scholarly journals Community Acquired Multi-drug Resistant Clinical Strains from Tracheal Aspirates of Patients in Hospital Settings in Dhaka, Bangladesh

2019 ◽  
Author(s):  
Md Murshed Hasan Sarkar ◽  
Jinia Afroz ◽  
Fatema Tuz Jubyda ◽  
Sanzida Sharmin ◽  
Md. Jobaid Faruq ◽  
...  
Keyword(s):  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
Hospital Data ◽  
Old Adults ◽  
Patients Âgés ◽  
Vitek 2 ◽  
Susceptibility Profiles ◽  
Tracheal Aspirates

Abstract Background: Antimicrobial resistance is a multi-sectoral problem which poses a major threat in the treatment of infectious diseases especially in developing countries like Bangladesh. Multidrug-resistant (MDR) bacteria along with extremely drug resistant (XDR) bacteria have emerged as major clinical and therapeutic dilemma in the treatment of tracheal infections in hospitals here. Thus the aim of this study was to document the incidence of MDR and XDR producing β-lactamases in clinical isolates from tracheal aspirates of patients in Dhaka, Bangladesh. Methods: Two hundred clinical isolates from tracheal aspirates were identified and their antibiotic susceptibility profiles were evaluated by using the VITEK 2 system following the Clinical and Laboratory Standards Institute guidelines. Patient information on diagnosis, sex, age was obtained from hospital data. Results: Of 200 clinical, non-duplicate bacterial isolates obtained, Pseudomonas aeruginosa was the most frequent pathogens (N=61/200, 30.5%) followed by Acinetobacter baumannii (N=58/200, 29%), Klebsiella pneumoniae (N=45/200, 22.5%), Streptococcus pneumoniae (N = 15/200, 7.5%), Escherichia coli (N=10/200, 5%), Staphylococcus aureus (N=4/200, 2%), Proteus spp (N=3/200, 1.5%), Enterobacter spp (N=2/100, 1%), Citrobacter spp (1/200, 0.5%), Providencia spp (N=1/200, 0.5%). Of 20 different antibiotics tested, highest number of isolates (N=172/200, 86%) showed resistance to third generation cephalosporin cefixime, however least number of isolates showed resistance to polymixin antibiotics- colistin (N=25/200, 12.5%) and polymixinB (N=12/200, 6%) . The patients’ ages ranged between 1 month to 95 years with the gender distribution of 133 (66.5%) males and 67 (33.5%) females. The prevalence of infections was highest among the patients of age-group (old adults) ≥60 years (N=123/200, 61.5%). Of 200 clinical isolates, 43 (21.5%) were XDR and 125 (62.5%) were MDR bacteria. Of 200 clinical isolates, the synthesis of extended spectrum β-lactamases (ESBL) and carbepenemase were detected in 59 (29.5%) and 98 (49%) strains respectively. Conclusion: Tracheal infections caused by MDR and XDR pathogens among patients are high at hospital settings in Bangladesh. Therefore, there is an urgent need for constant surveillance and interventions in Bangladesh in order to prevent further spreading of those resistant organisms.

scholarly journals Multidrug resistant clinical strains isolated from tracheal aspirates of patients in Dhaka, Bangladesh

2020 ◽  
Vol 8 (3) ◽  
pp. 1094
Author(s):  
Jinia Afroz ◽  
Fatema T. Jubyda ◽  
Sanzida Sharmin ◽  
Md. J. Faruq ◽  
Amit K. Dey ◽  
...  
Keyword(s):  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
Age Group ◽  
Old Adults ◽  
Clinical Strains ◽  
Vitek 2 ◽  
Susceptibility Profiles ◽  
Tracheal Aspirates

Background: Antimicrobial resistance poses a major threat in the treatment of respiratory disease especially in developing countries like Bangladesh. Multidrug-resistant (MDR) bacteria along with extremely drug resistant (XDR) bacteria have emerged as major clinical and therapeutic dilemma in the treatment of tracheal infections here. Thus, the aim of this study is to assess multidrug resistance among clinical strains isolated from tracheal aspirates of patients in Dhaka, Bangladesh.Methods: Total 200 clinical isolates from tracheal aspirates were identified and their antibiotic susceptibility profiles were evaluated by using the VITEK 2 system following the Clinical and Laboratory Standards Institute guidelines. Patient information on diagnosis, sex, age was obtained from hospital data.Results: Of 200 clinical isolates obtained, Pseudomonas aeruginosa was the most frequent pathogens (30.5%) followed by Acinetobacter baumannii (29%), Klebsiella pneumoniae (22.5%), Streptococcus pneumoniae (7.5%), Escherichia coli (5%), Staphylococcus aureus (2%), Proteus spp (1.5%), Enterobacter spp (1%), Citrobacter spp (0.5%), Providencia spp (0.5%). Of 20 different antibiotics tested, highest number of isolates (86%) showed resistance to third generation cephalosporin cefixime, however least number of isolates showed resistance to polymixin antibiotics- colistin (12.5%) and polymixin B (6%). Tracheal infection was found to be more prevalent in males rather than in females although this difference was not statistically significant. The prevalence of infections was highest among the patients of age-group (old adults) ≥60 years (61.5%). Of 200 clinical isolates, 43 (21.5%) were XDR and 125 (62.5%) were MDR bacteria. Of 200 clinical isolates, the synthesis of extended spectrum β-lactamases (ESBL) and carbepenemase were detected in 59 (29.5%) and 98 (49%) strains respectively.Conclusions: Tracheal infections caused by β-lactamase producing MDR and XDR pathogens among patients are high in Dhaka, Bangladesh. Therefore, there is an urgent need for constant surveillance and interventions in Bangladesh in order to prevent further spreading of those resistant organisms.

