scholarly journals Characterisation of "ESKAPE" Pathogens with Special Reference to Multidrug Resistance and Biofilm Production in a Nepalese Hospital

2019 ◽  
Author(s):  
Rosy Pandey ◽  
Angela Shrestha ◽  
Shyam Kumar Mishra

Abstract Background: “ESKAPE” is an acronym for group of organisms as Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter calcoaceticus baumannii complex, Pseudomonas aeruginosa and Enterobacter spp. They are associated in causing life threatening infections. Global efforts on controlling multidrug resistant (MDR) organisms have been hampered by their rapid emergence, inadequate tests for rapid detection and their ability to escape the antibacterial drugs. The objective of this study was to determine the prevalence of ESKAPE pathogens with prime focus on biofilm production and antibiotic resistance. Methods: A total of 8756 clinical specimens were processed for the isolation and identification of ESKAPE pathogens following standard microbiological protocol. These isolates were subjected to antibiotic sensitivity test as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Detection of resistance phenotypes, viz., extended-spectrum-beta-lactamase (ESBL), metallo-beta-lactamase (MBL), Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE) was done by disk diffusion method and E- test method as applicable. The VRE isolates were subjected for detection of Van A and Van B genes. All the isolates were processed for biofilm detection by tube adherence method. Results: The percentage distribution of Staphylococcus aureus was 33.5%, followed by Klebsiella pneumoniae 33.0%, Pseudomonas aeruginosa 18.3%, Acinetobacter calcoaceticus baumannii complex 8.7%, Enterococcus faecium 5.6% and Enterobacter aerogenes 0.9%. MRSA was 57.6% and Vancomycin resistance among Enterococcus faecium was 20%. ESBL and MBL producing Klebsiella pneumoniae were 16.1%, and 8.1%, Acb complex 10.3% each and Pseudomonas aeruginosa 10.7% and 8.3% respectively. A total of 42.3% of isolates were biofilm producers. Linezolid was drug of choice for VRE isolates. Piperacillin- tazobactam was found to be effective against Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter aerogenes; Ampicillin-sulbactam was the most effective drug against Acb complex excluding polymyxins. Van A gene was detected in all the VRE isolates. Conclusion: This study estimates the burden of the ESKAPE organisms and their antibiotic resistance pattern in a Nepalese hospital. The increasing percentages of drug resistance among these biofilm-producing pathogens pose great threat in medical setting. Surveillance targeting ESKAPE pathogens should be incorporated in infection control policy in Nepal.

Author(s):  
NS Kuptsov ◽  
MA Kornienko ◽  
RB Gorodnichev ◽  
DI Danilov ◽  
MV Malakhova ◽  
...  

The ever-rising prevalence of multidrug-resistant bacteria necessitates the search for a therapeutic alternative to antibiotics. Using therapeutic products based on virulent bacteriophages might provide such an alternative. The aim of our study was to evaluate the efficacy of commercial phage products and natural bacteriophage monoisolates recovered from environmental sources against clinical strains of Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa. We compiled a collection of 147 strains that were subsequently genotypes using the MLST method. The efficacy of bacteriophages was evaluated in spot tests. The highest efficacy was demonstrated by "Staphylococcal bacteriophage" (86%, effective against S. aureus), "Purified polyvalent pyobacteriophage" (87.8%, effective against K. pneumoniae), and a group of phage products against P. aeruginosa, including "Pseudomonas aeruginosa bacteriophage" (87.5%), "Complex pyobacteriophage" (79.5–90%) and "Purified polyvalent pyobacteriophage" (90–92.5%). The efficacy of "Intesti bacteriophage", which targets E. faecium, was 4.2%. The efficacy of commercial phage products against S. aureus and K. pneumoniae was higher than the efficacy of individual phage monoisolates (60% for the S. aureus phage vB_SauP-436-3w and 5.9% for the K. pneumoniae phage vB_Kp_M_ Seu621). Thus, all tested commercial phage products were highly effective against P. aeruginosa, K. pneumoniae and S. aureus. There are no commercial phage products on the market against other ESKAPE pathogens, including Acinetobacter baumannii and Enterobacter cloacae. Besides, there are no effective phage products against E. faecium. This dictates the need for new effective bacteriophages against these species.


