scholarly journals Clinical Profile of Bloodstream Infections in Covid-19 Patients: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Naveenraj Palanisamy ◽  
Nakka Vihari ◽  
Durga Shankar Meena ◽  
Deepak Kumar ◽  
Naresh Midha ◽  
...  
Keyword(s):  
Virus Disease ◽  
Demographic Data ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Clinical Profile ◽  
Resistance Pattern ◽  
Western India ◽  
Care Hospital ◽  
Timely Initiation ◽  
Gram Negative

Abstract Background: Bloodstream infections (BSIs) are emerging cause of significant morbidity and mortality in severe Corona virus disease (Covid-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill Covid-19 disease. Material and Methods: This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All the patients (age >18 years) with reverse-transcription polymerase chain reaction (RT-PCR) confirmed Covid-19 pneumonia admitted in Covid intensive care unit (ICU) between September 2020 to February 2021 were included. Hospital electronic records were searched for demographic data, time of bloodstream infection since admission, clinical profile, antimicrobial resistance pattern and clinical outcome of all patients who developed BSIs.Results: Out of 750 patients admitted in Covid ICU, 8.5% developed secondary BSIs. All severe Covid-19 pneumonia patients developed BSIs succumbed to illness. The major proportion of BSIs were gram-negative pathogens (53/64, 82.8%). Acinetobacter baumannii was the commonest isolate followed by Klebsiella pneumoniae (32.8% and 21.9% respectively). Multidrug-resistance microorganisms (MDRO) were found in 57.8% of the cases. The majority of MDRO belonged to K. pneumoniae and Enterococcus groups. The proportion of gram-negative bacteria resistant to carbapenems was 47.2% (25/53). Conclusion: BSIs in severe Covid-19 patients carries a substantial mortality, which is a cause for concern. Timely initiation of empirical antibiotics and prompt de-escalation are vital to improve the outcome. At the same time, strict compliance of infection control practices should be accomplished to reduce the occurrence of MDRO.

scholarly journals Clinical profile of bloodstream infections in COVID-19 patients: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Naveenraj Palanisamy ◽  
Nakka Vihari ◽  
Durga Shankar Meena ◽  
Deepak Kumar ◽  
Naresh Midha ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Clinical Profile ◽  
Western India ◽  
Care Hospital ◽  
Timely Initiation ◽  
Gram Negative ◽  
Leukocyte Counts

Abstract Background Bloodstream infections (BSIs) are an emerging cause of significant morbidity and mortality in severe Coronavirus disease 2019 (COVID-19). We aimed to assess the prevalence, clinical profile and outcome of BSIs in critically ill COVID-19 patients. Methods This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All patients (age > 18 years) with reverse-transcription polymerase chain reaction (RT-PCR) confirmed COVID-19 admitted in the intensive care unit (ICU) were included. Hospital electronic records were searched for demographic data, time of bloodstream infection since admission, clinical profile, antimicrobial resistance pattern and clinical outcome of all patients who developed BSIs. Results Out of 750 patients admitted in COVID ICU, 8.5% developed secondary BSIs. All severe COVID-19 patients who developed BSIs succumbed to illness. A significant proportion of BSIs were Gram-negative pathogens (53/64, 82.8%). Acinetobacter baumannii was the commonest isolate, followed by Klebsiella pneumoniae (32.8% and 21.9%, respectively). Multidrug-resistance organisms (MDRO) were found in 57.8% of the cases. The majority of MDRO belonged to K. pneumoniae and Enterococcus groups. The proportion of Gram-negative bacteria resistant to carbapenems was 47.2% (25/53). On multivariate analysis, raised total leukocyte counts, mechanical ventilation and presence of comorbidities were significantly associated with the incidence of BSIs. Conclusion We found a significant prevalence of Acinetobacter baumannii in COVID-19 associated BSIs. The presence of comorbidities raised leukocyte counts and mechanical ventilation should alarm clinicians for possible BSIs. The timely initiation of empirical antibiotics and rapid de-escalation is vital to improve the outcome. At the same time, strict compliance of infection control practices should be accomplished to reduce the occurrence of MDRO.

scholarly journals Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India

2020 ◽  
Vol 12 (01) ◽  
pp. 03-09
Author(s):  
Tsering Yangzom ◽  
Dechen Chomu Tsering ◽  
Sumit Kar ◽  
Jyotsna Kapil
Keyword(s):  
Multidrug Resistance ◽  
Tertiary Care ◽  
Resistance Index ◽  
Bloodstream Infections ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Klebsiella Species ◽  
Acinetobacter Species ◽  
Gram Negative

