scholarly journals Sepsis: Antibiotic Resistances of Gram-Positive and Gram-Negative Bacterial in a Tertiary Care Hospital

2021 ◽  
Vol 12 (1) ◽  
pp. 29
Author(s):  
Siti Nurul Jannah ◽  
Muhammad Vitanata Arfijanto ◽  
Musofa Rusli ◽  
Agung Dwi Wahyu Widodo
Keyword(s):  
Bacterial Resistance ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
Systemic Infection ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
New Research

Introduction: Sepsis is a systemic infection that causes multiorgan failure and death. The death rate that is caused by sepsis is increasing. This high value of death has a correlation with the resistance of antibiotics. However, increased antibiotic resistance is not balanced with new research about antibiotics. As a consequence, it causes difficulties in handling sepsis patients who need antibiotic 1-2 hours after diagnosis is enforced. Methods: This was a descriptive study with case study design to analyze medical records of the patients, evaluating the pattern of bacterial resistance to antibiotic in 221 patients with sepsis with 240 blood isolates to identify. Results: From 221 patients identified as sepsis, there were 97 male patients (43.9%) and 124 female patients (56.1%), mostly between 18-59 years old (63.8%), with the highest level in female (54.8 %) and elderly (66.3%). The bacteria that caused the most sepsis were gram-positive. The most species in gram-positive are Staphylococcus haemolyticus (16.3%) and Staphylococcus aureus (12.5%), and the most species in gram-negative is Escheriichia coli (13.3%). The most sensitive antibiotics in gram-positive bacteria were Piperacillin-Tazobactam (100%), Daptomycin (99.2%), and Clindamycin (99.2%). The sensitive antibiotics in gram-negative bacteria were Amikacin (85.9%), Cefoperazone (84.6%), and Piperacillin-Tazobactam (84.1%). Conclusion: The most sensitive antibiotics in gram-positive bacteria were Piperacillin-Tazobactam, Daptomycin, and Clindamycin. The sensitive antibitics in gram-negative bacteria were Amikacin, Cefoperazone, and Piperacillin-Tazobactam. 

scholarly journals Bacterial etiology and antibiotic resistance pattern of neonatal sepsis: a study in a tertiary care hospital, in Bangladesh

2019 ◽  
Vol 6 (5) ◽  
pp. 1839
Author(s):  
Mahfuza Shirin ◽  
M. Monir Hossain ◽  
Manifa Afrin ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Gram Positive Bacteria

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. The objective of the study was to detect causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns.Methods: This prospective cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal Medicine and NICU of Dhaka Shishu (Children) Hospital (DSH). Neonates diagnosed with probable sepsis were studied. After enrollment, 1 mL blood was taken and sent to Microbiology department of DSH for culture and sensitivity. With baseline characteristics, clinical examination findings and outcome, were also recorded.Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates, gram negative bacteria were 77.4% with Klebsiella pneumonae being the commonest (35, 41.7%), gram positive bacteria were 11.9% with Staphylococcus aureus and Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was Candida. Most of the isolated gram-negative bacteria were resistant to ampicillin, gentamicin, and ceftazidime; but gram-positive bacteria preserved 20-80% sensitivity. Klebsiella was more resistant than Acinetobacter to amikacin, netilmicin, ciprofloxacin and levofloxacin. Around 45-65% of gram-negative bacteria were resistant to imipenem and meropenem but gram-positive bacteria showed lesser resistance. Among the gram-negative bacteria, Klebsiella and Acinetobacter were resistant to piperacillin as same as carbapenem group, but gram-positive bacteria were 100% sensitive to piperacillin. All the gram-negative bacteria showed more resistance to 4th generation cephalosporin, cefepime than carbapenem. Out of culture positive 84 neonates, 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired neonates, 47.6% (10/21) were infected with Klebsiella.Conclusion: This study observed that gram-negative bacteria causing neonatal sepsis predominantly, with emergence of Candida. All the isolated gram-positive and gram-negative organisms were mostly resistant to available antibiotics

scholarly journals Bacteriological spectrum of urinary, wound and respiratory infection with antibiogram of gram negative bacteria in a Bangladeshi tertiary care hospital

