scholarly journals A Study to Assess Association of Previous Treatment with Development of Multi Drug Resistance among TB Patients of Tertiary Care Hospital of India

2015 ◽  
Author(s):  
Dr Vikas Kumar Mishra, Dr Rajveer Kuldeep ◽  
◽  
Dr Neeraj Gour, Dr Rakesh C. Gupta ◽  
Dr Dhiraj Srivastava, Dr Prerana Gupt
Keyword(s):  
Drug Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Previous Treatment ◽  
Multi Drug Resistance ◽  
Care Hospital

PROPORTION OF ESBL AND CARBAPENEMASE PRODUCING ENTEROBACTERIACEAE CAUSING BLOODSTREAM INFECTIONS AND SHOWING MULTI DRUG RESISTANCE IN INFECTED PATIENTS IN TERTIARY CARE HOSPITAL AT AGARTALA, TRIPURA

2021 ◽  
pp. 28-30
Author(s):  
Lija Ghosh ◽  
Arun B ◽  
Puja Ghosh ◽  
Tapan Majumdar
Keyword(s):  
Drug Resistance ◽  
Bloodstream Infection ◽  
Tertiary Care Hospital ◽  
Culture Media ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Biochemical Tests ◽  
North East

BACKGROUND: Enrerobacteriaceae species are the major leading cause of bloodstream infections in many developing countries. Moreover, ESBL and Carbapenemase-producing Enterobacteriaceae species are often associated with high resistance to a wide class of antibiotics. There are few studies regarding the bloodstream infections causing by Enterobacteriaceae with the production of Extended-spectrum β-lactamases and Carbapenemase enzymes in Tripura, North-East India. This study aimed to determine the “ proportion of ESBL and carbapenemase-producing Enterobacteriaceae causing bloodstream infection and showing Multi-drug resistance (MDR) in infected patients'' in Tertiary care Hospital at Agartala, Tripura. METHOD: Blood samples were collected from all indoor and outdoor patients suspected of Bloodstream infection. Then specimens were inoculated in various culture media after that with this culture isolates we performed gram staining and many biochemical tests (as per CLSI guidelines) to identies the Enterobacteriaceae species. And the production of β-lactamases and Carbapenemase was conrmed by the combined disk test and Modied Hodge method. RESULTS: In this study out of 760 samples processed in the laboratory 77 (10.13%) was tested positive for bacteremia from which 42 (54.54%) blood specimens were infected by Enterobacteriaceae. The members of the Enterobacteriaceae family isolated in patient samples are E.coli (22/42, 52.38%), K. pneumoniae (11/42, 52.38%) others are Enterobacter spp. (8/42, 52.38%) and S.typhi(1/42, 2.38%). In all 42 Enterobacteriaceae species, 17 (40.47%) isolates were found ESBL positive on antibiotic screening which is conrmed by Combined disc diffusion test, and out of 17 Beta-lactamase producers 8 (47.05%) were E. coli, 5 (29.41%) were K. pneumoniae and 4 (23.52%) were Enterobacter spp. And among 42 isolates of Enterobacteriaceae 16 (38.09%) isolates showed Carbapenemase producers, in that 8 (50%) were E.coli, 5 (31.25%) were K. pneumoniae, and 3 (18.75%) were Enterobacter spp. CONCLUSION: This study aims to provide an early, rapid, and effective phenotypic method for identifying Multi-drug resistant (MDR) Bloodstream infections (BSIs) causing by the species of the Enterobacteriaceae family

scholarly journals Evaluation of Drug Resistance and Treatment Outcomes among TB Patients with Diabetes Mellitus at Tertiary Care Hospital of Sindh, Pakistan

2021 ◽  
pp. 39-46
Author(s):  
Kahaf Khan ◽  
Ayaz Ali Unar ◽  
Khalida Unar ◽  
Faraz Qurban Rajper ◽  
Mirza Tasawar Baig
Keyword(s):  
Diabetes Mellitus ◽  
Drug Resistance ◽  
Treatment Outcomes ◽  
Tertiary Care Hospital ◽  
Local Population ◽  
Tertiary Care ◽  
Previous History ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Patients With Diabetes

The objective of the study is to evaluate of drug resistance and treatment outcomes among tuberculosis patients with diabetes mellitus at tertiary care hospital of Sindh, Pakistan.  Tuberculosis (TB) is considered as very dangerous infectious disease caused by Mycobacterium tuberculosis orother tubercle bacilli pathogen affects the lungs and it can be spread from person to person through very minute droplet released by infected person via coughing or sneezing. Descriptive cross-sectional study was carried out at different Tuberculosis setting located at tertiary care hospital of Sindh, Pakistan for the period of 10 months. Tuberculosis OPD is considered as major health care facility for the TB, MDR-TB and XDR-TB patients for the local population and peripheries. Total 389 samples were collected through purposive sampling techniques. From the given data, there were 209 Males and 180 females, all participants belong to different areas, so 216 patients belong to rural areas, 121 study participants were house wives, 134 were employed and 41 were have their own business. From the clinical data, 229 participants shown positive response with TB smear test, whereas; 156 participants had positive results with TB culture test. 247 patients had previous history of Tuberculosis, 120 had developed drug resistance and 24 had developed multi-drug resistance (MDR). 312 patients were recently diagnosed with Diabetes mellitus and they had one year of duration of diabetes. Complication of tuberculosis developed among 113 patients and complication of diabetes developed among 194 participants. 39 people were using oral therapy for the management of diabetes and 341 participants had successfully completed their therapy and cured whereas 2 patients were died due to complication It was concluded from the current research that there were many chances for developing drug resistance and multi-drug resistance among the patients suffering from co-morbid including tuberculosis along with Diabetes mellitus. Proper counseling should be conducted, in order to reduce the complication of either type of disease.