Abstract Background Bloodstream infections (BSIs) are one of the frequent nosocomial infections among hospitalized patients. To understand the local epidemiology and evolving antimicrobial drug resistance of blood-borne pathogens, we analyzed the distribution and antibiotic sensitivity profile of organisms causing BSI in our hospital-based study. Materials and Methods We reviewed retrospective data of laboratory-confirmed BSIs, from January 2013 to December 2018. Causative organisms and their antibiotic susceptibility profile of primary and secondary BSI reports were determined from BacT/Alert and Vitek systems findings (bioMérieux). A 6-year multidrug resistance indexing was done to document the resistance pattern of the commonly isolated organisms. Results A total of 1,340 (10.2%) BSIs were reported from 13,091 blood cultures. Organisms were frequently isolated from the younger population (≤20 years), especially from ages < 1 year (20.8% of total BSIs). Majority of pathogens were bacterial (97.1%) whereas 2.9% were fungal in origin. Monomicrobial growth was recorded in over 98% of BSIs. Gram-positive and gram-negative bacteria isolated were 518 (39.8%) and 783 (60.2%), respectively. Commonly isolated organisms were coagulase-negative Staphylococci (29.4%), Escherichia coli (19.8%), Klebsiella species (13.5%), Salmonella species (9.4%), and Staphylococcus aureus (7.5%). Multidrug-resistance index was observed highest in Acinetobacter species followed by Pseudomonas aeruginosa and S. aureus. Conclusion Overall, there has been a gradual decline in the reporting of BSI. However, infections by gram-negative bacilli and multidrug-resistant organisms remain persistently high. Ages < 20 years were the vulnerable group, with infants < 1 year contributing to the maximum number of BSI cases caused by both bacteria and fungi. Therefore, additional methods are required to study the origin and causation of these infections, particularly among vulnerable patients.

scholarly journals A study on the bacterial isolates from blood cultures of a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 171-174
Author(s):  
KMS Mohamed Ali ◽  
K Girija
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Tertiary Care Centre ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Blood Samples

Blood stream infections are the most important and common cause of morbidity and mortality in tertiary care hospitals. Since the results are usually not available promptly a knowledge of epidemiologic and antimicrobial susceptibility pattern of blood pathogens is life saving and very useful for early treatment and recovery of patients. The aim of this study is to describe the epidemiological, bacterial profile and antimicrobial resistance pattern of bloodstream infections in a tertiary care centre.A prospective cross-sectional study was done on seven hundred and eight blood samples collected over a period of six months in the Microbiology laboratory. Blood samples collected under aseptic conditions were cultured by aerobic culture method. Identification of bacterial isolates were done using standard bacteriologic and biochemical testing methods and antibiotic sensitivity testing done by Kirby - Bauer disc diffusion method.Bacteria was isolated in 201 (28.3%) samples with highest rates among newborns 84(41.8%). The most frequent isolates were 111 (55.2%) followed by 49 (24.4%). Results showed high susceptibilities of CoNS 111 (100%) to Vancomycin, Linezolid and 51 (98%) to Meropenem. This study highlights the common prevalent bacteriological agents in bacteremia, their antibiotic susceptibility & resistance patterns. and multi drug resistant were the leading causes of septicaemia in our hospital with Vancomycin, Linezolid and Carbapenems the effective antibiotics against these pathogens respectively.

scholarly journals Epidemiology and microbiology of Gram-negative bloodstream infections in a tertiary-care hospital in Beijing, China: a 9 -year retrospective study

2020 ◽  
Author(s):  
Zhixin Liang ◽  
Qiang Zhu ◽  
Minghui Zhu ◽  
Chunyan Li ◽  
Lina Li ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Resistance Rates ◽  
Beijing China