Mediscope ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 17-24
Author(s):  
NM Wahidur Rahman ◽  
Bushra Tanzem ◽  
Golam Nabi ◽  
Afsana Mahbub ◽  
Abu Md Mayeenuddin Al Amin
Keyword(s):  
Urinary Tract ◽  
Respiratory Tract ◽  
Antibiotic Susceptibility ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Infection remains the main cause of morbidity and mortality in man, particularly in developing areas where it is associated with poverty and overcrowding. Infectious disease cause nearly 25% of all human deaths. This rate of mortality is increasing day by day due to antibiotic resistance, which is a major concern nowadays. Wound, respiratory tract and urinary tract are commonly associated with bacterial infection in both hospital and community settings. Area-specific monitoring studies aimed to gain knowledge about the type of bacterial pathogens responsible for these kinds of infections and resistance pattern of the causative agents may help clinicians to choose correct treatment regimen. So, the present study was aimed to investigate the pattern of bacteria which are responsible for Urinary tract, respiratory tract and wound infection. In addition, we also determined the antibiotic susceptibility profile of gram negative bacteria isolated from the patients who were attending both in and out patient departments at Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) during January, 2009 to December, 2009. In this cross-sectional study, out of 308 clinical samples, a total of 159 (51.62%) samples were found to be positive for bacterial culture. Among the isolates 139 (87.42%) were Gram negative bacteria (Esch. coli, Klebsiella spp., Proteus spp., Pseudomonas spp., Acinetobacter spp.) and 20 (12.57%) were Gram positive bacteria (Staphylococcus aureus, Coagulase negative Staphylococcus). Antibiotic susceptibility of gram negative bacteria showed members of the Enterobacteriaceae were 100% sensitive to imipenem while they were found variably resistance to other commonly used antibiotics. We conclude that infections in the wound, respiratory and urinary tract are caused by both gram negative and gram positive bacteria. However, the frequency of gram negative bacteria is higher than the gram positive bacteria for these infections. Gram negative bacteria showed sensitive to imipenem and most of them were resistant to commonly used antibiotics. Therefore, clinicians should choose imipenem for patients who would be unresponsive to commonly used antibiotics. Mediscope Vol. 7, No. 1: Jan 2020, Page 17-24

Predictive Factors for the Development of Central Line–Associated Bloodstream Infection Due to Gram-Negative Bacteria in Intensive Care Unit Patients After Surgery

2008 ◽  
Vol 29 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Pranavi V. Sreeramoju ◽  
Jocelyn Tolentino ◽  
Sylvia Garcia-Houchins ◽  
Stephen G. Weber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Predictive Factors ◽  
Tertiary Care ◽  
Central Line ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Objectives.To examine the relative proportions of central line-associated bloodstream infection (BSI) due to gram-negative bacteria and due to gram-positive bacteria among patients who had undergone surgery and patients who had not. The study also evaluated clinical predictive factors and unadjusted outcomes associated with central line-associated BSI caused by gram-negative bacteria in the postoperative period.Design.Observational, case-control study based on a retrospective review of medical records.Setting.University of Chicago Medical Center, a 500-bed tertiary care center located on Chicago's south side.Patients.Adult intensive care unit (ICU) patients who developed central line-associated BSI.Results.There were a total of 142 adult patients who met the Centers for Disease Control and Prevention National Nosocomial Infection Surveillance System definition for central line-associated BSI. Of those, 66 patients (46.5%) had infections due to gram-positive bacteria, 49 patients (34.5%) had infections due to gram-negative bacteria, 23 patients (16.2%) had infections due to yeast, and 4 patients (2.8%) had mixed infections. Patients who underwent surgery were more likely to develop central line-associated BSI due to gram-negative bacteria within 28 days of the surgery, compared with patients who had not had surgery recently (57.6% vs 27.3%; P = .002). On multivariable logistic regression analysis, diabetes mellitus (adjusted odds ratio [OR], 4.6 [95% CI, 1.2-18.1]; P = .03) and the presence of hypotension at the time of the first blood culture positive for a pathogen (adjusted OR, 9.8 [95% CI, 2.5-39.1]; P = .001 ) were found to be independently predictive of central line-associated BSI caused by gram-negative bacteria. Unadjusted outcomes were not different in the group with BSI due to gram-negative pathogens, compared to the group with BSI due to gram-positive pathogens.Conclusions.Clinicians caring for critically ill patients after surgery should be especially concerned about the possibility of central line-associated BSI caused by gram-negative pathogens. The presence of diabetes and hypotension appear to be significant associated factors.

