scholarly journals Prevalence of infected chronic wound isolates and their Minimum inhibitory concentrations against third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda

2021 ◽  
Author(s):  
Wangoye Khalim ◽  
Mwesigye James ◽  
Tungotyo Martin ◽  
Twinomujuni Silvano Samba
Keyword(s):  
Staphylococcus Aureus ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Referral Hospital ◽  
Third Generation ◽  
Regional Referral Hospital ◽  
Surgical Ward ◽  
Broth Microdilution Method ◽  
Third Generation Cephalosporins ◽  
Klebsiella Spp

Abstract Background: Globally, the burden of infected chronic wounds is likely to increase due to the rising levels of bacterial resistance to antibiotics and non-communicable diseases such as Diabetes mellitus and cancer. Furthermore, the burden of antibiotic resistant strains in infected chronic wounds is likely to increase especially in resource constrained areas like Mbarara regional referral Hospital where the selection of antibiotic therapy does not usually depend on known antibiotic susceptibilities. Therefore the objectives of this study were; (I) to determine the prevalence of infected chronic wounds isolates from patients admitted in the surgical ward of MRRH, Uganda and (II) to determine the MIC of infected chronic wound isolates against the third generation cephalosporins.Method(s): This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Wound swabs were aseptically collected, registered in the laboratory register and depending on the nature of samples; each specimen was inoculated on chocolate, blood, mannitol salt sugar, xylose lysine decarboxylated agar, and MacConkey Agar and incubated at 350C-370C in the incubator. Broth microdilution method was used to test for MIC.The collected data was entered into Microsoft Excel and exported to STATA version 15.0 for statistical analysis. Chi square/Fishers’s Exact test and analysis of variance (ANOVA) tests were used to analyse data for objective 1 and 2 respectively.Results: The most prevalent pathogens isolated were staphylococcus aureus (40.6%,) and Klebsiella spp (29%,) while the least prevalent pathogens were Providencia spp(1.4%, n=1/69) and Enterobacter agglomerans(2.9%, n=2/29). Generally, staphylococcus aureus exhibited the lowest MIC against cefoperazone+sulbactum 2g (Sulcef®) and ceftriaxone 1g (Epicephin®) (4.33±8.41µ/ml and 15.77±23.32µ/ml respectively). However, the differences in mean MIC observed across various groups were not statistically significant (P >0.05).Conclusion: The most prevalent pathogens isolated from patients with infected chronic wounds at the surgical ward of MRRH were Staphylococcus aureus, Klebsiella spp and proteus spp and the most effective third generation cephalosporins were cefoprazone+sulbactam 2g and ceftriaxone 1g (Epicephin®) while the most ineffective antibiotics were cefpodoxime 200mg and cefixime 400mg.

scholarly journals Resistance pattern of infected chronic wound isolates and factors associated with bacterial resistance to third generation cephalosporins at Mbarara Regional Referral Hospital, Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261264
Author(s):  
Wangoye Khalim ◽  
James Mwesigye ◽  
Martin Tungotyo ◽  
Silvano Samba Twinomujuni
Keyword(s):  
Logistic Regression ◽  
Bacterial Resistance ◽  
Chronic Wounds ◽  
Third Generation ◽  
Bacterial Isolates ◽  
Factors Associated ◽  
The Third ◽  
Surgical Ward ◽  
Complete Resistance ◽  
Third Generation Cephalosporins

Background The objectives of this study were; (I) to determine the proportion of pathogens isolated from patients with infected chronic wounds in the surgical ward of MRRH that are resistant to the third-generation cephalosporins and (II) to determine the factors associated with resistance to third-generation cephalosporins in the surgical ward of MRRH. Method(s) This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Bacterial culture and identification was performed using standard microbiology laboratory procedures whereas broth microdilution method was used to establish the susceptibility of the identified pathogens. Data for objective one (1) was summarized as proportions while the categorized variables were analyzed using logistic regression to determine whether they were associated with the resistance patterns. The level of significance was preset at 5% and p-values less than 0.05 were considered statistically significant. Results Generally, all isolates had complete susceptibility (100%) to Cefoperazone+Sulbactam 2g except 7.1% of proteus spp that were resistant. Of all the bacterial isolates studied, Staphylococcus aureus, Enterobacter agglomerans, providencia spp and pseudomonas earuginosa had complete resistance (100%) to Cefopodoxime 200mg while providencia spp and pseudomomas earuginosa had complete resistance (100%) to Cefixime 400mg and cefotaxime 1g. Finally, higher odds of bacterial resistance to more 2 brands of the third generation cephalosporins were observed among participants who had prior exposure to the third generation cephalosporins (OR, 2.22, 95% CI, 0.80–6.14), comorbidities (OR, 1.76, 95% CI, 0.62–4.96) and those who had more than two hospitalizations in a year (OR, 1.39, 95% CI 0.46–4.25). However, multivariate logistic regression was not performed since no factor was significantly associated with resistance to more than two brands of third generation cephalosporins (p >0.05). Conclusion This study found that cefixime and cefpodoixme had high rates of resistance and should not be used in routine management of infected chronic wounds. In addition, the factors investigated in this study were not significantly associated with bacterial resistance to more than two brands of third generation cephalosporins.