scholarly journals Susceptibility trends of zoliflodacin against multidrug-resistant Neisseria gonorrhoeae clinical isolates in Nanjing, China (2014-2018)

2020 ◽  
Author(s):  
Wenjing Le ◽  
Xiaohong Su ◽  
Xiangdi Lou ◽  
Xuechun Li ◽  
Xiangdong Gong ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Dna Sequencing ◽  
Multidrug Resistant ◽  
Quinolone Resistance ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
Extended Spectrum ◽  
High Level ◽  
Level Resistance

ABSTRACTPreviously, we reported potent activity of a novel spiropyrimidinetrione, zoliflodacin, against N. gonorrhoeae isolates from symptomatic men in Nanjing, China, collected in 2013. Here, we investigated trends of susceptibilities of zoliflodacin in 986 gonococcal isolates collected from men between 2014 and 2018. N. gonorrhoeae isolates were tested for susceptibility to zoliflodacin and seven other antibiotics. Mutations in gyrA, gyrB, parC and parE genes were determined by PCR and DNA sequencing. The MIC of zoliflodacin for N. gonorrhoeae ranged from ≤0.002 to 0.25 mg/L; the overall MIC50s and MIC90s were 0.06 mg/L and 0.125mg/L in 2018, increasing two-fold from 2014. However, the percent of isolates with lower zoliflodacin MICs declined in each year sequentially while the percent with higher MICs increased yearly (P≤0.00001). All isolates were susceptible to spectinomycin but resistant to ciprofloxacin (MIC ≥1 μg/ml); 21.2% (209/986) were resistant to azithromycin (≥1 μg/ml), 43.4% (428/986) were penicillinase-producing (PPNG), 26.9% (265/986) tetracycline-resistant (TRNG) and 19.4% (191/986) were multi-drug resistant (MDR) isolates. Among 143 isolates with higher zoliflodacin MICs (0.125-0.25 mg/L), all had quinolone resistance associated double or triple mutations in gyrA; 139/143 (97.2%) also had mutations in parC. There were no D429N/A and/or K450T mutations in GyrB identified in the 143 isolates with higher zoliflodacin MICs; a S467N mutation in GyrB was identified in one isolate. We report that zoliflodacin has excellent in vitro activity against clinical gonococcal isolates, including those with high-level resistance to ciprofloxacin, azithromycin and extended spectrum cephalosporins.

scholarly journals Analysis of Susceptibility Patterns of Pseudomonas aeruginosa and Isolation, Characterization of Lytic Bacteriophages Targeting Multi Drug Resistant Pseudomonas aeruginosa

2018 ◽  
Vol 11 (2) ◽  
pp. 1105-1117 ◽  
Author(s):  
Shri Natrajan Arumugam ◽  
Akarsh Chickamagalur Rudraradhya ◽  
Sathish Sadagopan ◽  
Sunilkumar Sukumaran ◽  
Ganesh Sambasivam ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Host Range ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Dilution Method ◽  
Drug Resistant ◽  
Susceptibility Pattern ◽  
Infectivity Rate

Pseudomonas aeruginosa is known to be a major cause of Hospital Acquired Infections leading to high mortality in immune-compromised patients. Due to precipitous rise in antibiotic resistance, bacteriophages are significant alternative therapeutic approach for treatment and to combat resistance development. Objective of the current study was to identify MDR Pseudomonas aeruginosa from clinical isolates and to isolate bacteriophages from sewage samples against these MDR Pseudomonas aeruginosa strains. One hundred and forty-four Pseudomonas isolates were tested for their susceptibility pattern with 13 different antibiotics by micro-broth dilution method. Frequency of multidrug resistant (MDR) and Extensive Drug resistant (XDR) of Pseudomonas aeruginosa were found to be 35.5% and 23.6%, respectively. 7.61% isolates were identified as Pan drug resistant (PDR). Rate of susceptibility pattern were Piperacillin/Tazobactam 75%, Polymyxin B 74.6%, Meropenem 73.6%, Colistin 69.2%, Cefepime 54.9%, Ciprofloxacin 54.2%, Gentamicin 54.2%, Aztreonam 53.5%, Tobramycin 47.9%, Ticarcillin/Clavulanic acid 46.9%, Ertapenem 45.8%, Ceftazidime 40.3% and Imipenem 39.2%. Ninety-four bacteriophages were isolated from sewage samples against Pseudomonas aeruginosa PAO1/ATCC9027/clinical strains and host range testing study was carried out with all MDR clinical isolates. Among 51 MDR strains 34 strains were infected by phages. Phage infectivity rate were calculated for individual phages based on their host range infectivity results. AP025 and AP006 phages exhibited good infectivity rate of 39% and 30% respectively against MDR strains. Combination of 5 phages (AP002, AP006, AP011, AP025 and AP067) lysed 62.7% of the strains. Based on the obtained results, phages could be employed for treatment of infections caused by MDR strains with substantiated in-vivo experiments.