scholarly journals Aerobacterial Vaginosis among Women Attending an Infertility Clinic at a Tertiary Care Hospital in Chennai, India and Susceptibility Pattern of Isolates

2021 ◽  
Author(s):  
Abigail R. Sopia ◽  
Pushpa Innocent D. Joseph ◽  
M. Kalyani ◽  
B. Ananthi ◽  
Suresh Dhanaraj ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Protein Synthesis Inhibitors ◽  
Gram Positive ◽  
Gram Negative

Genital infections and subsequent vaginosis diagnosed through high vaginal swab in women is caused due to fungi or bacteria. The presented study focused on determining the types, numbers and antibacterial susceptibility pattern of aerobic bacteria causing vaginosis in 147 female patients attending infertility centre in Chennai, Tamil Nadu, India. Candida spp. caused 17% of infections with 15.7% of vaginosis caused by E.coli, Klebsiella spp., Acinetobacter spp., Citrobacter spp. and Gram positive cocci – Methicillin Sensitive Staphylococcus aureus (MSSA), Coagulase Negative Staphylococci(CONS), Staphylococcus aureus and Enterococcus spp. causing 12.9% of vaginitis in the study population. A total of 20 different antibiotics – cell wall inhibitors, protein synthesis inhibitors and nucleic acid synthesis inhibitors; were tested to determine the response of bacterial isolates by Kirby-Bauer disc diffusion method. The study result determined that the most effective drug for treating Gram positive bacterial vaginitis as per CLSI guidelines based on susceptibility pattern as: Linezolid(100%), Gentamycin(91.6%), Amikacin(87.5%),Erythromycin(79.2%), Co-Trimoxazole(72.2%), Ciprofloxacin(65.6%) and least Chloramphenicol(44.3%). High level gentamycin(83.3%) was found to be effective in treating Enterococci. The descending order of susceptibility of Gram negative aerobacteria causing vaginitis as per CLSI guidelines are: Amikacin(87.5%), Gentamycin(82.5%), Cefoperazone sulbactam (76.3%), Ciprofloxacin(68.5%), Ceftazidime(62.5%) and least Amoxyclav(25%).All Gram negative bacteria tested were susceptible to– Imipenem and Meropenem as well as Chloramphenicol. Ceftriaxone (87.5%) and Nitrofurantoin(72.3%) among other antibiotics was effective against Gram negative bacteria while all Enterobacteriaceae members were found to be resistant to tetracycline.

scholarly journals Neonatal Bacterial Sepsis and Its Susceptibility Pattern in Neonatal Care Unit of Tertiary Care Hospital

