scholarly journals Prospective Study on Microbiology of Respiratory Tract Infections with Interest in Multidrug Resistant Bacteria

Author(s):  
K.P. Aswathi ◽  
B.J. Deepthy ◽  
Gogi Suresh ◽  
P.V. Harish ◽  
U.V. Deepthy
2018 ◽  
Vol 51 (3) ◽  
pp. 1701656 ◽  
Author(s):  
Anne-Sophie Moreau ◽  
Ignacio Martin-Loeches ◽  
Pedro Povoa ◽  
Jorge Salluh ◽  
Alejandro Rodriguez ◽  
...  

The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients.All patients receiving mechanical ventilation for >48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297).The incidence of VA-LRTI was significantly lower among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53–0.80; p<0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; sub-hazard ratio 0.61, 95% CI 0.45–0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54–0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrug-resistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78–4.02; p<0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p<0.001).Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI.


2021 ◽  
Vol 5 (8) ◽  
pp. 13-18
Author(s):  
Darija Knežević ◽  
Silvana Trifunović ◽  
Duška Jović ◽  
Jadranka Stanisavić-Šimić

Introduction: Patients in intensive care units (ICUs) are at higher risk of infections due to invasive procedures and antibiotic therapy. Infections caused by multidrug-resistant (MDR) bacteria represent a global problem, limiting the choice of antimicrobial therapy. Objective: To determine the rate of infections in ICUs, as well as the type of MDR bacteria associated with such infections. Material and methods: The study included strains of MDR bacteria isolated from laboratory samples of hospitalized patients in surgical ICUs in a one-year period. All strains of MDR bacteria were isolated and identified by standard microbiological methods for aerobic bacteria according to the recommendations and guidelines are given by the Clinical and Laboratory Standards Institute (CLSI). Results: Infections caused by MDR bacterial isolates were confirmed in 199 (19.17%) patients in ICUs. The frequency of Gram-negative isolates was significantly higher than Gram-positive (88.35% and 11.65%, p <0.001). The most common infections in ICUs caused by MDR bacteria were respiratory tract infections (49%), followed by soft tissue and skin infections. The CDI incidence density 1.13 cases/10,000 patient-days. Conclusion: A high frequency of infections caused by MDR bacteria was found with patients in ICUs, and respiratory tract infections dominated. Information on the types of infections and pathogens can help develop policies for prevention, diagnosis, treatment, and resource allocation.


Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 218
Author(s):  
Taja Železnik Ramuta ◽  
Larisa Tratnjek ◽  
Aleksandar Janev ◽  
Katja Seme ◽  
Marjanca Starčič Erjavec ◽  
...  

Urinary tract infections (UTIs) represent a serious global health issue, especially due to emerging multidrug-resistant UTI-causing bacteria. Recently, we showed that the human amniotic membrane (hAM) could be a candidate for treatments and prevention of UPEC and Staphylococcus aureus infections. However, its role against multidrug-resistant bacteria, namely methicillin-resistant S. aureus (MRSA), extended-spectrum beta-lactamases (ESBL) producing Escherichia coli and Klebsiella pneumoniae, vancomycin-resistant Enterococci (VRE), carbapenem-resistant Acinetobacter baumannii, and Pseudomonas aeruginosa has not yet been thoroughly explored. Here, we demonstrate for the first time that the hAM homogenate had antibacterial activity against 7 out of 11 tested multidrug-resistant strains, the greatest effect was on MRSA. Using novel approaches, its activity against MRSA was further evaluated in a complex microenvironment of normal and cancerous urinary bladder urothelia. Even short-term incubation in hAM homogenate significantly decreased the number of bacteria in MRSA-infected urothelial models, while it did not affect the viability, number, and ultrastructure of urothelial cells. The hAM patches had no antibacterial activity against any of the tested strains, which further exposes the importance of the hAM preparation. Our study substantially contributes to basic knowledge on the antibacterial activity of hAM and reveals its potential to be used as an antibacterial agent against multidrug-resistant bacteria.


2019 ◽  
Vol 10 (2) ◽  
pp. 14-19 ◽  
Author(s):  
Dharm Raj Bhatta ◽  
Deependra Hamal ◽  
Rajani Shrestha ◽  
Supram HS ◽  
Pushpanjali Joshi ◽  
...  

Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.


2009 ◽  
Vol 52 (23) ◽  
pp. 7446-7457 ◽  
Author(s):  
Thomas V. Magee ◽  
Sharon L. Ripp ◽  
Bryan Li ◽  
Richard A. Buzon ◽  
Lou Chupak ◽  
...  

2009 ◽  
Vol 53 (8) ◽  
pp. 3285-3293 ◽  
Author(s):  
Carolyn L. Cannon ◽  
Lisa A. Hogue ◽  
Ravy K. Vajravelu ◽  
George H. Capps ◽  
Aida Ibricevic ◽  
...  

ABSTRACT The expanding clinical challenge of respiratory tract infections due to resistant bacteria necessitates the development of new forms of therapy. The development of a compound composed of silver coupled to a methylated caffeine carrier (silver carbene complex 1 [SCC1]) that demonstrated in vitro efficacy against bacteria, including drug-resistant organisms, isolated from patients with respiratory tract infections was described previously. The findings of current in vitro studies now suggest that bactericidal concentrations of SCC1 are not toxic to airway epithelial cells in primary culture. Thus, it was hypothesized that SCC1 could be administered by the aerosolized route to concentrate delivery to the lung while minimizing systemic toxicity. In vivo, aerosolized SCC1 delivered to mice resulted in mild aversion behavior, but it was otherwise well tolerated and did not cause lung inflammation following administration over a 5-day period. The therapeutic efficacy of SCC1 compared to that of water was shown in a 3-day prophylaxis protocol, in which mice infected with a clinical strain of Pseudomonas aeruginosa had increased survival, decreased amounts of bacteria in the lung, and a lower prevalence of bacteremia. Similarly, by using an airway infection model in which bacteria were impacted in the airways by agarose beads, the administration of SCC1 was significantly superior to water in decreasing the lung bacterial burden and the levels of bacteremia and markers of airway inflammation. These observations indicate that aerosolized SCC1, a novel antimicrobial agent, warrants further study as a potential therapy for bacterial respiratory tract infections.


2021 ◽  
Author(s):  
Riju Maharjan ◽  
Anup Bastola ◽  
Nabaraj Adhikari ◽  
Komal Raj Rijal ◽  
Megha Raj Banjara ◽  
...  

Abstract Background Bacterial opportunistic infections are quite common in HIV patients. Besides HIV-TB coinfection, lower respiratory tract infections by multidrug-resistant bacteria cause significant morbidity and mortality among HIV patients. This study was done to evaluate the bacterial coinfection of LRT and detect plasmid-mediated blaTEM and blaCTX−M genes among Extended-Spectrum β-Lactamase (ESBL) producing isolates from sputum samples in HIV patients. Methods A total of 263 sputum samples from HIV-positive cases were processed with standard microbiological methods to isolate and identify the possible pathogens. The identified bacterial isolates were assessed for antibiotic susceptibility pattern by using modified Kirby Bauer disk diffusion method following Clinical Laboratory Standard Institute (CLSI) guidelines. Plasmid DNA was extracted from multidrug-resistant and ESBL producers for screening of ESBL genes; blaCTX−M and blaTEM by conventional PCR method using specific primers. Results Of 263 sputum samples, 67 (25.48%) were culture positive showing Klebsiella pneumoniae; 17(25.37%) as the most predominant one. A higher rate of infection (4/8, 50%) was observed among old-aged people of 61 -70 years, whereas no infection was observed below 20 years. About 30.0% (15/50) of smokers, 32.86% (23/70) cases with previous pulmonary tuberculosis and 52.38% (11/21) with CD4 count <200 cells/µl were found to be susceptible to LRTIs. Among 53 bacterial isolates, 52.83% (n=28) were multidrug-resistant and 43.4% (n=23) were ESBL producers. All ESBL producers were sensitive to Colistin and Polymyxin B. Of 23 ESBL producers, 47.83% (11/23) and 8.6% (2/23) possessed only blaCTX−M and blaTEM genes respectively and 43.48% (10/23) possessed both ESBL genes. Conclusion The increasing rate of MDR bacterial infections mainly ESBL producers of LRTIs causes difficulty in the management of diseases leading to high morbidity and mortality of HIV patients.


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