scholarly journals Impact of Culture Sensitivity Reports on the Pattern of Antibiotics use and Cost of Therapy: A Prospective Observational study

2020 ◽  
Author(s):  
Ummara Altaf ◽  
Muhammad Furqan Akhtar ◽  
Bashir Ahmad ◽  
Hassan Mehmood Yasir ◽  
Brian Godman ◽  
...  
Keyword(s):  
Observational Study ◽  
Broad Spectrum ◽  
Prospective Observational Study ◽  
Inappropriate Prescribing ◽  
Empirical Therapy ◽  
Definitive Treatment ◽  
Diffusion Method ◽  
Gram Positive ◽  
Gram Negative ◽  
Culture Sensitivity

Abstract Background: There are concerns with inappropriate prescribing of antibiotics in hospitals especially broad spectrum in Pakistan and the subsequent impact on antimicrobial resistance rates. One recognized way to reduce inappropriate prescribing is for empirical therapy to be adjusted according to the result of culture sensitivity reports.Objective: To find the impact of culture sensitivity reports on the use of antibiotics and cost in a leading tertiary care hospital in Lahore.Methods: This prospective observational study was carried out in Ghurki trust teaching hospital. A total of 465 positive culture patients were taken over an 8 month study period using convenient sampling techniques and immediately sent to the microbiology laboratory for pathogen identification and susceptibility testing using the Kirby-Bauer disc diffusion method. Additional data was collected from the patient medical file which included demographic data, sample type, causative microbe, anti-microbial treatment given in empirical and definitive treatment as well as medicine costs. Results: Total of 497 isolates were detected from the 465 patient samples, which included 309 gram-negative rods and 188 gram-positive cocci. Out of 497 isolates, the most common Gram-positive pathogen isolated was MSSA (28.4%) and Gram-negative was E. coli (23.8%). Most of the gram-negative isolates were found to be resistant to ampicillin and co-amoxiclav. Most of the A. baumannii isolates were resistant to carbapenems. Gram-positive microorganism showed the maximum sensitivity to linezolid and vancomycin. The most widely used antibiotics in empirical therapy were cefoperazone+sulbactam, ceftriaxone, amikacin, vancomycin and metronidazole whereas high use of linezolid, clindamycin, meropenem and piperacillin + tazobactam was evidenced in definitive treatment. Empiric therapy was adjusted in 222 (71.8%) cases of Gram-negative infections and 131 (69.6%) cases of gram-positive infections (p-value <0.0001). Compared with empirical therapy, there was a 13.8% reduction in the number of antibiotics in definitive treatment. The average costs of antibiotics in definitive treatment was less than the empirical treatment (8.2%) and the length of hospitalization also decreased.Conclusion: Culture sensitivity reports helped reduce antibiotic utilization, hospital stay and costs as well as helping select the most appropriate treatment. We also found an urgent need for implementing antimicrobial stewardship programs and the development of hospital antibiotic guidelines within the hospital to reduce future unnecessary prescribing of broad-spectrum antibiotics.

scholarly journals Bacteraemia and antibiotic susceptibility pattern of isolates from patients visiting a private hospital of Kathmandu

2018 ◽  
Vol 5 ◽  
pp. 39-44
Author(s):  
Nandalal Jaishi ◽  
Pramila Pathak ◽  
Pradeep Kumar Shah ◽  
Puspa Raj Dahal
Keyword(s):  
Antibiotic Susceptibility ◽  
Blood Stream Infection ◽  
Empirical Therapy ◽  
Blood Stream ◽  
Salmonella Typhi ◽  
Diffusion Method ◽  
Microbiological Analysis ◽  
Gram Positive ◽  
Gram Negative ◽  
Causative Agents

