scholarly journals Risk factors analysis: screening of extended-spectrum-β-lactamase producing Gram-negative isolates of burn infections from tertiary care hospital Lahore, Pakistan

2019 ◽  
Author(s):  
Muhammad Hayat Haider ◽  
Noor Ul Ain ◽  
Shahida Hussain ◽  
Samyyia Abrar ◽  
Amina Asif ◽  
...  
Keyword(s):  
Risk Factors ◽  
Economic Status ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Skin Damage ◽  
Gram Negative ◽  
Pseudomonas Spp ◽  
Socio Economic Status ◽  
Case Series Study

Abstract Background Burnt patients are highly susceptible to invasion of multidrug resistant strains after the skin damage. The main objective of this study was to estimate the frequency of ESBLs producing Gram-negative in post-burn infections and its correlation with different risk factors (age, gender, socio-economic status, burns etiology etc.) Methods The descriptive case-series study was conducted at Jinnah Hospital Lahore’s Burn and Reconstructive Surgery Centre (JB & RSC) and the Department of Microbiology and Molecular Genetics (MMG), University of the Punjab, Lahore. The clinical specimens of wound swabs, biopsy, and blood were collected from 300 patients during 12th August, 2017 to 12th August 2018. The cephalosporins resistant Gram-negative isolates were further analyzed. The clinical history of burnt patients was recorded which included the age, gender, socio-economic status, residence, occupation, hospital stay, wards, burn degree, total burnt surface area (TBSA%), etiology of burn and other factors. CLSI guidelines 2017 were followed for the antimicrobial susceptibility testing (AST) and ESBLs screening. Results Pseudomonas spp. were the most-frequently isolated 49.33% (n=74) followed by 22.67% (n=34) Klebsiella spp., and 20.00% (n=30) Acinetobacter spp., strains. Pseudomonas spp., were the most frequently isolated from burnt specimens 70 (46.67%) having a significant correlation (x2=24.11, p < 0.001). Community acquired infections were observed in 50.70% (n=76) and nosocomial infections in 49.30% (n=74) patients. Burnt people having the age of ≤ 29 years were found to be significantly associated with the MDR infections (x2=24.96, p = 0.003). Low socio-economic status, longer hospitalization and all other risk factors had non-significant correlation (p > 0.05). A large fraction of the isolates 86.00% (n=129) were not confirmed as ESBLs producers by phenotypic screening. Conclusion It has been concluded that Gram-negative MDR strains are rapidly causing infections in burnt patients and need to be properly alleviated. The high frequency of multidrug resistant Pseudomonas spp., was associated with the burn infections. The patients belonging to young age were significantly found to be infected by MDR strain after burns.

scholarly journals Low knowledge of osteoporosis and its risk factors in urban Indian adults from Pune city, India

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Nidhi Kadam ◽  
Shashi Chiplonkar ◽  
Anuradha Khadilkar ◽  
Vaman Khadilkar
Keyword(s):  
Risk Factors ◽  
Economic Status ◽  
Tertiary Care ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Men And Women ◽  
Socio Economic Status ◽  
Indian Men

AbstractObjectiveTo assess knowledge of osteoporosis and its risk factors and to explore associations between knowledge and various sociodemographic factors in Indian adults.DesignCross-sectional study. The Revised Osteoporosis Knowledge Test (OKT) was used to assess knowledge of osteoporosis. Four scores (OKT-total, range 0–32; OKT-exercise, range 0–20; OKT-nutrition, range 0–26; OKT-risk factors, range 0–14) were generated by giving 1 point to every correct answer and 0 points for incorrect or ‘not known’ answers.SettingTertiary-care hospital in Pune city, India.ParticipantsAdults aged 40–75 years (n477; 234 males) enrolled through voluntary routine health checks and health camps.ResultsMean age of the study population was 54·6 (sd9·5) years. Half the participants were aware of osteoporosis and could correctly define it. Women showed significantly higher median OKT-total and OKT-nutrition scores than men (P&lt;0·05). Those with higher education and higher socio-economic status had significantly higher scores in both men and women (P&lt;0·05). All four scores were significantly higher in both men and women who could correctly define osteoporosis (P&lt;0·05). All four scores were significantly higher in women with a family history of osteoporosis (P&lt;0·05) but not in men (P&gt;0·1).ConclusionsUnderstanding about osteoporosis and its risk factors is low in the present cohort of Indian men and women. There is need to create awareness programmes aimed at both men and women especially targeting those with lower education, lower socio-economic status and no previous exposure to osteoporosis.

