Prevalence of ESBL and MBL Producing Acinetobacter species Isolated from Various Clinical Samples in Tertiary Care Hospital in North-West Region of Rajasthan

This study was conducted with an objective to find the prevalence of extended spectrum betalactamase (ESBL) and metallo betalactamase (MBL) in Acinetobacter species. It was conducted in the Department of Microbiology, Sardar Patel Medical college, Bikaner from Feb 2018 to Feb.2019. in various clinical specimens including urine, pus, blood, vaginal swabs, respiratory samples, and various body fluids were processed Acinetobacter species isolates were identified by standard protocols. Antibiotic sensitivity testing for all isolates was done using Kirby-Bauer disc diffusion method. Disc potentiation test was performed to check ESBL and MBL production in these bacteria. Maximum ESBL and MBL positive isolates of Acinetobacter species were observed among E.T. tube samples. Early detection, stringent antibiotic policies, and compliance towards infection control practices are the best defenses against this organisms.

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Detection of inducible clindamycin resistance in Staphylococcus aureus from various samples in a tertiary care hospital

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195541 ◽

2019 ◽

Vol 7 (12) ◽

pp. 4696

Author(s):

Rohit Kumar ◽

Jagarti . ◽

Mrinmoy Sarma ◽

Gautam Shalini

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistance ◽

Tertiary Care ◽

Antibiotic Sensitivity ◽

Clinical Isolates ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Sensitivity Testing ◽

Inducible Clindamycin Resistance

Background: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the usage of Macrolides-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcus aureus infection. Clindamycin is an important drug used in the treatment of MRSA and MSSA infection. The aim of this study was to determine inducible and constitutive clindamycin resistance among clinical isolates of Staphylococcus aureus by D-test.Methods: During a period of 6 months from July 2018 to December 2018, a total of 100 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Methicillin-resistance was determined by using the cefoxitin (30 µg) disc. Incidence of MLSBc and MLSBi in Staphylococcus aureus isolates by D-test as per CLSI guidelines.Results: Out of 100 isolates of Staphylococcus aureus obtained from 350 clinical samples, 70(70%) were found to be MRSA and 30(30%) were MSSA. Among 100 Staphylococcus aureus isolates, 40% isolates showed MLSBi resistance, 28% isolates showed MLSBc resistance, 6% isolates showed MS phenotype and 26% isolates showed Sensitive phenotype. MLSBc and MLSBi were found to be higher in MRSA as compared to MSSA (21%, 27% and 7%, 10% respectively). All clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing.Conclusions: Continuous surveillance of the MLSB resistance is important and required before the prescription of clindamycin to treat MRSA infections.

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TO STUDY ANTIBIOTIC SENSITIVITY PATTERN OF NONFERMENTATIVE GRAM NEGATIVE BACILLI FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL, JAIPUR.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1132 ◽

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.

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Prevalence of Extended Spectrum Betalactamase (ESBL) and Metallobetalactamase (MBL) ProducingPseudomonas aeruginosaandAcinetobacter baumanniiIsolated from Various Clinical Samples

Journal of Pathogens ◽

10.1155/2018/6845985 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Amandeep Kaur ◽

Satnam Singh

Keyword(s):

Antibiotic Sensitivity ◽

Carbapenem Resistance ◽

Diffusion Method ◽

Clinical Samples ◽

Medical Sciences ◽

Sensitivity Testing ◽

Extended Spectrum ◽

High Prevalence ◽

Vaginal Swabs ◽

Tracheal Aspirates

This study was conducted with an objective to find the prevalence of extended spectrum betalactamase (ESBL) and metallobetalactamase (MBL) inP. aeruginosaandA. baumanniiisolates obtained from various clinical samples. It was conducted in the Department of Microbiology, Adesh Institute of Medical Sciences and Research, Bathinda, over a period of two years from July 2014 to June 2016. Clinical specimens including urine, pus, blood, high vaginal swabs, respiratory samples, and various body fluids were processed andP. aeruginosaandA. baumanniiisolates were identified by standard protocols. Antibiotic sensitivity testing for all isolates was done using Kirby-Bauer disc diffusion method. Disc potentiation test was performed to check ESBL and MBL production in these bacteria. Maximum ESBL positive isolates ofP. aeruginosawere observed among pus samples and maximum MBL positive isolates were detected in tracheal aspirates.A. baumanniishowed maximum positivity for ESBL and MBL production in endotracheal secretions. This study gives an alarming sign towards high prevalence of cephalosporin and carbapenem resistance due to production of extended spectrum betalactamases and metallobetalactamases, respectively. Early detection, stringent antibiotic policies, and compliance towards infection control practices are the best defenses against these organisms.