Abstract Background Gram-negative bacterial bloodstream infections (BSIs) are serious diseases associated with high morbidity and mortality. The following study examines the incidence, clinical characteristics and microbiological features, drug resistance situations and mortality associated with gram-negative BSIs at a large Chinese tertiary-care hospital in Beijing, China. Methods A retrospective cohort study of patients with gram-negative BSIs was performed between January 1, 2010, and December 31, 2018, at the Chinese People's Liberation Army General Hospital. The patients’ data were collected and included in the reviewing electronic medical records. Results A total of 6867 episodes of gram-negative BSIs occurred among 3199 patients over 9 years, and there were 3032 significant BSI episodes 77% of these cases were healthcare-associated, while 23% were community-associated. The overall incidence of gram-negative BSIs fluctuated from 2.30 to 2.55 episodes per 1000 admissions over 9 years. Malignancy was the most common comorbidity and indwelling central intravenous catheter was the most common predisposing factor for gram-negative BSI. Escherichia coli were the major pathogen (34.3%), followed by Klebsiella pneumoniae (23.3%) and other bacterial pathogens (9.9%). The resistance rates of Escherichia coli and Klebsiella pneumoniae to penicillins were more than 90%. and the resistance rates of Acinetobacter baumannii to the most antibiotic were more than 70% include the Carbapenem. The resistance of ESBLs-producing Escherichia coli to the most antibiotic was higher than non-ESBLs producing Escherichia coli but to Carbapenems(0.7% VS 5.1%). The rates of Carbapenems resistance of ESBLs-producing Klebsiella pneumoniae and non-ESBLs producing Klebsiella pneumoniae were 32.8% and 8.1%. The rates of Carbapenems resistance of Enterobacter cloacae and Pseudomonas aeruginosa were 1.4% and 27.8% respectively. Between 2010 and 2018, the overall mortality of gram-negative BSIs decreased from 11.41–9.05%(X2 = 6.95, P = 0.434). Moreover, the mortality in the ICU decreased from 27.03–14.93%(X2 = 9.61, P = 0.212), while in the general ward fluctuated from 8.85–8.13% that without obvious decrease change(X2 = 9.29, P = 0.232). Conclusions The mortality of gram-negative BSIs have showed downward trends. carbapenem antibiotics is still consider the best treatment for patients with Gram-negative BSIs except Acinetobacter baumannii.

scholarly journals Neonatal Bacterial Sepsis and Its Susceptibility Pattern in Neonatal Care Unit of Tertiary Care Hospital

2020 ◽  
pp. 106-111
Author(s):  
Abdul Hameed Tunio ◽  
Delijan Mugheri ◽  
Muhammad Khan ◽  
Wasim Sarwar Bhatti ◽  
Abdul Majeed Soomro ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Large Scale ◽  
Tertiary Care ◽  
Research Work ◽  
Antibiotic Sensitivity ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: The drug resistance and pathogens are different in various Hospitals of any country. Very high resistance pattern is observed nowadays to the frequently used antibiotics. The important observation has been noted that most of the doctors do not obtain blood cultures before start of the antibiotics, which becomes competent source of resistance. For the same purpose, this study has been done to find out the responsible microbes causing ailment and their susceptibility towards antibiotics to plan early and effective management. Materials and Methods: A number of 100 new borns admitted in the NICU CMC Children Hospital Larkana with signs and symptoms of sepsis were included in this research work. The study will help in provision of a comprehensive record on microorganisms causing sepsis in the neonates and their antibiotic sensitivity. The epidemiology and presence of neonatal sepsis in particular area makes it more easy and convenient to implement the rationale of empirical antibiotic strategy. Results: From100 neonatal blood samples taken for culture, only 21 proved to be positive which stands 21%. In majority gram positive bacteria were found in (85.71%=18 cases) and gram negative bacteria stood (14.28%=3 cases).Staphylococcus species were found on the large scale (52.38%=11 cases) secondly Streptococcus species (33.33%=7 cases) and the remaining were Escherichia species being least common (14.28%=3 cases). Conclusion: Staphylococcus species provided major share as gram positive bacteria and Escherichia species were found to be major gram negative bacterial population responsible for neonatal sepsis. Profound resistance pattern is seen against widely used antibiotics. It is mandatory to have a routine check over the antibiotic resistance.

scholarly journals Clinical profile and renal complications among cases of malaria in children attending a tertiary care hospital of South India

2019 ◽  
Vol 6 (4) ◽  
pp. 1445
Author(s):  
Tenali Ravi Kumar ◽  
Sai Lakshmi Ananya Tenali
Keyword(s):  
Renal Failure ◽  
Vivax Malaria ◽  
Statistical Significance ◽  
Demographic Data ◽  
Renal Involvement ◽  
Tertiary Care ◽  
Clinical History ◽  
Clinical Profile ◽  
Care Hospital ◽  
Early Recovery