scholarly journals A novel genome editing platform for drug resistantAcinetobacter baumanniirevealed an AdeR-unrelated tigecycline resistance mechanism

2016 ◽  
pp. AAC.01275-16 ◽  
Author(s):  
Vincent Trebosc ◽  
Sarah Gartenmann ◽  
Kevin Royet ◽  
Pablo Manfredi ◽  
Marcus Tötzl ◽  
...  
Keyword(s):  
Genome Editing ◽  
Efflux Pump ◽  
Treatment Options ◽  
Resistance Mechanism ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Future Research ◽  
Drug Resistant ◽  
Loss Of Function ◽  
Drug Resistant Phenotype

Infections with the Gram-negative coccobacillusAcinetobacter baumanniiare a major threat in hospital settings. The progressing emergence of multidrug resistant clinical strains significantly reduces the treatment options for clinicians to fightA. baumanniiinfections. The current lack of robust methods to genetically manipulate drug resistantA. baumanniiisolates impedes research on resistance and virulence mechanisms in clinically relevant strains. In this study we developed a highly efficient and versatile genome editing platform enabling the markerless modification of the genome ofA. baumanniiclinical and laboratory strains, regardless of their resistance profile.We applied this method for the deletion of AdeR, a transcription factor that regulates the expression of the AdeABC efflux pump in tigecycline resistantA. baumannii, to evaluate its function as a putative drug target. Loss ofadeRreduced the MIC90of tigecycline from 25 μg/ml in the parental strains to 3.1 μg/ml in theΔadeRmutants indicating its importance in the drug resistant phenotype. However, 60% of the clinical isolates remained non-susceptible to tigecycline afteradeRdeletion. Evolution of artificial tigecycline resistance in two strains followed by whole genome sequencing revealed loss of function mutations intrm,suggesting its role in an alternative AdeABC-independent tigecycline resistance mechanism. This finding was strengthened by the confirmation oftrmdisruption in the majority of the tigecycline resistant clinical isolates. This study highlights the development and application of a powerful genome editing platform forA. baumanniienabling future research on drug resistance and virulence pathways in clinical relevant strains.

scholarly journals Antimicrobial Resistance of Salmonella enterica Isolates from Tonsil and Jejunum with Lymph Node Tissues of Slaughtered Swine in Metro Manila, Philippines

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Kamela Charmaine S. Ng ◽  
Windell L. Rivera
Keyword(s):  
Lymph Node ◽  
Salmonella Enterica ◽  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Cefuroxime Axetil ◽  
Antimicrobial Use ◽  
Drug Resistant ◽  
The Novel ◽  
Metro Manila ◽  
Vitek 2

Due to frequent antibiotic exposure, swine is now recognized as potential risk in disseminating drug-resistant Salmonella enterica strains. This study thus subjected 20 randomly selected S. enterica isolates from tonsil and jejunum with lymph node (JLN) tissues of swine slaughtered in Metro Manila, Philippines, to VITEK 2 antimicrobial susceptibility testing (AST). The test revealed all 20 isolates had resistance to at least one antimicrobial agent, in which highest occurrence of resistance was to amikacin (100%), cefazolin (100%), cefuroxime (100%), cefuroxime axetil (100%), cefoxitin (100%), and gentamicin (100%), followed by ampicillin (50%), and then by sulfamethoxazole trimethoprim (30%). Three multidrug-resistant (MDR) isolates were detected. The sole S. enterica serotype Enteritidis isolate showed resistance to 12 different antibiotics including ceftazidime, ceftriaxone, amikacin, gentamicin, and tigecycline. This study is the first to report worldwide on the novel resistance to tigecycline of MDR S. enterica serotype Enteritidis isolated from swine tonsil tissues. This finding poses huge therapeutic challenge since MDR S. enterica infections are associated with increased rate of hospitalization or death. Thus, continual regulation of antimicrobial use in food animals and prediction of resistant serotypes are crucial to limit the spread of MDR S. enterica isolates among hogs and humans.

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