scholarly journals Trends in antibiotic susceptibility of enteric fever isolates among children attending a tertiary care hospital of Peshawar, KP

2020 ◽  
Vol 6 (3) ◽  
pp. 20-23
Author(s):  
Samreen Ahmad ◽  
Shahzada Bakhtyar Zahid ◽  
Abid Salahuddin ◽  
Adnan Khan ◽  
Muhammad Hassam Khan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Salmonella Enterica ◽  
Antibiotic Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Salmonella Typhi ◽  
Multi Drug Resistance ◽  
Medical Institute ◽  
Care Hospital ◽  
Salmonella Spp

Introduction: The rising trend of multi-drug resistance in bacteria has also been documented in the organism Salmonella enterica causing Typhoid or Enteric Fevers, and cases of multidrug and extended drug resistance are on the rise. Determining the trends of antibiotic susceptibility provides an important therapeutic aid to the practicing clinician.Objective: To evaluate the ten-year trends in antibiotic susceptibilities of Salmonella typhi and Salmonella paratyphi isolated from blood cultures in the paediatric patients of a tertiary care hospital of Peshawar, Khyber Pakhtunkhwa, Pakistan.Materials & Methods: A descriptive study was conducted in the department of Paediatrics, Rehman Medical Institute, Peshawar from June 2019 to May 2020 based on ten years retrospective data of children with positive blood culture for Salmonella spp. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY). The level of significance was set at p ≤0.05. Results: A total of 168 cases Salmonella enterica spp. were isolated over the 10-year study period, of which 97(64.88%) isolates were identified as Salmonella typhi and 71(42.26%) as Salmonella paratyphi A; 94(55.95%) patients were male and 74(44.04%) were female, with mean age of 4.76 ± 2.65 years (range 2 to 12 years); majority, 69(41.07%) of patients were of ages 5-8 years. S. typhi strains showed the highest sensitivity to Imipenem and Meropenem; the lowest sensitivity seen was to Ampicillin. Bacterial sensitivity to Ceftriaxone was 79.76% and to Ciprofloxacin 58.97%. In the S. typhi group, there were six (2.6%) cases of MDR typhoid and four (2.38%) cases of XDR typhoid which was only sensitive to Imipenem. Conclusion: Increased resistance to Ampicillin, Ciprofloxacin and Ceftriaxone was found, however complete sensitivity was found to Imipenem along with Meropenem.

scholarly journals A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sulochana Manandhar ◽  
Raphael M. Zellweger ◽  
Nhukesh Maharjan ◽  
Sabina Dongol ◽  
Krishna G. Prajapati ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Global Public Health ◽  
Gram Negative ◽  
E Coli ◽  
Extended Spectrum ◽  
High Prevalence

Abstract Background Multi-drug resistance (MDR) and extensive-drug resistance (XDR) associated with extended-spectrum beta-lactamases (ESBLs) and carbapenemases in Gram-negative bacteria are global public health concerns. Data on circulating antimicrobial resistance (AMR) genes in Gram-negative bacteria and their correlation with MDR and ESBL phenotypes from Nepal is scarce. Methods A retrospective study was performed investigating the distribution of ESBL and carbapenemase genes and their potential association with ESBL and MDR phenotypes in E. coli, Klebsiella spp., Enterobacter spp. and Acinetobacter spp. isolated in a major tertiary hospital in Kathmandu, Nepal, between 2012 and 2018. Results During this period, the hospital isolated 719 E. coli, 532 Klebsiella spp., 520 Enterobacter spp. and 382 Acinetobacter spp.; 1955/2153 (90.1%) of isolates were MDR and half (1080/2153) were ESBL producers. Upon PCR amplification, blaTEM (1281/1771; 72%), blaCTXM-1 (930/1771; 53%) and blaCTXM-8 (419/1771; 24%) were the most prevalent ESBL genes in the enteric bacilli. BlaOXA and blaOXA-51 were the most common blaOXA family genes in the enteric bacilli (918/1771; 25%) and Acinetobacter spp. (218/382; 57%) respectively. Sixteen percent (342/2153) of all isolates and 20% (357/1771) of enteric bacilli harboured blaNDM-1 and blaKPC carbapenemase genes respectively. Of enteric bacilli, Enterobacter spp. was the most frequently positive for blaKPC gene (201/337; 60%). The presence of each blaCTX-M and blaOXA were significantly associated with non-susceptibility to third generation cephalosporins (OR 14.7, p < 0.001 and OR 2.3, p < 0.05, respectively).The presence of each blaTEM, blaCTXM and blaOXA family genes were significantly associated with ESBL positivity (OR 2.96, p < 0.001; OR 14.2, p < 0.001 and OR 1.3, p < 0.05 respectively) and being MDR (OR 1.96, p < 0.001; OR 5.9, p < 0.001 and OR 2.3, p < 0.001 respectively). Conclusions This study documents an alarming level of AMR with high prevalence of MDR ESBL- and carbapenemase-positive ESKAPE microorganisms in our clinical setting. These data suggest a scenario where the clinical management of infected patients is increasingly difficult and requires the use of last-resort antimicrobials, which in turn is likely to intensify the magnitude of global AMR crisis.