Experience of using atraumatic ointment bandages based on peruvian balsam in the complex treatment of patients with chronic wound defects of the lower limbs

2020 ◽  
pp. 43-57
Author(s):  
Anna Tabuika
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Local Treatment ◽  
Lower Limbs ◽  
Complex Treatment ◽  
Average Area ◽  
Arterial Insufficiency ◽  
Significant Activation

The article reflects the results of a retrospective non-comparative study, the objects of which were 34 outpatient comorbid patients (15 of which are over 60 years old) with chronic wounds of the lower limbs developed against the background of varicosity, post-thrombotic disease, chronic arterial insufficiency of the lower limbs, diabetes mellitus or their combination. Their local treatment was carried out using atraumatic ointment dressing «Branolind N» containing Peruvian balsam. There were 23 women (67.6 %) and 11 men (32.4 %). In microbiological study prior to the beginning of treatment in 31 patients the growth of a pathogen of wound infection was revealed; in 19 patients — Staphylococcus aureus in monoculture and in various associations, in 6 patients — Pseudomonas aeruginosa in monoculture, in other cases — other pathogens. In 3 patients the pathogen was not detected. The average wound size was 34 cm2 . The phase of the wound process was additionally confirmed by cytological studies. After treatment the average area of the wound defect decreased by 10 cm2 and made 24 cm2 on average. Full healing of the wound defect occurred in 11 patients, the others had granulation and active marginal epithelization. There was also a decrease in bacterial semination of wounds, a change in composition of infection agents to less aggressive monoflora, and cytologically — a decrease in signs of inflammation against the background of significant activation of reparative processes.

scholarly journals Methicillin and Vancomycin Resistant Staphylococcus aureus and Associated Factors from Surgical Ward Inpatients at Debre Markos Referral Hospital, Northwest Ethiopia

2020 ◽  
Author(s):  
Samrawit Tefera Demsie ◽  
Tewachew Awoke ◽  
Daniel Mekonnen
Keyword(s):  
Staphylococcus Aureus ◽  
Associated Factors ◽  
Northwest Ethiopia ◽  
Referral Hospital ◽  
Mannitol Salt Agar ◽  
Surgical Ward ◽  
Hospital Infection Control ◽  
Multiple Variables ◽  
Vancomycin Resistant ◽  
Debre Markos

Abstract Background: Staphylococcus aureus is one of the leading wound infections. It is considered as a super bug. The epidemiology of Methicillin Resistant S. aureus (MRSA) and Vancomycin Resistant S. aureus (VRSA) is not well studied in Ethiopia particularly in Debre Markos Referral Hospital (DMRH). The objective of the study was to determine the prevalence of MRSA and VRSA and associated factors from wound cases admitted to surgical ward in DMRH, Northwest Ethiopia.Methods: A cross-sectional study was conducted from February-April 2020 at DMRH. A structured questionnaire was used to collect demographic and clinical characteristics. Wound swabs were collected using sterile cotton swab followed by culturing on Blood agar and Mannitol Salt agar. Then isolates were characterized by gram stain and biochemical tests. The presence of MRSA and VRSA was determined using the cefoxitin (30μg) antibiotic disc diffusion and vancomycin E-test, respectively. The data was analyzed using Statistical Package for Social Sciences, version 20 software. P-value <0.05 was considered statistically significant.Results: A total of 242 wound cases were enrolled and a majority of them were males (172, 71.1%). Among the total wound cases, the isolation rate of S. aureus was 29.3%. The proportion of MRSA was 13.22% and that of VRSA was 4.1%. The proportion of vancomycin intermediate S. aureus (VISA) was gauged at 4.5%. Hospital stay >72h (p=0.014), wound depth (p=0.043), antibiotic use (p=0.017) and previous history of wound infection (p=0.001) showed statistical significant association with MRSA. No variables showed significant association with VRSA.Conclusion: High proportions of S. aureus isolates are resistant to methicillin and vancomycin. Moreover, multiple variables demonstrated associations with drug resistance. Hence, hospital infection control and antibiotic stewardship program shall be strengthened.