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 MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

2017 ◽  
Vol 10 (6) ◽  
pp. 78
Author(s):  
Bhuvaneshwari Gunasekar
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Multiple Antibiotic Resistance ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Mar Index ◽  
Surgery Department

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of  surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

scholarly journals Risk factors for and clinical outcomes of carbapenem non-susceptible gram negative bacilli bacteremia in patients with acute myelogenous leukemia

2020 ◽  
Author(s):  
Dong Hoon Shin ◽  
Dong-Yeop Shin ◽  
Chang Kyung Kang ◽  
Suhyeon Park ◽  
Jieun Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Acute Myelogenous Leukemia ◽  
Tertiary Care ◽  
Myelogenous Leukemia ◽  
Care Hospital ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Appropriate Treatment ◽  
Acute Myelogenous

Abstract Background: Carbapenem is frequently used when gram negative bacilli (GNB) bacteremia is detected especially in neutropenic patients. Consequently, appropriate treatment could be delayed in GNB bacteremia cases involving organisms which are not susceptible to carbapenem (carba-NS), resulting in a poor clinical outcomes. Here, we explored risk factors for carba-NS GNB bacteremia and its clinical outcomes in patients with acute myelogenous leukemia (AML) that underwent chemotherapy. Methods: We reviewed all GNB bacteremia cases that occurred during induction or consolidation chemotherapy, over a 15-year period, in a tertiary-care hospital. Results: Among 489 GNB bacteremia cases from 324 patients, 45 (9.2%) were carba-NS and 444 (90.8%) were carbapenem susceptible GNB. Independent risk factors for carba-NS GNB bacteremia were: carbapenem use at bacteremia onset (adjusted odds ratio [aOR]: 91.2; 95% confidence interval [95%CI]: 29.3-284.1; P<0.001); isolation of carbapenem-resistant Acinetobacter baumannii (aOR: 19.4, 95%CI: 3.4-112.5; P=0.001) in the prior year; and days from chemotherapy to GNB bacteremia (aOR: 1.1 per day, 95%CI: 1.1-1.2; P<0.001). Carba-NS bacteremia was independently associated with in-hospital mortality (aOR: 6.6, 95%CI: 3.0-14.8; P<0.001). Conslusion: Carba-NS organisms should be considered for antibiotic selection in AML patients having these risk factors.

scholarly journals Bacteriological profile of surgical site infections in a tertiary care hospital of western Nepal

2021 ◽  
Vol 14 (1) ◽  
pp. 33-38
Author(s):  
Dharm Raj Bhatta ◽  
Abhijit Adhikari ◽  
Jampa Lhamo Gurung ◽  
Niroj Man Amatya ◽  
Niranjan Nayak ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Gram Positive ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Resistance Patterns ◽  
Microbiological Techniques