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Frequency and susceptibility pattern of metallo-beta-lactamase producers in a hospital in Pakistan

The Journal of Infection in Developing Countries ◽

10.3855/jidc.1050 ◽

2010 ◽

Vol 4 (12) ◽

pp. 810-813 ◽

Cited By ~ 11

Author(s):

Fatima Kaleem ◽

Javaid Usman ◽

Afreenish Hassan ◽

Aslam Khan

Keyword(s):

Tertiary Care ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Gram Negative ◽

Medical College ◽

Strip Method ◽

Carbapenem Resistant ◽

Microbiological Methods ◽

National University

Introduction: The rapid spread of acquired metallo-beta-lactamases (MBLs) among major Gram-negative pathogens is an emerging threat and a matter of particular concern worldwide. Methodology: This descriptive study was conducted between January and August 2009 in the department of Microbiology, Army Medical College, National University of Sciences and Technology, Rawalpindi, to determine the frequency and susceptibility patterns of MBL-producers among carbapenem-resistant Gram-negative rods (GNRs) from clinical isolates of a tertiary care hospital. All clinical samples were processed according to standard microbiological methods. Isolated GNRs were subjected to susceptibility testing against various antibiotics by disc diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Carbapenem-resistant isolates were subjected to the detection of MBL production by the E-test MBL strip method. Results: Out of 50 carbapenem resistant isolates, 39 (78%) of were confirmed to be MBL producers by the E-strip method. Acinetobacter baumannii were the most frequent MBL producers, followed by Pseudomonas aeruginosa. A total of 19 (37%) of the MBL producers were susceptible to cefoperazone-sulbactam. Conclusion: The findings strongly suggest that there is a need to track the detection of MBL producers and that judicious use of carbapenems is necessary to prevent the further spread of these organisms.

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PREVALENCE AND ANTIBIOTIC SUSCEPTIBILITY OF ACINETOBACTERIN A TERTIARY CARE HOSPITAL IN CHENNAI, INDIA

International Journal of Current Pharmaceutical Research ◽

10.22159/ijcpr.2021v13i1.40803 ◽

2021 ◽

pp. 35-40

Author(s):

ANGELINE ANJALI A. ◽

ABIRAMASUNDARI V. K.

Keyword(s):

Antibiotic Susceptibility ◽

Tertiary Care Hospital ◽

Therapeutic Option ◽

Tertiary Care ◽

Fourth Generation ◽

Clinical Samples ◽

Care Hospital ◽

Acinetobacter Species ◽

Medical College ◽

Acinetobacter Infection

Objective: The present study is to determine the prevalence and antibiotic susceptibility of Acinetobacter species in samples collected from patients in tertiary care hospital in Chennai. Methods: A total of17,827patient’s clinical samples were collected from various wards and ICUs of Saveetha Medical College and Hospital, Chennai, Tamilnadu over a period of 7 mo [between January 2020 and July 2020]. All samples were tested in the microbiology lab of Saveetha Medical College and Hospital using standard operating procedures. Results: Out of 17,827 samples, 2,816 were culture positive. 122 of the isolates tested positive for Acinetobacter spp.and 81.1% of the isolates belonged to Acinetobacterbaumannii. Most of the infection occurred in the age group of 21-40 y and predominantly in female patients (female, male ratio 1.9:1).General wards contributed to 54.9% of the Acinetobacter infection, followed by ICU(27%) and OPD(18%). Maximum isolates were recovered from urine(34.4%) and endotracheal secretions(29.5%).60.7% of the Acinetobacterspp were multidrug-resistant(MDR)i.e. resistant to more than 3 antibiotic group.In our study, most Acinetobactersppwere resistant to penicillin(46-100%), third and fourth generation cephalosporin (36-61.5%), carbapenems (34.4-82.8%)and quinolones(39.3-46.7%). None of the isolates were resistant to colistin. 93.4% ofisolates were sensitive to tigecycline and 87.7% sensitive to amikacin. Conclusion: Our study observed a high incidence of MDR inAcinetobacterspp, which is in line with most of the research findings in recent times. Most of Acinetobacterspp were resistant to penicillin, third and fourth generation cephalosporins, quinolones, carbapenems,which is alarming as it leaves fewer options for the line of treatment. Some strains were sensitive to cefepime, ceftazidime, piperacillin-tazobactam, levofloxacin, imipenem and meropenem. Considering the increasing MDR nature of Acinetobacterspp a combination of the former along with colistin, tigecycline, amikacin(which have shown more than 85% sensitivity) would need to be studied.Also, strict measures to control the spread of Acinetobacter infection, better management of antibiotics usage and newer therapeutic option for treatment need to be looked at.

