scholarly journals A Clinical-Bacteriological Profile of Multidrug Resistant Pseudomonas aeruginosa at Tertiary Care Hospital Shahjahanpur, Uttar Pradesh

2021 ◽  
Vol 10 (9) ◽  
pp. 301-313
Author(s):  
Jitendra Kumar Chaudhary
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Uttar Pradesh ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
Clinical Samples ◽  
Care Hospital ◽  
Bacteriological Profile ◽  
Drug Resistant Strains

The Pseudomonas aeruginosa is predominant agent causing nosocomial infections. In recent time, it develops resistance continuously to the antibiotics becomes Multidrug-resistant P. aeruginosa. So, in cystic fibrosis patents it difficult to eradicate P. aeruginosa infections with antimicrobial treatment. Therefore, focus on alternative mechanisms for treating P. aeruginosa infections. On the basis of growth, morphological and biochemical characteristics, P. aeruginosa strains were isolated from the clinical samples in this work. After that the antibiotic sensitivity was performed and the Multidrug resistant Pseudomonas aeruginosa was identified according to CLSI standard guideline chart by measuring the zone of inhibition for P. aeruginosa. The isolated strains showed resistance against three or more antibiotics, considered as MDR Pseudomonas aeruginosa. By antibiogram pattern 51 showed Multi drug resistant strains out of 102 isolated strains. As P. aeruginosa abide to develop resistance to the antibiotics, the quorum sensing increased transcriptional regulator QscR might performs another target. Thus the prevalence of MDR strains of Pseudomonas aeruginosa was investigated on current study. The antibiogram pattern revealed 51 MDR strains of P. aeruginosa. In which the majority of strains exhibited resistance towards Piperacillin (98%), Ciprofloxacin (90%), Ofloxacin (90%), Levofloxacin (80%) and Tobramycin (60%).

scholarly journals Prevalence of Multidrug-resistant and Carbapenemase-producing Klebsiella Pneumoniae and Pseudomonas Aeruginosa Isolates in Tertiary Care Hospital in Kathmandu, Nepal

2021 ◽  
Vol 23 (4) ◽  
pp. 290-296
Author(s):  
Rojina Darnal ◽  
Mehraj Ansari ◽  
Ganesh Rai ◽  
Kul Raj Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Disk Diffusion Method

Carbapenemases are the enzymes that catalyze β–lactam groups of antibiotics. The carbapenemase producers are resistant to β–lactam antibiotics and are usually multidrug-resistant bacteria challenging widely used therapeutics and treatment options. Therefore, the detection of carbapenemase activity among clinical isolates is of great therapeutic importance. We aimed to study the MDR and carbapenemase-producing Klebsiella pneumoniae and Pseudomonas aeruginosa isolated from various clinical samples at a tertiary care hospital in Nepal. A total of 3,579 clinical samples were collected from the patients visiting the Department of Microbiology, B&B Hospital, Gwarko, Lalitpur. The samples were processed to isolate K. pneumoniae and P. aeruginosa and then subjected to antibiotic susceptibility testing (AST) by the Kirby-Bauer disk diffusion method. Phenotypic detection of carbapenemase activity was performed in the imipenem-resistant isolates by the modified Hodge test (MHT). Of the total samples, 1,067 (29.8%) samples showed significant growth positivity, out of which 190 (17.3%) isolates were K. pneumoniae and 121 (11.3%) were P. aeruginosa. Multidrug resistance was seen in 70.5% of the K. pneumoniae isolates and 65.3% of the P. aeruginosa isolates. Carbapenemase production was confirmed in 11.9%, and 12.2% of the imipenem-resistant K. pneumoniae and P. aeruginosa isolates, respectively, by the MHT. This study determined the higher prevalence of MDR among K. pneumoniae and P. aeruginosa; however, carbapenemase production was relatively low.

scholarly journals Isolation, identification and antibiotic sensitivity pattern of aerobic bacteria from burn wound patient admitted in tertiary care hospital

2020 ◽  
Vol 8 (6) ◽  
pp. 2095
Author(s):  
Amit Kumar Sah ◽  
Varun Goel ◽  
Siddu Lagamappagol
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Infectious Complications ◽  
Aetiological Factor ◽  
Research Centre ◽  
Care Hospital ◽  
Burn Wound ◽  
Sensitivity Pattern