Background: Bacteraemia can develop a broad array of complications that may be difficult to recognize initially and can increase morbidity. The study was thus conducted to identify the causative agents of bacteraemia and to assess antibiogram of the isolates among the patients suspected of blood stream infection visiting Everest hospital, New Baneshwor Kathmandu. Methods: Altogether 400 blood cultures were processed during March, 2015 to August, 2015. Standard Operating Procedures (SOPs) was followed during the processing of the specimens. Antibiotic susceptibility testing of bacterial isolates was done by Kirby Bauer disc diffusion method with Muller-Hinton agar using the guidelines and interpretive criteria of the Clinical and Laboratory Standards Institute (CLSI 2013). Result: The positivity of blood culture was found to be 48 (12%). Gram negative bacterial were found to be more predominant 27(56.2%) than gram positive bacteria 21(43.7%) in causing bacteraemia. The most prevalent isolate was Staphylococcus aureus 15 (31.2%) followed by Salmonella Paratyphi A 10 (20.8%) and Salmonella Typhi 8 (16.6%), E. coli & CoNS 4 (8.3%), Pseudomonas aeruginosa 3 (6.2%) and Klebsiella pneumoniae & Streptococcus pneumoniae 2 (4.1%) respectively. All gram-positive isolates were found to be sensitive to Cefoxitin, Ceftriaxone and Vancomycin followed by Ampicillin (90.42%), Erythromycin (85.71%), Ciprofloxacin (83.33%), Doxycycline (75%) and Cephalexin (70.58%) whereas gram negative isolates were sensitive to Ceftriaxone followed by Chloramphenicol (92%), Gentamicin (88.8%), Cefixime (85.71%), Ofloxacin (83.3%) and Amoxycillin and Ciprofloxacin (71.3%) Conclusion: The isolation of etiological agents of blood stream infection should be assessed by proper microbiological analysis and it would be helpful for controlling of the outbreaks of resistance strains through effective empirical therapy.

scholarly journals STUDY TO ANALYZE THE DRUG SENSITIVITY PROFILE OF THE PATIENTS SUFFERING FROM SORE THROAT: AN OBSERVATIONAL STUDY.

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Abhiniti . ◽  
Pawan Kumar Lal
Keyword(s):  
Observational Study ◽  
Sore Throat ◽  
Drug Sensitivity ◽  
Throat Swab ◽  
Gram Positive ◽  
Benzyl Penicillin ◽  
Gram Negative ◽  
Culture Sensitivity ◽  
Gram Negative Organisms ◽  
Sensitivity Profile

Aim: to analyze the drug sensitivity profile of the patients suffering from sore throat. Materials and Methods: The present prospective observational study was conducted in the Department of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. Among 200 patients of either gender and of any age group attended the OPD of the ENT presented with the complaint of sore throat, throat pain, throat irritation, throat itching and foreign body sensation were recruited. A thorough ENT examination is done including ear examination, throat examination, and nasal examination. Throat swab samples collected through a sterile culture sensitivity tube and sent to microbiological lab and culture sensitivity reports collected from the patients during follow up visits. Results: majority of the patients were male 58.5% and rest 41.5% were female. Gram negative organisms are detected in (70.5%), Gram positive organisms detected (21.0%), and no organism detected (8.5%) of the swab samples. Conclusion: gram positive organisms were resistant to benzyl penicillin or ampicillin, clindamycin, ciprofloxacin or levofloxacin and sensitive to tetracycline, gentamicin, linezolid. Gram negative organisms were resistant to ampicillin, amoxyclav and sensitive to pipracillin or tazobactum, cefoperazone, amikacin, gentamicin, imipenem, cefepime, ciprofloxacin. Keywords: couture, throat swab, gram positive, gram negative, throat infection

Empiric Treatment of Foot Infection in Patients with Severe Diabetes

2021 ◽  
Author(s):  
Alexandre Sacchetti Bezerra ◽  
◽  
Flavia Altheman Loureiro ◽  
Carla Maria Pasquareli Vazquez ◽  
Afonso Cesar Polimanti ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Bacterial Resistance ◽  
Empirical Therapy ◽  
Empirical Treatment ◽  
Diabetic Patients ◽  
Gram Positive ◽  
International Consensus ◽  
Gram Negative ◽  
Severe Diabetes ◽  
High Incidence