2020 ◽  
pp. 106-111
Author(s):  
Abdul Hameed Tunio ◽  
Delijan Mugheri ◽  
Muhammad Khan ◽  
Wasim Sarwar Bhatti ◽  
Abdul Majeed Soomro ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Large Scale ◽  
Tertiary Care ◽  
Research Work ◽  
Antibiotic Sensitivity ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: The drug resistance and pathogens are different in various Hospitals of any country. Very high resistance pattern is observed nowadays to the frequently used antibiotics. The important observation has been noted that most of the doctors do not obtain blood cultures before start of the antibiotics, which becomes competent source of resistance. For the same purpose, this study has been done to find out the responsible microbes causing ailment and their susceptibility towards antibiotics to plan early and effective management. Materials and Methods: A number of 100 new borns admitted in the NICU CMC Children Hospital Larkana with signs and symptoms of sepsis were included in this research work. The study will help in provision of a comprehensive record on microorganisms causing sepsis in the neonates and their antibiotic sensitivity. The epidemiology and presence of neonatal sepsis in particular area makes it more easy and convenient to implement the rationale of empirical antibiotic strategy. Results: From100 neonatal blood samples taken for culture, only 21 proved to be positive which stands 21%. In majority gram positive bacteria were found in (85.71%=18 cases) and gram negative bacteria stood (14.28%=3 cases).Staphylococcus species were found on the large scale (52.38%=11 cases) secondly Streptococcus species (33.33%=7 cases) and the remaining were Escherichia species being least common (14.28%=3 cases). Conclusion: Staphylococcus species provided major share as gram positive bacteria and Escherichia species were found to be major gram negative bacterial population responsible for neonatal sepsis. Profound resistance pattern is seen against widely used antibiotics. It is mandatory to have a routine check over the antibiotic resistance.

scholarly journals Microbiological Profile and Antibiotic Sensitivity Pattern of Bacteria in Diabetic Foot Ulcers in a Tertiary Care Hospital

2021 ◽  
Vol 08 (01) ◽  
pp. 1-8
Author(s):  
Gajender Singh Ranga ◽  
Keyword(s):  
Diabetic Foot ◽  
Tertiary Care ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
E Coli ◽  
Gram Positive Bacteria ◽  
Sensitivity Pattern

Introduction: Diabetic foot is any foot pathology due to diabetes or sequelae of diabetes mellitus. This study was conducted to identify the common microorganisms isolated from diabetic foot and to analyse the antibiotic susceptibility pattern of bacteria isolated from diabetic foot. Materials and Method: The study was a hospital based cross-sectional study where 146 foot ulcer samples (who had type 2 diabetes) were analysed. Swabs were collected from the edge and margins of ulcers, and organisms were identified by gram staining culture and biochemical reactions. Result:Out of 146 patients, 69 specimens showed growth of organisms. Total 84 aerobic organisms were isolated and out of them, 64 cases showed bacterial growth, in which 84 bacteria were isolated, which represented an average of 1.28 organisms per case. Among these organisms, 62 gram-negative and 22 gram-positive organisms were isolated. E. coli was the most common gram-negative isolate (23.81%), followed by Pseudomonas aeruginosa (21.4%), and Klebsiella pneumonia(8.33%), while among gram-positive bacteria, S. aureus was the most common isolate (22.6%). Conclusion: Incidence of growth was 47.2% in which E. coli (23.8%) was the most common isolate. Gram-negative bacteria were more common than gram-positive bacteria. Diabetic foot infections are polymicrobial in nature.

scholarly journals Antibiotics Sensitivity Pattern of Post-Operative Wound Infections in a Tertiary Care Hospital, Western Nepal

2020 ◽  
Author(s):  
Sulochana Khatiwada ◽  
Susma Acharya ◽  
Rajesh Poudel ◽  
Shristi Raut ◽  
Rita Khanal ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Surgical Site Infections ◽  
Suspected Case ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Sensitivity Pattern ◽  
The Common ◽  
Antibiotics Sensitivity