scholarly journals Clinical Features, Outcomes, and Risk Factors of Bloodstream Infections due to Stenotrophomonas maltophilia in a Tertiary-Care Hospital of China: A Retrospective Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Yibing Chen ◽  
Jijiang Suo ◽  
Mingmei Du ◽  
Liangan Chen ◽  
Yunxi Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Drug Resistance ◽  
Clinical Features ◽  
Stenotrophomonas Maltophilia ◽  
Pathogenic Bacteria ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
T Tube

Background. Stenotrophomonas maltophilia bacteremia (SMB) is the most perilous situation as compared to other types of S. maltophilia infection. The present study aimed to investigate the clinical features, distribution, drug resistance, and predictors of survival of SMB in a tertiary-care hospital of China. Methods. SMB that occurred in a tertiary-care hospital in Beijing, China, within 9 years (2010–2018) was investigated in a retrospective study. Demographics, incidence, commodities, drug resistance, mortality, as well as antibiotics administration were summarized according to the electronic medical records. The risk factors for survival were analyzed by Chi-square test, Kaplan–Meier curve and Cox regression. Results. A total of 76 episodes of SMB were analyzed. The overall incidence of SMB fluctuated from 3.4 to 15.4 episodes per 1000 admissions over 9 years. Malignancy was the most common comorbidity. High in vitro sensitivity was observed to minocycline (96.1%), levofloxacin (81.6%), and trimethoprim-sulfamethoxazole (89.5%). Central venous catheter (CVC) (p=0.004), mechanical ventilation (MV) (p=0.006), hemodialysis (p=0.024), and septic shock (p=0.016) were significantly different between survival and death group. The 30-day mortality was 34.2% within 30 days after confirmation of blood culture. Factors such as hemodialysis (OR 0.287, 95% CI: 0.084–0.977, p=0.046), T-tube (OR 0.160, 95% CI: 0.029–0.881, p=0.035), and septic shock (OR 0.234, 95% CI: 0.076–0.719, p=0.011) were associated with survival. Conclusions. S. maltophilia is the major nosocomial blood stream infectious pathogenic bacteria. Trimethoprim-sulfamethoxazole and minocycline are optimal antibiotics for the treatment of SMB. T-tube, hemodialysis, and septic shock were the risk factors associated with survival of SMB patients.

scholarly journals To determine antimicrobial susceptibility and biofilm production among coagulase negative staphylococci at a tertiary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 230-234
Author(s):  
Naga Sri Latha Bathala ◽  
M Sasidhar ◽  
S Kusuma Bai
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Susceptibility ◽  
Biofilm Formation ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional

CoNS are gaining importance due to increase in resistance rates to betalactam antibiotics and multi drug resistance. Although specific virulence factors are not as clearly established, it seems clear that factors such as bacterial polysaccharide components, and ability to form biofilm are involved in attachment and/or persistence of bacteria on foreign materials. Biofilms usually result in persistent infections that cannot be easily resolved with standard antibiotic treatments; therefore, the biofilm formation ability and the resistance to antimicrobial therapy can be intimately related. A prospective cross-sectional study was done on purely isolated CoNS from various clinical samples from both out patients and inpatients. All the test strains were subjected to antimicrobial susceptibility testing. The ability to produce biofilm was detected by tube adherence method. Among 193 CoNS isolates 156 were from inpatients and 37 were from out patients. Methicillin resistant was seen in 80.31%. Of the total, 40.41% showed moderate biofilm formation by tube adherence method. 23.32% of isolates did not form biofilm. All the isolates from blood samples showed moderate (20/26) and strong (6/26) biofilm formation. Among non biofilm producers 66.67% were MS CoNS isolates and 33.33% were MRCoNS. 94.59% of biofilm producers were MRCoNS and 5.41% were MSCoNS. Production of biofilm was relatively more (1.16) among CoNS isolates of IPD than OPD.  As Coagulase negative Staphylocooci are exhibiting multi drug resistance and are able to form biofilm, these organisms causing a major challenge for the physicians. Hence, such problems can be prevented by detection of biofilm producers and appropriate antibiotic doses modification. The issue of antibiotic resistance among CoNS needs to be addressed through a more rational use of existing antibiotics as well as the development of new antimicrobial agents.

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