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Identification, Speciation and Antibiogram along with Detection of Metallo Beta-lactamase Production in Acinetobacter Isolated from Clinical Samples in a Tertiary Care Hospital

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.15.2.38 ◽

2021 ◽

Author(s):

N Ashwin Chitrabanu ◽

Shrikara Mallya

Keyword(s):

Acinetobacter Baumannii ◽

Tertiary Care ◽

Antibiotic Sensitivity ◽

Clinical Samples ◽

Care Hospital ◽

Acinetobacter Species ◽

Carbapenem Resistant ◽

Appropriate Treatment ◽

Sensitivity Pattern ◽

Synergy Test

Acinetobacter species are gram negative non fermenters, which are important nosocomial pathogens involved in various outbreaks in hospitals due to widespread resistance to majority antibiotics. The aim of this study is to speciate Acinetobacter isolated from clinical samples, to assess the antibiotic sensitivity pattern and to detect the production of metallo-β-lactamase by double disc synergy test. The study was conducted in the department of microbiology, A. J Institute of Medical Sciences. All clinical samples were subjected to gram stain & cultured; the Acinetobacter isolates obtained were subjected to antibiogram. Those isolates that showed Imipenem resistant were further tested for production of metallo-β-lactamase by double disc synergy test. Out of 6625 culture positive isolates, 414 (36.1%) were identified biochemically to belong to Acinetobacter species. Of the 414 cases, 393 (94.9%) were further identified to be Acinetobacter baumannii and the remaining 21 (5.1%) to be Acinetobacter lwoffi. Acinetobacter lwoffii showed 100% sensitivity to all the drugs. Of the 393 Acinetobacter baumannii isolates 109 (27.7%) showed resistant to Imipenem. Out of these 109 isolates, 65 (59.63%) were positive for metallo-β-lactamase production by double disk synergy test. The speciation is highly demanding and laborious but it’s important to be demonstrated due to difference in the antibiotic susceptibility pattern. Carbapenem resistant Acinetobacter nosocomial strains in ICUs are detected to be more resistant to antibiotics. As shown in this study the metallo-β-lactamase producing A.baumannii isolates were 59.63% and therapeutic options were limited. Therefore early identification of metallo-β-lactamase producers is of great importance to start appropriate treatment and to control the spread.

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ARBEKACIN – A RAY OF HOPE TO FIGHT AGAINST MDR AND XDR GRAM-NEGATIVE BACTERIA IN A SCIENTIFIC AND COST-EFFECTIVE WAY IN INDIAN SCENARIO

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2020.v13i5.37069 ◽

2020 ◽

pp. 121-125

Author(s):

SOMA SARKAR ◽

DIPANKAR SARKAR ◽

ANJUM NAMHATA ◽

MANIDEEPA SENGUPTA

Keyword(s):

Severe Sepsis ◽

Tertiary Care ◽

Antibiotic Sensitivity ◽

Good Alternative ◽

Clinical Samples ◽

Care Hospital ◽

Drug Resistant ◽

Sensitivity Testing ◽

Gram Negative

Objective: The objective of the study was to see the in vitro activity of arbekacin, a novel aminoglycoside, against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacilli (GNB) so that it can become a good alternative as empirical treatment for severe sepsis. Methods: Identification and antibiotic sensitivity testing of the GNB isolated from the clinical samples were done using the VITEK-II system in a tertiary care hospital, Kolkata. MDR and XDR strains were selected by their definitions and molecular characterization was done by multiplex polymerase chain reaction. The minimum inhibitory concentration (MIC) value of arbekacin was detected by the E-test strip and compared with other aminoglycosides. Results: A total of 140 drug-resistant strains including ESBL- and carbapenemase-producing GNB were selected for the study. Arbekacin showed reduced values of MIC50 and MIC90 compared to other aminoglycosides for most of the drug-resistant GNB. Conclusion: Hence, in this drug-resistant era, arbekacin with the advantage of a single daily dose can be used as an empirical choice in severe sepsis as monotherapy or in combination with other antibiotics such as colistin or polymyxin to fight against MDR and XDR bugs.