Carriage of Staphylococcus aureus and of Gram-Negative Bacilli Resistant to Third-Generation Cephalosporins in Cirrhotic Patients A Prospective Assessment of Hospital-Acquired Infections

2001 ◽  
Vol 22 (7) ◽  
pp. 427-432 ◽  
Author(s):  
Catherine Dupeyron ◽  
Bernard Campillo ◽  
Nicole Mangeney ◽  
Muriel Bordes ◽  
Jean-Philippe Richardet ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Third Generation ◽  
Gram Negative ◽  
Bacterial Peritonitis ◽  
Prospective Assessment ◽  
Cirrhotic Patients ◽  
Tract Infections ◽  
Third Generation Cephalosporins

AbstractObjective:To study the relation between Staphylococcus aureus nasal and stool colonization, stool carriage of gram-negative bacilli resistant to third-generation cephalosporins (CephR), and subsequent infections during hospitalization.Design:Prospective study.Patients:551 cirrhotic patients with 589 consecutive hospital stays. All patients were screened within 48 hours of admission; 589 nasal swabs, 417 stool specimens, and 589 urine samples were analyzed.Results:Carriage rates were 18.8% for methicillin-sensitive S aureus (MSSA), 16.3% for methicillin-resistant S aureus (MRSA), and 13.7% for CephR. We observed 87 episodes of spontaneous bacterial peritonitis, 63 cases of bacteremia, and 167 urinary tract infections occurred. Only 1 case of bacteremia and 4 urinary tract infections due to CephR occurred in patients carrying the same organism in their stools. The risk of MRSA ascitic fluid infections, bacteremia, and urinary tract infections was 3.1% versus 1% (not significant), 8.3% versus 0.8% (P<.001), and 11.4% versus 0.6% (P<.001) in carriers and noncarriers, respectively. Pulsed-field gel electrophoresis (PFGE) of isolates from 16 patients infected by MSSA (3 cases) and MRSA (13 cases) demonstrated that the colonizing strains matched the invasive strains in the 3 MSSA cases and in 8 of 13 MRSA cases.Conclusion:Carriage of CephR strains is not associated with subsequent infection by these organisms in hospitalized cirrhotic patients. In contrast, MRSA carriage was an important risk factor for MRSA bacteremia and urinary tract infection.

Antimicrobial Use Prior to the Acquisition of Multiresistant Bacteria

2002 ◽  
Vol 23 (3) ◽  
pp. 155-158 ◽  
Author(s):  
Matthieu Eveillard ◽  
Jean-Luc Schmit ◽  
François Eb
Keyword(s):  
Staphylococcus Aureus ◽  
Prospective Study ◽  
Clavulanic Acid ◽  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Antimicrobial Use ◽  
Third Generation ◽  
Multiresistant Bacteria ◽  
Amoxicillin Clavulanic Acid ◽  
Third Generation Cephalosporins

AbstractWe assessed whether patients who acquired methicillin-resistantStaphylococcus aureus(MRSA) had less exposure to antimicrobial agents than did those who acquired Enterobacteriaceae that produced extended-spectrum β-lactamase (ESβL). In a 6-month, prospective study, ESβL carriers had received antimicrobial therapy more often than had MRSA carriers. Amoxicillin-clavulanic acid, fluoroquinolones, and third-generation cephalosporins, especially ceftazidime, had been prescribed more often for ESβL carriers than for MRSA carriers.

scholarly journals Evaluation of the relationship between the minimum inhibitory concentration of ceftiofur and third-generation cephalosporins in Escherichia coli isolates from food-producing animals