Background: Despite being treated with antibiotics of broad spectrum recommended by International Consensus, severe diabetic patients with lower limb infection do not present a positive clinical evolution during empirical treatment. This study’s bacterial profile was analysed and compared with other worldwide hospital centers. Objective: To confirm the need of an individualized empirical treatment for severe diabetic patients with foot infection. Methods: Retrospective analysis of cultures and antibiograms of severe diabetic patients admitted by foot infection. Results: The results were consistent with the socioeconomic realities of developing countries. Gram-negative bacteria (52,11%) were present in most bone cultures. Results presented a high incidence of Enterococcus faecalis in both gram-positive (21,2%) and polymicrobial (34,7%) samples. Bacterial resistance with the use of ordinary antibiotics in the statistical analysis was high. Conclusion: The community infections should undergo broad spectrum empirical therapy combining amikacin (80,43%) or meropenem (72,00%) with gram-negative and vancomycin (100%) or teicoplanin (90,00%) or linezolid (74,19%) with gram-positive.

scholarly journals Uropathogens antibiotic susceptibility as an indicator for the empirical therapy used for urinary tract infections: a retrospective observational study

2020 ◽  
Author(s):  
Raad Saad Luty ◽  
Adil Ghalib Fadil ◽  
Jasim Mohammed Najm ◽  
Hala Haitham Abduljabbar ◽  
Sarmad Abdul Abbas Kashmar
Keyword(s):  
Urinary Tract ◽  
Observational Study ◽  
Empirical Therapy ◽  
Retrospective Observational Study ◽  
Gram Positive ◽  
Gram Negative ◽  
South Of Iraq ◽  
Antibiotics Susceptibility ◽  
Tract Infections ◽  
Resistance Rates

Background and Objectives: Urinary tract infection (UTI) is a common infection affects people of different ages. It is important to explore the antibiotics susceptibility of the bacterial agents to improve the empirical antibacterial prescription because of emerging of multi-drug resistant (MDR) bacteria. Materials and Methods: This is a retrospective observational study including 322 patients with UTI at the largest hospital at the center of Al-Basrah Governorate in the far south of Iraq from August 2018 to November 2019. Bacterial isolates from urine samples with significant bacteria were investigated by automated VITEK® 2 compact system to determine the causative bacteria and their antibiotics susceptibility. Results: Escherichia coli and Klebsiella pneumoniae were the first and second most frequent Gram-negative isolates, whereas Staphylococcus haemolyticus and Enterococcus faecalis were the first and second most frequent Gram-positive isolates. Fosfomycin, tigecycline, colistin, meropenem, imipenem, amikacin and nitrofurantoin had high susceptibility rates against Gram-negative isolates. Nitrofurantoin, tigecycline, daptomycin, teicoplanin, vancomycin and linezolid had a high effect against Gram-positive isolates. Conclusion: The leading causative isolates especially the most predominant Gram-negative isolates E. coli and K. pneumoniae show high resistance rates against important antibiotics including penicillin/β-lactamase inhibitors piperacillin/tazobactam, ceftazidime cefepime, ciprofloxacin, levofloxacin and trimethoprim/sulfamethoxazole which call for reconsidering them for treatment of UTI.

In-vitro Antioxidant and Antibacterial Activity of Methanolic Extract of Shorea robusta Gaertn. F. Resin

2016 ◽  
Vol 6 (4) ◽  
pp. 68
Author(s):  
Sushma Vashisht ◽  
Manish Pal Singh ◽  
Viney Chawla
Keyword(s):  
Antibacterial Activity ◽  
Methanolic Extract ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Disc Diffusion ◽  
Gram Positive ◽  
Gram Negative ◽  
Shorea Robusta ◽  
Dose Dependent ◽  
Resin Extract

