused by A. baumannii.


2020 ◽  
Vol 28 (4) ◽  
pp. 427-439
Author(s):  
Annamária Főldes ◽  
Szabolcs Molnár ◽  
Doina-Veronica Bilca ◽  
Septimiu Toader Voidăzan ◽  
Edit Székely

AbstractIntroduction: A dramatic increase of infections induced by carbapenemase-producing Enterobacterales (CPE) has been registered worldwide. The aim of this study was to evaluate the molecular epidemiology and the clinical impact of CPE strains isolated from adult inpatients.Material and methods: A one-year, single-center, retrospective observational study including 34 consecutive patients with 37 non-duplicate CPE strains recovered from clinical specimens was accomplished. The Vitek 2 Compact, M.I.C.Evaluator strips, the modified carbapenem inactivation method (mCIM), and the combination disks test (KPC, MBL, OXA-48 Confirm kit, Rosco Diagnostica) were applied as phenotypic tests. A multiplex polymerase chain reaction (PCR) assay was used for detection of blaKPC, blaNDM, and blaOXA-48-like genes. The clonality was assessed with pulsed-field gel electrophoresis (PFGE).Results: Klebsiella pneumoniae (n=25) was the most frequent CPE encountered. The carbapenemase types were NDM (n=13), KPC (n=12), and OXA-48-like (n=12). Two distinct clonal clusters were identified among the 12 KPC positive strains. All CPE isolates exhibited non-susceptibility to carbapenems, cephalosporins, ciprofloxacin. Respiratory tract infections (n=16) and hospitalization in the intensive care unit (ICU) (n=14) were dominant. The most common comorbidity was congestive heart failure (n=11). Monotherapy was the main strategy adopted (n=15). Death occurred in 18 patients.Conclusions: Our analysis underscores the scarcity of antibiotic solutions and high mortality. Monotherapy for urinary tract infections (UTIs) is beneficial. Inter- or intrahospital dissemination of successful epidemic clones is proved. The adequate CPE infections control programs and antimicrobial policies are essential..


2017 ◽  
Vol 364 (14) ◽  
Author(s):  
Yanfang Feng ◽  
Roosmarijn T Bakker ◽  
Reinier M van Hest ◽  
Caspar J Hodiamont ◽  
Stanley Brul ◽  
...  

Abstract Pseudomonas aeruginosa is an opportunistic pathogen that can cause life-threatening infections in patients admitted to intensive care units. Resistance rapidly develops against two drugs of choice: ceftazidime and meropenem. Several therapeutic protocols were compared for reduction in viable cells and limiting development of resistance. Chemostat cultures were exposed to antibiotic concentrations measured in the blood of patients at low (5th percentile), medium (50th percentile) or high (95th percentile) levels in several therapy protocols to simulate therapy. Cultures exposed to ceftazidime recovered after 1 day at low, 2 days at medium and 3 days at high concentrations and developed corresponding levels of resistance. Patterns were very similar for meropenem except that recovery was delayed. Fluctuating levels and intermittent treatment achieved similar reduction of cell numbers at lower resistance costs. Treatment alternating ceftazidime and meropenem reduced cell numbers more than monotherapy, while strongly limiting resistance. Combination therapy was even more effective in both respects. Therapeutic goals are best reached with least risk of resistance when ceftazidime and meropenem are used in combination or alternating, at the highest concentrations the patient can endure. Monotherapy should also apply the highest concentration that is safe for the shortest time that achieves treatment objectives.


2015 ◽  
Vol 57 (5) ◽  
pp. 412 ◽  
Author(s):  
María Dolores Alcántar-Curiel ◽  
Celia Mercedes Alpuche-Aranda ◽  
Héctor Javier Varona-Bobadilla ◽  
Catalina Gayosso-Vázquez ◽  
Ma. Dolores Jarillo-Quijada ◽  
...  

Objective. To assess the risks factors for urinary tract infections (UTIs) caused by Extended-Spectrum Beta-Lactamases (ESBLs)-producing E. coli and the molecular characterization of ESBLs. Materials and methods. A case-control study was performed to identify risk factors in consecutively recruited patients with UTIs caused by ESBLs or non-ESBLs-producing E. coli in a tertiary hospital in Mexico. Results. ESBLs-producing E. coli were isolated from 22/70 (31%) patients with E. coli UTIs over a three month period. All isolates were resistant to cephalosporins and quinolones but susceptible to carbapenems, amikacin and nitrofurantoin. Prior antibiotic treatment with more than two antibiotic families (OR=6.86; 95%CI 1.06-157.70; p=0.028), recurrent symptomatic UTIs (OR=5.60; 95%CI 1.88-17.87; p=0.001) and previous hospitalization (OR=5.06; 95%CI 1.64-17.69;p=0.002) were significant risk factors. Sixteen isolates harbored the beta-lactamase (bla)CTX-M-15 gene and five the blaTEM-1 gene. Conclusions. One of every three patients presented UTIs with ESBLs-producing beta-lactams and fluoroquinolone resistant E. coli. Risk factors and resistance patterns must be taken into account for developing antibiotic use policies in these settings


2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12


2016 ◽  
Author(s):  
Olubukola Ojo ◽  
Olalekan Ojo ◽  
Adebola Omosehin ◽  
Kayode Oluwatusa ◽  
Sulaeman Okoro ◽  
...  
Keyword(s):  

2001 ◽  
Vol 71 (3) ◽  
pp. 342-349
Author(s):  
Lucian Eva ◽  
Letitia Doina Duceac ◽  
Liviu Stafie ◽  
Constantin Marcu ◽  
Geta Mitrea ◽  
...  

The fourth generation cephalosporin antibacterial agent, cefepime, was loaded into layered double hydroxides for enhancing antibiotic efficiency, reducing side effects, as well as achieving the sustained release property. The intercalation of antibiotic into the inter-gallery of ZnAl-layered double hydroxide (LDH) was carried out using ion exchange method, by this constituting a nano-sized organic-inorganic hybrid material for a controlled release novel formulation. Although cefepime is a broad spectrum antibiotic, it has various adverse effects and a significant degradation rate. Thus, the preparation and physico-chemical characterization of nanomaterials able to intercalate this drug is an important study for medical and pharmaceutical field. The antibiotic inclusion into LDHs nanostructure was confirmed by advanced characterization techniques and the release profile of cefepime was analysed with the respect to pH of the simulated media.


Sign in / Sign up

Export Citation Format

Share Document