Introduction: Surgical site infections are one of the most commonly reported nosocomial infections resulting into significant morbidity and mortality. Hospital admission and surgical procedures increase the risk of infection with multidrug resistant pathogens. This study was aimed to determine the bacterial agents associated with surgical site infections and antibiotic resistance patterns of the isolates. Methods: A total of 161 specimens from patients with surgical site infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Results: Out of 161 samples, 94 bacterial isolates were recovered. Gram positive bacteria were isolated in 57.4% (54/94) cases and Staphylococcus aureus was the most common organism (49/54) with 65.3% (32/49) methicillin resistant Staphylococcus aureus isolates. All S. aureus isolates were susceptible to vancomycin. Gram negative bacteria constituted 42.6% (40/94) of total isolates and Escherichia coli was the commonest organism (13/40). Majority of Gram negative isolates were susceptible to amikacin, imipenem and piperacillin-tazobactam. Resistance to imipenem was detected among isolates of E coli, Pseudomonas and Acinetobacter species. Conclusion: Gram positive isolates were more commonly associated with surgical site infections. High percentage of MRSA was detected among the S. aureus isolates but no vancomycin resistant S. aureus. High percentage of Gram negative isolates was susceptible to imipenem, piperacillin-tazobactam, amikacin and gentimicin.

scholarly journals Assessment of knowledge regarding diet among hospitalized patients undergoing treatment for chronic ailments in a tertiary care hospital from Hyderabad

2021 ◽  
Vol 8 (4) ◽  
pp. 1694
Author(s):  
Varun Vijay Gaiki ◽  
Venkartamana K. Sonkar ◽  
Ramesh Butta
Keyword(s):  
Chronic Diseases ◽  
Cross Sections ◽  
Chronic Conditions ◽  
Tertiary Care Hospital ◽  
Economic Status ◽  
Tertiary Care ◽  
Hospitalized Patients ◽  
Care Hospital ◽  
Nutritional Counselling ◽  
Socio Economic Status

Background: Nutrition plays important tole in the health, and specially in chronic diseases.  It plays important role in all levels if prevention. Thus awareness of patients, suffering from chronic diseases is important in view of secondary and tertiary levels of prevention.Methods: The present cross sections study was carried out with 20 question predesigned and tested questionnaire, in patients admitted to hospital for chronic diases with stay more than 15 days. Scores were calculated from the questionnaire administered and results compared.Results: it was observed that awareness of patients about diet in chronic conditions was not adequate. Average scores on the 40-point questionnaire scale was 13.34, with SD±2.23. It was observed that awareness increased as education, socio economic status increases.Conclusions: It is recommended to have special nutritional counselling sessions for patients. 

scholarly journals Antimicrobial Susceptibility Patterns of Pseudomonas Species Isolated from Various Clinical Samples at a Tertiary Care Hospital

2020 ◽  
Vol 25 (2) ◽  
pp. 49-54
Author(s):  
Rabin Gyawali ◽  
Ram Bahadur Khadka ◽  
Basudha Shrestha ◽  
Sarita Manandhar
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Pseudomonas Spp ◽  
Global Issue ◽  
Pseudomonas Species ◽  
Susceptibility Patterns

Considerable increase in the prevalence and multidrug-resistant (MDR) Pseudomonas has been observed with towering morbidity and mortality. As a consequence of the haphazard use of antimicrobials, the spread of antimicrobial resistance is now a global issue. This study aimed to access the distribution rate and antibiotic susceptibility patterns of Pseudomonas species isolated from various clinical specimens in Kathmandu Model Hospital, Nepal. During the study period, 1252 samples were collected, cultured and the organism was isolated and identified. The antimicrobial susceptibility testing was done using the modified Kirby-Bauer disc diffusion method as per CLSI guidelines. Out of 1252 samples, 28 clinical isolates of Pseudomonas species were isolated. The highest number of Pseudomonas spp. was isolated from swab samples that included pus, ear, and wound (46.4 %). Pseudomonas spp. demonstrated marked resistance against cefixime (96.4 %) and showed higher sensitivity to piperacillin/tazobactam (92.9 %). The result showed pus, wound exudates, ear discharges samples exhibit Pseudomonas as common etiology of infection. Pseudomonas spp. demonstrated highest sensitivity against piperacillin/tazobactam, amikacin, meropenem, gentamycin. The steady resistance of Pseudomonas spp. to most of the antibiotics, necessitates these drugs to be confined to extreme infections and hospital intensive care units to circumvent the speedy emergence of resistant strains.

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