The methanolic extract of the resin of Shorea robusta was subjected to investigate its antioxidant and antibacterial properties its utility in free radical mediated diseases including diabetic, cardiovascular, cancer etc. The methanol extract of the resin was tested for antioxidant activity using scavenging activity of DPPH (1,1-diphenyl-2-picrylhydrazil) radical method, reducing power by FeCl3 and antibacterial activity against gram positive and gram negative bacteria using disc diffusion method. The phytochemical screening considered the presence of triterpenoids, tannins and flavoniods. Overall, the plant extract is a source of natural antioxidants which might be helpful in preventing the progress of various oxidative stress mediated diseases including aging. The half inhibition concentration (IC50) of resin extract of Shorea robusta and ascorbic acid were 35.60 µg/ml and 31.91 µg/ml respectively. The resin extract exhibit a significant dose dependent inhibition of DPPH activity. Antibacterial activity was observed against gram positive and gram negative bacteria in dose dependent manner.Key Words: Shorea robusta, antioxidant, antibacterial, Disc-diffusion, DPPH.

Antibacterial activity of magnesium oxide nanoparticles prepared by Calcination method

2019 ◽  
Vol 10 (03) ◽  
Author(s):  
Elaf Ayad Kadhem ◽  
Miaad Hamzah Zghair ◽  
Sarah , Hussam H. Tizkam, Shoeb Alahmad Salih Mahdi ◽  
Hussam H. Tizkam ◽  
Shoeb Alahmad
Keyword(s):  
Antibacterial Activity ◽  
Magnesium Oxide ◽  
Diffusion Method ◽  
Oxide Nanoparticles ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Magnesium Oxide Nanoparticles ◽  
Agar Disc

magnesium oxide nanoparticles (MgO NPs) were prepared by simple wet chemical method using different calcination temperatures. The prepared NPs were characterized by Electrostatic Discharge (ESD), Scanning Electron Microscope (SEM) and X-ray Diffraction (XRD). It demonstrates sharp intensive peak with the increase of crystallinty and increase of the size with varying morphologies with respect to increase of calcination temperature. Antibacterial studies were done on gram negative bacteria (E.coli) and gram positive bacteria (S.aureus) by agar disc diffusion method. The zones of inhibitions were found larger for gram positive bacteria than gram negative bacteria, this mean, antibacterial MgO NPs activity more active on gram positive bacteria than gram negative bacteria because of the structural differences. It was found that antibacterial activity of MgO NPs was found it has directly proportional with their concentration.

scholarly journals Antibacterial, Antioxidant and Cytotoxic Properties of Crinum asiaticum Bulb Extract

2012 ◽  
Vol 28 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Md Atiar Rahman ◽  
Rumana Sharmin ◽  
Md Nazim Uddin ◽  
Md Sohel Rana ◽  
Nazim Uddin Ahmed
Keyword(s):  
Radical Scavenging ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Scavenging Effect ◽  
Ic50 Value ◽  
Radical Scavenging Effect ◽  
Dpph Scavenging ◽  
Crinum Asiaticum

Antibacterial effect of Crinum asiaticum bulb extract (1mg/disc) was tested on four Gram- positive and six Gram-negative bacteria by disc diffusion method using kanamycin (30 ìg/disc) as standard antibiotic disc. The bulb extract (250-1000mg/disc) showed significant zone of inhibition against all Gram-positive and Gram-negative bacteria ranging from 12-14 mm in diameter. Antioxidant potential of the same extract was evaluated by 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging method. The extract showed remarkable free radical scavenging effect (95.96%) providing the IC50 value of 5.62 for the bulb extract and 5.46 for ascorbic acid (standard antioxidant) at the concentration of 1000 ìg/ml. The bulb extract was found to be (LC50 value 94.06 ?g/ml) in Brine-Shrimp lethality test. DOI: http://dx.doi.org/10.3329/bjm.v28i1.11801 Bangladesh J Microbiol, Volume 28, Number 1, June 2011, pp 1-5

scholarly journals 660. Evaluation of Qvella’s FAST-Prep™ Liquid Colony™ for Early Antimicrobial Sensitivity Testing of Positive Blood Culture by Disk Diffusion Method