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Characterisation and Isolation of Candida Species from ICU Patients in Nobel Medical College Teaching Hospital, Biratnagar

Journal of Nobel Medical College ◽

10.3126/jonmc.v5i1.15777 ◽

2016 ◽

Vol 5 (1) ◽

pp. 61-65

Author(s):

Bigu Kumar Chaudhari ◽

Ganesh K. Singh ◽

Kamal Prasad Parajuli ◽

Kewal Shrestha ◽

Dharmendra Shah

Keyword(s):

Candida Albicans ◽

Teaching Hospital ◽

Candida Species ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Antifungal Drugs ◽

Clinical Samples ◽

Care Hospital ◽

Sensitivity Testing ◽

Medical College

Background Fungi have emerged as major causes of human diseases. Intensive Care Units (ICU), harbor almost all the risk factors for opportunistic fungal infections. Among these, Candida infections are very common with recent trends being rise in the non-Candida albicans (NCA) species along with an increase in resistance of these species to antifungal drugs. Increament in invasive Candidasis during last three decades have been reported in several studies, among all Candida species the Candida albicans is considered as the most common infectious agent the other non-albicans like C. Tropicalis, C. glabrata, C. parapsilosis C. krusei, and C. dubliniensis were raised as infectious agents. The aim of current study is to characterize the candida species from the clinical specimens of patients admitted in the ICU of Tertiary Care hospital in Eastren Nepal and to perform their antifungal susceptibility.Material and Methods The study was carried out in the tertiary care hospital Nobel Medical College and Teaching Hospital Biratnagar Nepal over a period of 6 monthsbetween September 2015 to February 2016. The following techniques were employed to characterize the isolates in the study – Gram’s stain, culture on Sabouraud’s Dextrose Agar, Germ Tube test, morphology in Cornmeal Agar and chromogenic agar media, sugar fermentation and sugar assimilation tests, and the results were interpreted by using standard protocols.Results Out of 50 candida isolates from different clinical samples including 37 blood samples, 9 urines and 4 Endo Tracheal (ET) tube, the most common species was C.albicans (44%) followed by C.tropicalis (26%), C.Glabrata (18%), C.Parapsilosis (08%), C.Krusei (02%), and C.Dubliniensis(02%).Conclusion The purpose of the study is to show the value of species isolation, identification and antimicrobial sensitivity testing of the ICU & NICUs patients.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 61-65

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MOLECULAR EPIDEMIOLOGY OF METALLO BETA LACTAMASES IN ACINETOBACTER BAUMANNII AT A TERTIARY CARE HOSPITAL

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.500 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Sulaiman A Mohammed ◽

Dr. Suman P Singh

Keyword(s):

Acinetobacter Baumannii ◽

Tertiary Care ◽

Diffusion Method ◽

Clinical Samples ◽

Care Hospital ◽

Sensitivity Testing ◽

Beta Lactamases ◽

Carbapenem Resistant ◽

Significant Difference ◽

Vitek 2

Background: Carbapenem resistance mediated by metallo beta lactamases (MBL) in Acinetobacter baumannii is a global challenge due to its rapid spread and limited therapeutic options. Objective: To determine the prevalence of MBL in A. baumannii isolates in hospitalized patients by both phenotypic and genotypic methods. Materials and Methods: The clinical samples were collected from inpatients and subcultured on routine culture media for growth. Identification of bacteria along with antimicrobial sensitivity testing was done by VITEK -2 Compact (bioMerieux). Antibiotics that were not tested by VITEK-2 were tested manually by Kirby-Bauer disk diffusion method according to CLSI 2017 and EUCAST 2016 guidelines. The isolates which were resistant to carbapenem (imipenem and/ or meropenem) were tested by phenotypic (imipenem-EDTA combined disk method) and genotypic method for presence of common metallo beta lactamases genes (blaIMP, blaNDM, blaGIM, blaVIM, blaSPM and blaSIM). Results: 84 non duplicate A.baumannii were isolated out of 947 pathogenic gram negative isolates. Majority (47.6%) of isolates were obtained from tracheostomy/endotracheal/bronchoalveolar lavage (TT/ET/BAL) followed by sputum (21.4%). None of the isolates were found to be resistant to colistin and tigecycline. 73 (86.9%) isolates were found to be carbapenem resistant, among these 60 (82.2%) were found to be MBL positive by phenotypic and 32 (43.2%) by genotypic method. MBL genes detected were blaNDM (39.7%), blaGIM (2.7%) and blaVIM (1.4%). None of the isolates were positive for blaIMP, blaSPM and blaSIM. Conclusion: The prevalence of MBL in carbapenem resistant isolates of A.baumannii was 87.7%. blaNDM was the most common gene detected. No significant difference was found in the ability of phenotypic and genotypic methods for MBL detection. The resistance rate of the A.baumannii is high for most antibiotics except for polymyxins (E&B) and tigecycline. Key words: Metallo beta Lactamases, Acinetobacter baumannii, Carbapenem.

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