2016 ◽  
Vol 27 (2) ◽  
pp. 83 ◽  
Author(s):  
José Enrique Oliva-Menacho ◽  
Marco Antonio García-Hjarles ◽  
José Arturo Oliva-Candela ◽  
Hugo Saturnino De la Cruz-Roca

Objetivos: Determinar el grado de contaminación bacteriana con bacterias patógenas de los estetoscopios del personal médico en un hospital general de Lima, Perú. Material y métodos: Estudio de tipo observacional, descriptivo y transversal, realizado en el Hospital Nacional Arzobispo Loayza, entre los meses de enero y juniodel 2013. Se estudiaron 124 muestras de estetoscopios del personal médico en las siguientes áreas: UCI 20; neonatología 13; quemados 3; medicina 52; emergencia 36. Se recolectaron las muestras con hisopos humedecidos, en condiciones estériles (En presencia de un mechero de vidrio para alcohol) y luego fueron introducidos en tuboscon preparado de caldo BHI (Infusión cerebro corazón) para ser incubados por 24 horas a 37°C; se cultivó en Agar sangre, Agar MacConkey, Agar manitol y Agar cetrimidepara su posterior determinación de bacterias patógenas por procedimientos bioquímicos ,luego se identificó la susceptibilidad bacteriana con la técnica de Kirby- Bauer. Resultados: De los 124 estetoscopios estudiados; 114 (91,9%) estuvieron contaminados; se aislaron 123 cepasbacterianas: Staphylococcus spp coagulasa negativa 106(86,1%), Staphylococcus aureus 5(4,0%), Enterobacter aerogenes 4 (3,2%), Acinetobacter spp 2(1,6%), Pseudomonas aeruginosa 4(3,2%), Klebsiella Pneumoniae 1(0,8%) y Escherichia coli 1(0,8%). Conclusiones: El aislamiento de bacterias patógenas sugiere que el estetoscopio debe ser considerado como un vector de la infección nosocomial.


2016 ◽  
Vol 11 (31) ◽  
pp. 113-122
Author(s):  
Carla Franco Porto Belmont Souza ◽  
Luiz Eduardo Souza da Silva Irineu ◽  
Renan Silva De Souza ◽  
Renato da Silva Teixeira ◽  
Ivina Sanches Pereira ◽  
...  

A resistência microbiana tem se mostrado um problema de proporções mundiais, causando estado de morbidade e mortalidade em diversos pacientes. Em vista disso, tem crescido a busca por métodos alternativos naturais de profilaxia. A investigação clínica sugere que o Extrato de Cranberry está entre as melhores propostas de prevenção natural. O Cranberry (Vaccinium macrocarpon) é um fruto que tem crescido comercialmente pelo sabor e propriedades benéficas à saúde. Dentre as formas comercializadas estão: o suco, o chá e as cápsulas contendo o extrato seco. A ação desta planta está relacionada ao tratamento de doenças do trato urinário, por possuir substâncias que inibem a adesão bacteriana ao epitélio do trato urinário, dificultando sua proliferação e reprodução. Dentre todas as infecções relacionadas à assistência a saúde, a Infecção do Trato Urinário é a mais frequentemente associada a procedimentos invasivos. Se não for tratada, pode resultar em complicações como pielonefrite aguda, bacteremia e pionefrose. Portanto, cranberry pode ser uma nova alternativa para o combate das infecções uroepiteliais, por ser um produto natural de preço acessível, e com formas de comercialização diversificada, ao contrário dos antimicrobianos convencionais, que por sua vez são caros e podem acabar causando resistência nos micro-organismos. Este trabalho teve como objetivo avaliar in vitro a atividade antimicrobiana do extrato de Cranberry, adquirido em farmácia de manipulação, sobre 8 micro-organismos isolados de infecções urinárias. As cepas utilizadas, adquiridas da coleção da FIOCRUZ, foram: Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Serratia marscecens, Staphylococcus aureus, Enterococcus faecalis e Enterococcus faecium. No estudo, foram utilizados o caldo Mueller Hinton (MH), Extrato de Cranberry e as bactérias patogênicas. O ensaio foi realizado em triplicata, com o uso de um controle de crescimento dos micro-organismos e o experimento para avaliação do crescimento bacteriano na presença do extrato. A turbidez foi medida com o auxílio de um espectrofotômetro, no comprimento de onda de 600 nm, antes e após 24 horas de incubação à 37 ºC. O procedimento forneceu a Densidade Ótica, do qual possibilitou a identificação da inibição microbiana. Para análise estatística foi utilizado o Teste t de Student. O Extrato de Cranberry apresentou atividade antimicrobiana sobre as bactérias Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, Serratia marscecens e Enterococcus faecalis (p < 0,05), confirmando seu efeito benéfico em infecções urinárias. No entanto, não teve efeito inibitório significativo sobre Pseudomonas aeruginosa, Proteus mirabilis e Enterococcus faecium (p > 0,05).