Background: Malaria is one of the major vectors borne disease globally responsible for 1 million deaths a year. Changing trends in the causative species and epidemiological distribution have identified icterus and renal involvement as an emerging complication associated with severe mortality in children. The objectives of this study were aimed to study the clinical profile of malaria cases admitted in a pediatric ward. The study also highlights the involvement of renal manifestations in the cases with regard to species distribution and associated complications in the study group.Methods: A prospective study for 14 months was conducted, and all positive cases of malaria admitted in paediatric unit were enrolled and socio demographic data, clinical history were collected, and biochemical investigations were performed and analyzed. SPSS software version 12 was used for analysis. Statistical significance was set at p ≤0.05.Results: About 278 subjects with 55.4% males, 44.6% females and with 5-10 years was most common age group. 102 cases of vivax malaria, 152 cases were falciparum and 24 were mixed cases. Cerebral malaria, hyperparasitemia was identified in 28 cases, DIC in 5.04% of cases. Renal involvement was observed in 38.16% of falciparum infections and 27.45% of vivax infections. 68 cases developed acute renal failure as a severe complication.Conclusions:  Renal involvement is more in falciparum and mixed infections than vivax malaria. Early diagnosis and prompt treatment help in early recovery of cases and halts to progression to renal failure. An urgent need for a biomarker for early identification of renal involvement in malaria before biochemical involvement is detected.

Fluoroquinolones Resistance Among Bacterial Uropathogens In A Tertiary Care Hospital Of Western Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1137-1141
Author(s):  
Dharm Raj Bhatta ◽  
Rajani Shrestha ◽  
Deependra Hamal ◽  
Supram HS ◽  
Niranjan Nayak
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Empirical Treatment ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Klebsiella Species ◽  
Cross Sectional ◽  
Gram Negative ◽  
Microbiological Techniques ◽  
Tract Infections

Introduction: Urinary tract infections are one of the most common clinical illnesses in developing countries. Most of the infections are treated empirically due to unavailability of laboratory facilities. Fluoroquinolones are frequently used for empirical treatment of UTIs. Objectives: This study was aimed to determine prevalence and antibiotic resistance pattern of bacterial uropathogens, especially to fluoroquinolones. Methodology: This hospital based cross sectional study was carried out at Manipal Teaching Hospital, Pokhara, Nepal. A total of 2450 mid stream urine samples were included in this study.  Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Results: Significant bacteriuria was detected in 258 (10.5%), insignificant bacteruria in 614 (25%), growth of multiple organisms in 238 (9.7%) while no growth was recorded in 1340 (54.7%) samples. E coli was the commonest isolate followed by Klebsiella species. Fluoroquinolones resistance among Gram negative isolates was high. Most of the Gram negative isolates were susceptible to amikacin, gentamicin, nitrofurantoin and imipenem. Conclusion: High resistance to fluoroquinolones, cotrimoxazole and cephalosporins dictates these to be unsuitable for empirical treatment of UTIs. Amikacin, gentamicin, nitrofurantoin and imipenem were the most effective antibacterials.

scholarly journals Aerobic Bacteriological and Antibiotic Susceptibility Profile of Pus Isolates from A Tertiary Care Hospital, Puducherry

2020 ◽  
Vol 14 (3) ◽  
pp. 1961-1966
Author(s):  
A. Deboral ◽  
Namrata K. Bhosale ◽  
S. Umadevi
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Antibiotic Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Negative

The antibiotic resistance pattern was observed significantly in various geographical locations. Routine surveillance is therefore essential for constant monitoring of AMR rates in the clinically important pathogens. It is imperative to track the changing resistance pattern over time, to guide proper therapeutic strategies to combat infections due to drug-resistant pathogens. This study aims to highlights the distribution of aerobic bacterial isolated from pus samples, and their susceptibility to different antibiotics collected during 2017 (July to December) in a tertiary care hospital. Nearly 637 clinical pus samples were received during July to December 2017 to the Department of Microbiology, Tertiary care hospital, Puducherry. Bacterial identification was performed using standard conventional biochemical tests and antibiotic susceptibility was carried out according to CLSI guidelines 2017 on each one of the aerobic bacterial isolates from the pus samples. Among the isolates 76.5% were Gram-negative bacilli (GNB) as well as 23.5% were Gram-positive cocci (GPC). The most common bacteria isolated were Pseudomonas spp 24.88% (108 in 434), followed by Escherichia coli 21.66% (94 in 434), Staphylococcus aureus 19.82% (86 in 434) and Klebsiella pneumoniae 13.13% (57 in 434). Of the 86 (19.82%) Staphylococcus aureus isolates, 16 (18.40%) were MRSA. Pseudomonas aeruginosa was highly susceptible to the carbapenems and least susceptible to ciprofloxacin. Acinetobacter baumannii was the most resistant organism according to this study and showed the least susceptibility to ceftriaxone and maximum susceptibility to aminoglycosides. This study concluded that the Pseudomonas aeruginosa isolate was found to be a predominant in our clinical pus samples. Gram negative bacteria are more commonly associated with the pyogenic lesion that Gram positive. A high level of an antibiotic resistance was observed in most of our bacterial isolates.

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