Background: Significant burn injuries induce a state of immunosuppression that predisposes patients to infectious complications, thus the rate of nosocomial infections are higher. Rapidly merging multidrug resistant among the various isolate in indoor burn patients are depending on time-line becoming serious threat for managing therapeutically. Objective of this study is to determine the aetiological factor, prevalence, antimicrobial susceptibility pattern and emerging nosocomial pathogens.Methods: A prospective study was carried in burn ward of K.L.E.’s Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum for the period of 1 year. Pair of wound swab were collected from patient having burnt more than 30% (RULE OF NINE) on 3rd day of stay. Sample were collected aseptically from 30 patients and processed by convectional culture and biochemical identification procedures and tested against commonly used antibiotics.Results: 30 patients that fall under inclusive criteria were enrolled in the study. The total burn surface area (TBSA) ranges from 30-82%. The ratio of female to male patient suffering burn wound in our study is 1.5:1. Aetiology of burn is heat (moist/dry) mostly. Depending upon degree of burn, most of patient suffered from 20 degree (superficial to deep) injury. From 30 swab cultures, 42 isolates were identified during the study in which mixed were 66.66% and one is fungi. The most commonly isolated is Pseudomonas aeruginosa (45.24%) then Klebsiella pneumoniae (19.04%), Acinetobacter spp. (14.28%), Staphylococccus aureus (11.90%). Among gram positive isolates, isolates are found to be most resistant to Erythromycin (100%) and Co-trimoxazole (100%) and sensitive to Vancomycin (71.42%). Among gram negative isolates are found to be most resistant to Gentamicin (91.65%), Ciprofloxacin (82.35%), Ceftazidime (82.35%) and sensitive to Meropenem (52.95%), Piperacillin (35.30%), Carbenicillin (29.41%).Conclusions: Pseudomonas aeruginosa was found to be the most common isolate. The nature of microbial wound colonization and flora changes with time should be taken into consideration in empirical antimicrobial therapy.

scholarly journals Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Confirmatory Test ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe 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. Methods A 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 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. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) 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. Conclusion Multidrug 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 Epidemiological characterization of dermatophytes at a tertiary care hospital in Eastern Uttar Pradesh, India

2019 ◽  
Author(s):  
Ankur Kumar ◽  
Vandana Upadhyay ◽  
Amresh K. Singh ◽  
Jayesh Pandey
Keyword(s):  
Low Socioeconomic Status ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Common Species ◽  
Personal Hygiene ◽  
Clinical Samples ◽  
Care Hospital ◽  
Direct Microscopic Examination ◽  
Superficial Mycosis

Background and Purpose: Superficial mycosis is more prevalent in tropical and subtropical countries, such as India. Regarding this, the present study was conducted to determine the epidemiology of superficial mycosis and identify the most common dermatophytic species in this region. Materials and Methods: For the purpose of the study, a total of 220 skin scraping, nail, and hair root specimens were collected. Direct microscopic examination was performed using potassium hydroxide mount. Additionally, the samples were inoculated onto Sabouraud dextrose agar (SDA) and dermatophyte test medium (DTM). The fungal colony of each isolates was stained with lactophenol cotton blue mount, and observed under microscope for species identification. Results: Out of 220 isolates, 172 samples, obtained from 108 males 64 females, were positive for skin fungal infections by either KOH mount or culture. Furthermore, 113 isolates were identified as dermatophytes, while 59 samples were found to be non-dermatophytes. Among the dermatophytes isolated from different clinical samples, Trichophyton verrucosum (42/113, 38%) was the most common species, and Tinea corporis was the most common infection (36.2%). Conclusion: As the findings indicated, dermatophytes had an isolation rate of 78%, which is higher than normal. This can be due to the fact that the majority of the patients were from a rural background (71.7%) with a low socioeconomic status and poor personal hygiene who were exposed to climatic changes.

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 and antibiotic susceptibility pattern of Klebsiella species isolated from various clinical samples in a tertiary care hospital Coimbatore

2021 ◽  
Vol 8 (10) ◽  
pp. 4886
Author(s):  
Vijayashree V. ◽  
Saikeerthana D. ◽  
Prabha P.
Keyword(s):  
Antibiotic Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Clinical Samples ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Klebsiella Species ◽  
Antibiotic Susceptibility Pattern ◽  
Sensitivity Pattern

Background: The genus Klebsiella of Enterobacteriaceae family is ubiquitous in nature. They cause many nosocomial infections like pneumonia, urinary tract infections, wound infections, bacteremia and septicemia. Multidrug resistance is seen in Klebsiella which serves as the most common cause of increased morbidity and mortality. This study reveals the prevalence and antibiotic sensitivity pattern of Klebsiella species from various clinical samples. The primary objectives are as follows: To isolate and characterize Klebsiella species from various clinical samples. To study the antibiotic susceptibility pattern of Klebsiella isolates.Methods: This prospective study was conducted in our tertiary care hospital during the period from August 2019 to October 2019. A total of 3521 samples were tested during this period. The samples include blood, sputum, urine, and pus.Results: Out of the total samples tested,1106 samples were showing the growth of the organisms. Among this,351 were identified as Klebsiella species and the highest rate of isolation of Klebsiella species is from the sputum sample and also the same was reported high in medical wards. The study also shows that the isolation of Klebsiella species shows male preponderance when compared to females. The antibiotic sensitivity pattern was done by Kirby-Bauer's disc diffusion method and the sensitivity was noted to be higher to amikacin and ciprofloxacin.Conclusions: Thus, this study shows the prevalence rate of Klebsiella species and sensitivity pattern of Klebsiella, which may help select appropriate antibiotics and prevent overuse and misuse of antibiotics.