2017 ◽  
Vol 29 (5) ◽  
pp. 716-720 ◽  
Author(s):  
Mototaka Hiki ◽  
Yasuhito Shimizu ◽  
Michiko Kawanishi ◽  
Manao Ozawa ◽  
Hitoshi Abo ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Inhibitory Concentration ◽  
Correlation Coefficients ◽  
Third Generation ◽  
Susceptibility Data ◽  
Microdilution Method ◽  
C Statistic ◽  
Broth Microdilution Method ◽  
The Relationship ◽  
Third Generation Cephalosporins

To enable future comparison of the antimicrobial susceptibility data between bacteria obtained from animals and humans, it is necessary to compare the relationships between minimum inhibitory concentrations (MICs) of veterinary and human medicine. We evaluated the relationship between the MIC of ceftiofur (CTF) and the MICs of other third-generation cephalosporins (TGCs): cefotaxime (CTX), cefpodoxime (CPDX), and ceftazidime (CAZ), determined by the broth microdilution method using 118 cefazolin-resistant Escherichia coli isolates from food-producing animals. Using the Clinical and Laboratory Standards Institute criteria, very major classification errors were observed only in CAZ (17.8%, 21 of 118); major and minor errors were observed in all TGCs (CTX: 0.8% [1 of 118] and 9.3% [11 of 118]; CPDX: 9.3% [11 of 118] and 6.8% [8 of 118]; CAZ: 2.5% [3 of 118] and 9.3% [11 of 118], respectively). The Spearman correlation coefficients between the MICs of CTF and CTX, CPDX, and CAZ were 0.765, 0.731, and 0.306, respectively. The sensitivity and specificity values were 100.0% and 81.8% for CTX, 99.0% and 27.3% for CPDX, and 76.0% and 86.4% for CAZ compared with CTF. The C-statistic was 0.978 for CTF and CTX, 0.953 for CPDX, and 0.798 for CAZ. For the TGCs evaluated in our study, testing for CTX susceptibility results showed the highest correlation with the results given when testing for CTF susceptibility.

scholarly journals Methicillin Resistant Staphylococcus aureus nasal carriage and associated factors in a rural tertiary hospital in Eastern Uganda: A prospective cross-sectional study

2019 ◽  
Author(s):  
Nobert Thembo ◽  
George Masifa ◽  
Gerald Kamugisha ◽  
Robinah Nabitaka ◽  
Benjamin Akais ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Associated Factors ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Phenotypic Expression ◽  
Nasal Carriage ◽  
Referral Hospital ◽  
Carriage Rate ◽  
Regional Referral Hospital ◽  
Methicillin Resistant

Abstract Background: Asymptomatic carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) can predispose the host to a wide array of infections that can be difficult to treat due to antibiotic resistance. To inform public health strategies, the study sought to describe MRSA nasal carriage frequencies and the associated factors concerning nasal carriage among patients attending Mbale Regional Referral Hospital (MRRH). Methods: Nasal swabs were obtained from consented (aged >15years) participants presenting to the hospital for medical care between January and April 2018[L1] . Direct Culture of swabs was performed on blood agar and then incubated at 37℃ for 24 hours. Identification of S. aureus was done using conventional biochemical tests. Phenotypic screening and confirmation of MRSA was done using cefoxitin disc (30µg) test and MICs on the Phoenix M50 instrument respectively. Patient demographic characteristics and the MRSA nasal carriage risk factors were collected using a pre-tested questionnaire. Results: Overall, majority of the participants were in-patients (138, 63.3%) with the proportions of both females and males among the participants being 154/218 (70.6%) and 64/218 (29.3%) respectively. Mean age for both female and male participants was 40.16 (SD± 17.04) years respectively. S. aureus nasal carriage rate among the participants was 22.9% (50/218), with 57.9% (29/50) of the harboured strains phenotypically expressing methicillin resistance (mecA mediated). Phenotypic co-expression with inducible clindamycin resistance and vancomycin resistance was displayed in 45.5% (23/50) and 2% (1/50) of the studied isolates respectively. Colonisation with MRSA did not show any significant relationship with all the studied factors. Conclusion: There was a moderate S. aureus nasal carriage among the participants in Mbale Regional Referral Hospital with a highly noted phenotypic expression of methicillin resistance among the isolated S. aureus strains. The studied factors were not significantly associated with the rate of MRSA nasal carriage. For surveillance purposes to combat future outbreaks, there is a need to do a larger study to better draw generalizable conclusions of carriage in the population. [L1]This is an important statement. I suggest that we reinstatate it if we are still in recommended word count

Sign in / Sign up

Export Citation Format

Share Document