2009 ◽  
Vol 54 (3) ◽  
pp. 1354-1357 ◽  
Author(s):  
Iraida E. Robledo ◽  
Edna E. Aquino ◽  
María I. Santé ◽  
Jorge L. Santana ◽  
Diana M. Otero ◽  
...  

ABSTRACT During an island-wide PCR-based surveillance study of beta-lactam resistance in multidrug-resistant (MDR) Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus-baumannii complex isolates obtained from 17 different hospitals, 10 KPC-positive Acinetobacter isolates were identified. DNA sequencing of the bla KPC gene identified KPC-2, -3, and -4 and a novel variant, KPC-10. This is the first report of a KPC-type beta-lactamase identified in Acinetobacter species.


2020 ◽  
Vol 3 (2) ◽  
pp. 96
Author(s):  
Isna Romadhona ◽  
Fauna Herawati ◽  
Rika Yulia

Antibiotik merupakan obat yang digunakan untuk mengatasi dan mencegah infeksi bakteri. Penggunaan antibiotik yang tidak tepat dapat menimbulkan berbagai masalah, diantaranya pengobatan akan lebih mahal dan juga risiko terjadinya resistensi bakteri terhadap antibiotik. Penelitian ini bertujuan untuk mengetahui profil penggunaan antibiotik dan profil peta kuman pada pasien gangren diabetes melitus di sebuah RSUD di Kabupaten Gresik serta untuk mengetahui kesesuaian penggunaan antibiotik dengan mengacu pada Permenkes Republik Indonesia No. 2406/Menkes/PER/XII/2011. Data penggunaan antibiotik diperoleh dari catatan Rekam Medis pada periode Januari – November 2017. Data penggunaan antibiotik dihitung dengan menggunakan rumus DDD/100 pasien-hari rawat. Hasil perhitungan DDD/100 pasien-hari rawat menunjukkan hasil sebesar 470,11 DDD/100 pasien-hari rawat. Peta kuman pada pasien gangren, melaporkan adanya bakteri Enterobacter cloacae 24%, Escherichia coli 18%, Staphylococcus aureus 15%, Acinetobacter baumannii 9%, Pseudomonas aeruginosa 6%, Citrobacter youngae 6%, Enterobacter aerogenes 6%, Proteus vulgaris 6%, Staphylococcus schleiferi 6%, Klebsiella pneumoniae 3%, dan Proteus mirabilis 3% . Penggunaan antibiotik seftriakson dan metronidazol pada pasien gangren diabetes melitus di sebuah RSUD di Kabupaten Gresik pada periode Januari – November 2017 telah sesuai dengan pedoman penggunaan antibiotik berdasarkan Permenkes Republik Indonesia No. 2406/Menkes/PER/ XII/2011, yaitu antibiotik golongan sefalosporin generasi III yang lebih aktif terhadap Enterobacteriaceae dan antibiotik golongan nitroimidazol yang dapat mengobati infeksi bakteri basil anerob Gram-Negatif.


mBio ◽  
2016 ◽  
Vol 7 (2) ◽  
Author(s):  
George G. Zhanel ◽  
James A. Karlowsky

ABSTRACT Clay minerals are naturally occurring layered phyllosilicates which consist of fine particles and possess antimicrobial activity. In a recent article, Behroozian et al. obtained Kisameet clay (KC) from Kisameet, from the central coast of British Columbia, Canada, northwest of Vancouver and assessed its antimicrobial activity versus 16 selected ESKAPE pathogens ( Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , and Enterobacter spp.) possessing a variety of different resistance profiles [S. Behroozian, S. L. Svensson, and J. Davies, mBio 7(1):e01842-15, 2016, http://dx.doi.org/10.1128/mBio.01842-15]. KC demonstrated complete bacterial eradication of Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , and Staphylococcus aureus within 24 h. For Enterobacter spp., the organisms were eradicated with 1% KC within 5 h, while for Enterococcus faecium , it took 48 h to kill all organisms. Although many questions need to be answered, these exciting findings highlight the importance of testing natural substances/products from around the globe to assess whether they possess antimicrobial activity and potential for usage as topical, oral, or systemic agents for the treatment of multidrug-resistant pathogens.