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S386-S386
Author(s):  
Susan M Novak-Weekley ◽  
Aye Aye Khine ◽  
Tino Alavie ◽  
Namidha Fernandez ◽  
Laxman Pandey ◽  
...  
Keyword(s):  
Direct Method ◽  
Viable Cell ◽  
Turnaround Time ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Sensitivity Testing ◽  
Gram Positive ◽  
Disk Diffusion Method ◽  
Gram Negative

Abstract Background Conventional antimicrobial susceptibility testing (AST) of microorganisms from positive blood cultures (PBC) can take ≥ 2 days. In order to improve the turnaround time for AST on a PBC, CLSI and EUCAST have made efforts to standardize procedures for disk diffusion (DD) direct from a PBC. Qvella Corporation (Richmond Hill, ON, Canada) has recently developed FAST-Prep, an automated centrifugal sample preparation system that rapidly delivers a Liquid Colony consisting of a purified, concentrated, viable cell suspension directly from a PBC. This study was performed to investigate the feasibility of DD AST off of a PBC using a FAST-Prep Liquid Colony. Methods Contrived PBC samples were prepared by spiking 6 species of Gram-positive and 4 species of Gram-negative bacteria (3-5 strains per species) into FA® Plus bottles and incubating in the BACT/ALERT® VIRTUO® System (bioMerieux, Durham, NC). After positivity, 3 mL of PBC was added to the FAST-Prep cartridge. After 20 minutes of processing in the FAST-Prep instrument, the Liquid Colony was removed from the cartridge and a 0.5 McFarland sample was prepared for DD AST. In parallel, the DD AST from a PBC was performed using 4 drops of PBC (CLSI direct method). Both methods were compared to conventional colony-based DD AST. After 16-18 hours of incubation zone diameters and S/I/R interpretations were determined. Categorical agreement (CA) and errors for both DD AST methods were calculated. In addition, colony plate counting was performed on 0.5 McFarland suspensions of Liquid Colony and the plate colony to determine biomass recovery and sample purity. Results CA for a FAST-Prep DD AST for Gram-positive and Gram-negative bacteria was 95.6% and 98.6%, respectively, compared to CA for CLSI DD AST of 77.2% and 81.9%, respectively. Biomass in the Liquid Colony was 7.2x108 and 1.2x109 CFU for Gram-positive and Gram-negative bacteria, respectively. Cell concentration in the 0.5 McFarland suspension of the Liquid Colony was 3.7x107 and 5.9x107 CFU/mL for Gram-positive and Gram-negative bacteria, respectively, which was similar to the concentration for the reference colony suspension. Conclusion The results support the potential role of FAST-Prep in providing a Liquid Colony for use in rapid AST. Disclosures Susan M. Novak-Weekley, PhD, D(ABMM), Qvella (Employee, Shareholder) Aye Aye Khine, PhD, Qvella (Employee, Shareholder) Tino Alavie, PhD, Qvella (Employee) Namidha Fernandez, MS, Qvella (Employee) Laxman Pandey, MS, Qvella (Employee) Abdossamad Talebpour, PhD, Qvella (Employee, Shareholder)

Fusogenic porous silicon nanoparticles as a broad-spectrum immunotherapy against bacterial infections

2021 ◽  
Author(s):  
Byungji Kim ◽  
Qinglin Yang ◽  
Leslie W. Chan ◽  
Sangeeta N. Bhatia ◽  
Erkki Ruoslahti ◽  
...  
Keyword(s):  
Porous Silicon ◽  
Broad Spectrum ◽  
Therapeutic Efficacy ◽  
Bacterial Infections ◽  
Silicon Nanoparticles ◽  
First Line ◽  
Gram Positive ◽  
Gram Negative ◽  
Porous Silicon Nanoparticles

RNAi-mediated immunotherapy provided by fusogenic porous silicon nanoparticles demonstrates superior therapeutic efficacy against both Gram-positive and Gram-negative bacterial infections compared with first-line antibiotics.

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