scholarly journals A 5- Year Surveillance of Nosocomial Infections in a University Hospital: A Retrospective Analysis

2021 ◽  
Author(s):  
Ilknur Erdem ◽  
Ilker Yildirim ◽  
Birol Safak ◽  
Ritvan Karaali ◽  
Berna Erdal ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Nosocomial Infections ◽  
Antimicrobial Agents ◽  
Public Health Problem ◽  
University Hospital ◽  
Esherichia Coli ◽  
Study Results

Abstract OBJECTIVE: ‘Nosocomial infections’ or ‘healthcare associated infections’ are a significant public health problem around the world. This study aimed to assess the rate of culture confirmed nosocomial infections (NIs), frequency of nosocomial pathogens and the antimicrobial resistance patterns of bacterial isolates in a University Hospital. METHODS: A retrospective evaluation of NIs in a tertiary hospital, between the years 2015 and 2019 in Tekirdag, Turkey. RESULTS : During the five years, the overall incidence rates (NI/100) and incidence densities (NI/1000 days of stay) of NIs were 2.04% (range 1.76-2.41/100) and 3.50/1000 patients-days (range 2.85-4.64/1000), respectively. 57.4 % of the infections were originated from the Intensive Care Units. The most common NIs according to the primary sites were bloodstream infections (55.3 %) and, pneumonia (20.4%). 67.5% of the isolated microorganisms as nosocomial agents were Gram negative bacteria, 24.9% of Gram positive bacteria and 7.6 % of candida. The most frequently isolated causative agents were Esherichia coli (16.7%) and Pseudomonas aeruginosa (15.7%). The rate of extended spectrum beta-lactamase production among E. coli isolates was 51.1%. Carbapenem resistance was 29.8% among isolates of Pseudomonas aeruginosa; 95.1% among isolates of Acinetobacter baumannii, 18.2% among isolates of Klebsiella pneumoniae. Colistin resistance was 2.4% among isolates of Acinetobacter baumannii. Vancomycin resistance was 5.3% among isolates of Enterococci.CONCLUSION: Our study results demonstrates the microorganisms of isolated from Intensive Care Units demonstrates high level resistance to many antimicrobial agents. The rising in incidence of multidrug-resistant microorganisms indicate that more interventions are urgently needed to reduce NIs in our ICUs.

scholarly journals Determination of Colistin and Tigecycline Resistance Profile of Acinetobacter Baumannii Strains from Different Clinical Samples in a Territory Hospital in Turkey

2020 ◽  
Author(s):  
Merih Şimşek ◽  
Cengiz Demir
Keyword(s):  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Antimicrobial Agents ◽  
Empirical Treatment ◽  
Clinical Samples ◽  
Broth Microdilution ◽  
Broth Microdilution Method ◽  
Vitek 2

Objective: Acinetobacter baumannii (A. baumannii) can develop resistance to various antimicrobial agents via different mechanisms. Hence, the aim of this study was to investigate, by using different methods, the resistance profiles of A. baumannii strains isolated from different clinical specimens; from colistin and tigecycline antibiotics, and also the distribution of this resistance according to the clinical samples. Material and Methods: For this study, 1,265 clinical samples (a samples from each patient) were obtained from various clinics, between; January 2015/December 2018. Identification was conducted by VITEK® 2 compact (bioMerieux, USA) and conventional biochemical tests. Antibiotic susceptibility tests were performed by VITEK 2, and the results of colistin and tigecycline were confirmed by E test and the broth microdilution method. Results: A. baumannii strains (1,265) were most frequently isolated from tracheal aspirate, sputum and blood samples. At the same time, strains were obtained from intensive care units (70.4%) as well as other clinics (29.6%). The rates of colistin and tigecycline-resistant strains were determined using VITEK 2, E test and the broth microdilution methods as: 3.0%, 5.7%, 9.0% and 21.7%, 24.5%, 33.0%, respectively. Conclusion: The determination of appropriate antibioticis are important for empirical treatment. Colistin and tigecycline have become prominent as an important, alternative agent in the treatment of A. baumannii-related infections. The results of this study show that colistin and tigecycline resistance rates in intensive care units have been increasing gradually over the years. Monitoring of resistance patterns of nonfermentative bacteria, isolated from intensive care units, is important for the immediate initiation of appropriate empirical treatment. In-vitro studies with A. baumannii strains should also be supported by clinical trials.

scholarly journals Pseudomonas aeruginosa: Evaluation of Antimicrobial Resistance Patterns in Strains Isolated from Blood Culture in a University Hospital

2020 ◽  
Vol 25 (3) ◽  
pp. 308-315
Author(s):  
Ayşe Hümeyra Taşkın Kafa ◽  
Cem Çelik ◽  
Mürşit Hasbek ◽  
Mustafa Zahir Bakıcı
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Antibiotic Susceptibility ◽  
Empirical Treatment ◽  
University Hospital ◽  
High Rate ◽  
Automated System ◽  
Treatment Protocols ◽  
Susceptibility Profiles