scholarly journals Drug Resistance and Biofilm Production among Pseudomonas aeruginosa Clinical Isolates in a Tertiary Care Hospital of Nepal

2019 ◽  
Vol 21 (2) ◽  
pp. 110-116
Author(s):  
Rajani Shrestha ◽  
N. Nayak ◽  
D.R. Bhatta ◽  
D. Hamal ◽  
S.H. Subramanya ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Drug Resistance ◽  
Biofilm Formation ◽  
Tertiary Care ◽  
Clinical Problem ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Care Hospital ◽  
Microbiological Methods

Clinical isolates of Pseudomonas aeruginosa often exhibit multidrug resistance due to their inherent ability to form biofilms. Drug resistance in Ps. aeruginosa is a major clinical problem, especially in the management of patients with nosocomial infections and those admitted to ICUs with indwelling medical devices. To evaluate the biofilm forming abilities of the clinical isolates of Ps. aeruginosa and to correlate biofilm formation with antibiotic resistance. A total of 90 consecutive isolates of Ps. aeruginosa obtained from various specimens collected from patients visiting the Manipal Teaching Hospital, Pokhara, Nepal between January 2018 - October 2018 were studied. Isolates were identified by standard microbiological methods. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion method. All the isolates were tested for their biofilm forming abilities by employing the tissue culture plate assay. Of the 90 Ps. aeruginosa isolates, maximum i.e 42 (46.6%) were from patients in the age group of > 50 years. Majority (30; 33.3%) of the isolates were obtained from sputum samples. However, percentage isolation from other specimens like urine, endotracheal tube (ETT), pus, eye specimens and blood were 18.9%, 16.7%, 16.7%, 7.8% and 6.7% respectively. All the isolates were sensitive to polymixin B and colistin, 91.1% of the organisms were sensitive to imipenem, and more than 80% to aminoglycosides (80% to gentamicin, 83.3% to amikacin). A total of 29 (32.2%) organisms were biofilm producers. Maximum numbers of biofilm producing strains were obtained from ETT (8 of 15; 53.3%), pus (8 of 15; 53.3%) and blood (2 of 6; 33.3%) i.e from all invasive sites. None of the isolates from noninvasive specimens such as conjunctival swabs were biofilm positive. Significantly higher numbers of biofilm producers (23 of 29; 79.3%) were found to be multidrug resistant as compared to non-biofilm (6 of 61; 9.8%) producers (p=0.000). Ps. aeruginosa colonization leading to biofilm formation in deep seated tissues and on indwelling devices is a therapeutic challenge as majority of the isolates would be recalcitrant to commonly used antipseudomonal drugs. Effective monitoring of drug resistance patterns in all Pseudomonas clinical isolates should be a prerequisite for successful patient management.

scholarly journals PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ACINETOBACTER SPECIES AMONG VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE TEACHING HOSPITAL, SVIMS, TIRUPATHI.

2020 ◽  
pp. 1-3
Author(s):  
P. Sneha ◽  
N. Ramakrishna ◽  
R. Jayaprada ◽  
K.K. Sharma
Keyword(s):  
Clinical Laboratory ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Acinetobacter Species ◽  
Strict Adherence ◽  
Stewardship Program ◽  
Acinetobacter Sp

Multidrug resistance isolates of Acinetobacter sp. are increasing due to indiscriminate use of antibiotics in health care settings. The incidence of resistance to broad spectrum antibiotics is increasing and thus posing a therapeutic challenge. All samples were processed and isolates were identified as per standard protocol. 5Antibiotic susceptibility of all isolates was determined by the standard Kirby Bauer disc diffusion method as per Clinical laboratory standards institute (CLSI) guidelines 2017.6 Majority of the Acinetobacter sp. were isolated from E.T aspirates (47.3%). In our study A.baumannii (65.3%) was the most common species responsible for the infections. Among 150 Acinetobacter isolates, 68% of isolates were multidrug resistant organisms, 52% were extended spectrum beta-lactamase (ESBL) producers and 44% of isolates were carbapenem resistant. To abate antimicrobial resistance, antimicrobials ought to be prescribed sensibly and observational antimicrobial treatment ought to be resolved for every hospital as per institutional antibiogram. Strict adherence to the antibiotic policy and proper implementation of antibiotic stewardship program in coordination with clinicians can reduce emergence of multidrug resistant Acinetobacter species which is of great concern.

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