2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Taciéli Fagundes da Rosa ◽  
Vitória Segabinazzi Foletto ◽  
Marissa Bolson Serafin ◽  
Angelita Bottega ◽  
Rosmari Hörner

O persistente uso de antibióticos, automedicação e exposição a infecções hospitalares têm provocado o aumento de microrganismos multirresistentes. Com essa emergência da multirresistência bacteriana, seis patógenos figuram papel essencial. O termo ESKAPE trata de seis microrganismos com alta multirresistência e virulência: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa e Enterobacter spp. Recentemente, a Organização Mundial da Saúde (OMS) liberou uma lista de agentes patogênicos prioritários para pesquisa e desenvolvimento de novos agentes antibacterianos. Todos os patógenos ESKAPE fazem parte desta lista. Elencando, assim, uma grande questão: a importância emergente de novas estratégias de tratamento para infecções ocasionadas por esses microrganismos.


1996 ◽  
Vol 40 (8) ◽  
pp. 1825-1831 ◽  
Author(s):  
M Y Kim ◽  
J I Oh ◽  
K S Paek ◽  
Y Z Kim ◽  
I C Kim ◽  
...  

In vitro activity of LB10522 was compared with those of cefpirome, ceftazidime, ceftriaxone, and cefoperazone against clinical isolates. Against gram-positive bacteria, LB10522 was most active among the compounds tested. It was fourfold more active than cefpirome against methicillin-susceptible Staphylococcus aureus and Enterococcus faecalis. LB10522 was highly effective against most members of the family Enterobacteriaceae tested. Ninety percent of isolates of Escherichia coli, Klebsiella oxytoca, Proteus vulgaris, Proteus mirabilis, and Salmonella spp. were inhibited at a concentration of < or = 0.5 micrograms/ml. These activities were comparable to those of cefpirome. Against Pseudomonas aeruginosa, LB10522 with a MIC at which 90% of the isolates are inhibited of 2 micrograms/ml was 16- and 32-fold more active than ceftazidime and ceftazidime against systemic infections caused by Staphylococcus aureus giorgio, Streptococcus pneumoniae III, Pseudomonas aeruginosa 1912E, Escherichia coli 851E, Proteus mirabilis 1315E, Serratia marcescens 1826E, and Acinetobacter calcoaceticus Ac-54. LB10522 was very resistant to hydrolysis by various beta-lactamases such as TEM-3, TEM-7, SHV-1, FEC-1, and P-99. LB10522 did not induce beta-lactamase in Enterobacter cloacae 1194E, although most of the reference cephalosporins acted as inducers of beta-lactamase in this strain. Time-kill study showed that LB10522, at concentrations of two or four times the MIC, had a rapid bactericidal activity against Staphylococcus aureus 6538p, Escherichia coli 851E, and Pseudomonas aeruginosa 1912E.


2013 ◽  
pp. 35-42
Author(s):  
Nguyen Ngoc Trac Mai

Objective: Study on the distribution of common pathogens at Binh An hospital in 2010 and their antibiotic resistance. Methods: Retrospective, descriptive and cross-sectional methods were used. Data of bacterial identification and antibiogram results were collected at Binh An hospital from January to December 2010. Results: The top 5 bacterias were E.coli (33.93%), Streptococcus spp. (23.21%), Staphylococcus aureus (14.29%), Klebsiella pneumoniae (8.93%) and Pseudomonas aeruginosa (7.14%). E.coli strains were high resistant to Ampicillin (100%), Ticarcillin (100%), Trimethoprim/Sulfamethoxazol (85%) and highly sensitive to Imipenem (94%), Cefoperazone/Sulbactam (93%) and Piperacillin/Tazobactam (83%). Resistant rates for Streptococcus spp. were as follows: Oxacillin (100%), Gentamicin (77%), Amikacin (77%), Trimethoprim/Sulfamethoxazol (62%). Streptococcus spp. were sensitive to Vancomycin (100%), Imipenem (100%), Piperacillin and Cefoperazone/Sulbactam (100%). Staphylococcus aureus were high sensitive to Vancomycin (100%) and combinations of Betalactam/Beta-lactamase inhibitor (100%). Carbapenems and combinations of Betalactam/Beta-lactamase inhibitor were effective to Klebsiella spp. Imipenem is still a realistic selection for Pseudomonas aeruginosa Conclusion: Continuous surveillance of antibiotic resistance as well as reasonable antibiotic use are required to mitigate the progression of antibiotic resistance. Key words: antibiotic, common pathogens


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