Introduction: The aim of this study was to contribute to the establishment of appropriate empirical treatment protocols by determining antibiotic susceptibility profiles of Pseudomonas aeruginosa strains isolated from bacteremia patients in intensive care units and various clinics. Materials and Methods: Antibiotic susceptibility of a total of 111 P. aeruginosa isolates isolated from the blood of inpatients in intensive care units and other services between January 2014 and July 2018 in Cumhuriyet University, Faculty of Medicine were evaluated retrospectively. In the study, the susceptibility profiles of amikacin, piperacillin-tazobactam, ceftazidime, cefepim, gentamicin, ciprofloxacin, levofloxacin, imipenem and meropenem were investigated using the automated system of Phoenix 100 (Becton Dickinson Co., Sparks, MD, USA). The results were evaluated based on the criteria of the Clinical and Laboratory Standards Institute (CLSI) for 2014 and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) from 2015 onwards. Results: One hundred and eleven P. aeruginosa were isolated from blood samples, 77 from intensive care units and 34 from various services of the hospital. P. aeruginosa strains isolated from cultures have a high rate of resistance against antimicrobial agents. The highest resistance was determined for imipenem with 20.7% and the lowest resistance was determined for amikacin with 1.8%. Piperacillintazobactam, ceftazidim, cefepim, ciprofloxacin, levofloxacin, and meropenem resistance rates were 18%, 17.1%, 17.8%, 18.9%, 13.9%, 19.8% respectively. Multidrug-resistant was found to be 10.8%. This ratio was determined as 13% in intensive care units. Conclusion: Considering the current antibiotic susceptibility profiles while determining empirical treatment protocols is rather important to prevent resistance. In addition, putting forward the bacterial resistance status periodically through this type of studies, to determine the strength of existing drugs and to guide therapy, presents valuable data. Within this context, we propose that the data of our study will contribute to the current literature

scholarly journals Characteristics of Carbapenem-Resistant Pseudomonas aeruginosa Strains in Patients with Ventilator-Associated Pneumonia in Intensive Care Units

Medicina ◽  
2012 ◽  
Vol 47 (12) ◽  
pp. 95
Author(s):  
Astra Vitkauskienė ◽  
Erika Skrodenienė ◽  
Asta Dambrauskienė ◽  
Giedrė Bakšytė ◽  
Andrius Macas ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
University Hospital ◽  
Test Results ◽  
Disk Diffusion Test ◽  
Carbapenem Resistant ◽  
Resistant Strains ◽  
High Level ◽  
O 11

The aim of this study was to determine the characteristics of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) strains and 5-year changes in resistance in a tertiary university hospital. Material and Methods. The study included 90 and 101 randomly selected P. aeruginosa strains serotyped in 2003 and 2008, respectively. The standardized disk diffusion test and E-test were used to determine resistance to antibiotics. P. aeruginosa strains were considered to have high-level resistance if a minimum inhibitory concentration (MIC) for imipenem or meropenem was >32 μg/mL. To identify serogroups, sera containing specific antibodies against O group antigens of P. aeruginosa were used. P. aeruginosa isolates resistant to imipenem or/and meropenem were screened for metallo-β-lactamase (MBL) production by using the MBL E-test. Results. Comparison of the changes in resistance of P. aeruginosa strains to carbapenems within the 5-year period revealed that the level of resistance to imipenem increased. In 2003, 53.3% of P. aeruginosa strains were found to be highly resistant to imipenem, while in 2008, this percentage increased to 87.8% (P=0.01). The prevalence of MBL-producing strains increased from 15.8% in 2003 to 61.9% in 2008 (P<0.001). In 2003 and 2008, carbapenem-resistant P. aeruginosa strains were more often resistant to ciprofloxacin and gentamicin than carbapenem-sensitive strains. In 2008, carbapenem- resistant strains additionally were more often resistant to ceftazidime, cefepime, aztreonam, piperacillin, and amikacin than carbapenem-sensitive strains. MBL-producing P. aeruginosa strains belonged more often to the O:11 serogroup than MBL-non-producing strains (51.7% vs. 34.3%, P<0.05). A greater percentage of non-MBL-producing strains had low MICs against ciprofloxacin and amikacin as compared with MBL-producing strains. Conclusions. The results of our study emphasize the need to restrict the spread of O:11 serogroup P. aeruginosa strains and usage of carbapenems to treat infections with P. aeruginosa in the intensive care units of our hospital

scholarly journals Plasmid curing pattern of nosocomial pathogens of intensive care units (ICU) in Zagazig University Hospital

2017 ◽  
Vol 2 (4) ◽  
pp. 703-711
Author(s):  
Soheir El Salam ◽  
Mohammed Farouk Ghaly ◽  
Ahmed Anwar Shahen ◽  
Mahmoud Mostafa Amer ◽  
Sanaa Atef Abdelkader
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Complete Removal ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Klebsiella Pneumonia ◽  
Plasmid Curing

Nosocomial infections and antibiotic resistance are serious and growing phenomenon in contemporary medicine and has emerged as one of the public health concerns. A total of seventy isolates of bacteria were collected from patients. The selected isolates include 33 (56.9%) from males and 25 (43.1%) from females. All bacteria were susceptible to imipenem followed by amikacin, ceftazidime, ciprofloxacin and tobramycin, respectively. The multi-drug resistant (MDR) bacterial isolates (33 isolates) divided into four groups named Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus were selected to be identified according to the keys of different identification protocols. Escherichia coli found to be the most frequent pathogen within MDR isolates followed by Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumonia, respectively. The MICs and MBCs of (Imipenem, Amikacin, Ceftazidime and ciprofloxacin) against the most resistant isolates were determined. Generally, P. aeruginosa (Strain No. 55) was found to be the highest resistant bacteria. Plasmid profile of Pseudomonas aeruginosa was carried out, after incubation at 37oc for 24hr recorded no changes in plasmid and compared with incubation at 43oc (plasmid curing) which showed complete removal of plasmid bands and the tested bacteria became more sensitive to antibiotics. This study therefore determined the prevalence, anti-biotic susceptibility and plasmid patterns of P. aeruginosa strains from clinical specimens obtained from the intensive care units of Zagazig University Hospital in Egypt.Asian J. Med. Biol. Res. December 2016, 2(4): 703-711

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