Abstract Background: Surgical site infections (SSIs) is one of the most common postoperative complications and cause significant postoperative morbidity, mortality, prolong hospital stay and increase in hospital cost. The condition is serious in developing countries like Nepal owing to irrational prescriptions of antimicrobial agent. SSIs in those countries rates from 2.5% to 41.9%. This study was performed to find the common organisms causing surgical site infections and their antibiotics sensitivity pattern in a tertiary care hospital, western Nepal.Materials and methods: Pus or swab samples collected from suspected post- operative wound infections and submitted for culture and sensitivity in the Department of Microbiology were included in this study. Isolation and identification of the organisms was done as recommended by American society of microbiology (ASM). Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method as recommended by Clinical Laboratory Standard Institute (CLSI) guideline.Results: Out of 152 pus and swab samples processed for culture, (64.5%) showed culture positivity. In total isolates (65.7%) were Gram negative bacteria and (34.3%) Gram positive bacteria. Staphylococcus aureus (23.9%) was the predominant Gram positive isolate and Escherichia coli (18%) was the major Gram negative isolate. S. aureus showed (100%) sensitivity towards Linezolid and (94.4%) towards Vancomycin. Among commonly used antibiotics for Gram positive bacteria Penicillin (94.4%), Erythromycin (80.5%) were highly resistant. Sixty percent of Staphylococcus aureus isolated showed methicillin resistant (MRSA). Gram negative bacteria showed (100%) sensitivity towards the Colistin sulphate and Polymyxin B and were highly resistant towards Ampicillin (98.2%), Cefexime (87.3%), Ceftriaxone (87.3%) and other commonly used antibiotics. Overall multi-drug resistance was found in (89.5%) isolates. Among Gram negative bacterial isolates (23.1%) were MBL producer and (21.7%) were ESBL producer.Conclusion: Culture positivity in suspected case of SSIs was high (65.1%). Staphylococcus aureus was the common causative agent of SSIs. Bacteria showed more than 50% resistance towards commonly used antibiotics. So for the selection of appropriate antibiotic for better treatment of patients, culture and sensitivity should be done in every suspected case of SSIs.

scholarly journals Antibiotic resistance pattern in intensive care unit of a tertiary care teaching hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 906
Author(s):  
Amit Bhatia ◽  
Juhi Kalra ◽  
Saurabh Kohli ◽  
Barnali Kakati ◽  
Reshma Kaushik
Keyword(s):  
Intensive Care Unit ◽  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents. 

scholarly journals Study of antimicrobial susceptibility pattern of Gram positive organisms causing UTI in a tertiary care hospital in eastern region of Nepal

2013 ◽  
Vol 11 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Ratna Baral ◽  
S Timilsina ◽  
P Jha ◽  
NR Bhattarai ◽  
N Poudyal ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Bacterial Resistance ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Eastern Region ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Tract Infections

Background: Urinary tract infections (UTIs) are the most important cause of mortality and morbidity affecting all age groups with an estimated 150 million cases occurring globally per year. Resistance to antibiotics is highly prevalent in bacterial isolates causing UTI. Objectives: To observe the isolation of gram positive bacteria causing UTIs and determine their resistance pattern to antibiotics. Methods: A retrospective study was conducted in BPKIHS from August 2009- August 2010. A total of 11022 urine samples from patients who visited BPKIHS were analyzed. All specimens were inoculated on routine culture media. Bacterial isolates were identified by conventional bacteriological methods. Susceptibility testing was performed by standard methods as recommended by clinical laboratory standard institute. Results: A total of 459 gram positive uropathogens were isolated. Altogether 5 different gram positive bacteria were isolated among which Staphylococcus aureus (47%) was the most predominant organism followed by Enterococcus species (34%), Enterococcus faecalis (18%), and Coagulase-negative Staphylococci (1%). UTI caused by gram positive uropathogens was seen in 68.8% females as compared to 31.2% males. Multidrug resistance (MDR) isolates accounted for 308 out of 459 isolates (67.10%). Multidrug resistance was commonest with Enterococcus spp (71.5%) followed by Streptococcus spp (66.6%). Drugs, which retained usefulness for Gram-positive isolates were vancomycin, nitrofurantoin, ciprofloxacin and norfloxacin. Conclusion: The study revealed that bacterial resistance in gram positive uropathogens in tertiary hospital in eastern region continues to be a great problem. So, regular monitoring of emergence of resistance is highly recommended and specific antibiotics should be given only after the laboratory results are available. Health Renaissance, January-April 2013; Vol. 11 No.1; 119-124 DOI: http://dx.doi.org/10.3126/hren.v11i2.8218

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