scholarly journals STUDY OF ANTIBIOTIC-RESISTANCE AND SENSITIVITY PATTERN IN A TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
Vol 9 (12) ◽  
pp. 161-168
Author(s):  
Sailajapriyadarsini Parlapalli ◽  
◽  
V.V Padmavathy ◽  
Gunapati Rama Mohan Reddy ◽  
◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Clavulanic Acid ◽  
Body Fluid ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Study Data ◽  
Urine Samples ◽  
Sensitivity Pattern ◽  
Amoxicillin Clavulanic Acid

Introduction: Antibiotics are helpful in bacterial infection control and management. Irrational antibiotic use leads to resistance, which puts modern medicines achievements at risk. This study aims to know antibiotic resistance and sensitivity patterns and to assess possible factors that favor the development of antibiotic resistance. Methods: It is a retrospective observational study. Data collected from June 2019 to May 2020 from the culture & sensitivity records of various clinical isolates at the Microbiology department of SMC, Vijayawada, and analyzed by descriptive statistics. Results: Total samples collected 2905. Only746 samples showed significant growth. Most commonly, isolated organisms were from Pus and Body fluids Staphylococcus aureus (31.16%), Klebsiella (23.02%), from blood samples Staphylococcus aureus (44%,) Klebsiella (32%), from urine samples Escherichia coli (27.31%),Staphylococcus aureus (16.66%). Bacteria isolated from, Blood and Pus & body fluid samples showed more resistance to Amoxicillin + Clavulanic acid, 60% &58.60%, and urine samples showed more resistance to Norfloxacin69.44%. Conclusion: In this study, bacteria isolated from, blood, pus, and body fluid samples showed more resistance to Amoxicillin + Clavulanic acid, from urine samples showed more resistance to Norfloxacin. Parenterally used drugs like aminoglycosides and vancomycin have retained their sensitivity but bacteria also showed resistance to Imipenem, Vancomycin, new combinations like Cefoperazone + Sulbactam. A culture & sensitivity test and following antibiotic stewardship guidelines before prescribing antibiotics will give good results to prevent antibiotic resistance.

scholarly journals Sensitivity to Antibiotics of Staphylococcus Aureus Strains, Able to Biofilm Formation

2021 ◽  
Vol 6 (3) ◽  
pp. 226-231
Author(s):  
A. O. Vashchenko ◽  
◽  
Yu. S. Voronkova ◽  
A. I. Vinnikov ◽  
T. N. Shevchenko ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Clavulanic Acid ◽  
Rapid Determination ◽  
Diffusion Method ◽  
Upper Respiratory Tract ◽  
Isolation And Identification ◽  
Methicillin Resistant ◽  
Opportunistic Bacteria ◽  
Amoxicillin Clavulanic Acid

The problem of respiratory diseases associated with staphylococcal carriers is considered to be one of the most acute in modern society due to its high prevalence and problems with treatment due to the high resistance of these bacteria to antibiotics. The purpose of the study was to determine the sensitivity of Staphylococcus aureus strains, able to form biofilm, isolated from the upper respiratory tract of human. Materials and methods. Bacteriological methods of isolation and identification of staphylococci, the method of rapid determination of the ability to form biofilm on a tablet and the disk-diffusion method of determining the susceptibility to antibiotics were used to perform the research. As a result of the conducted researches it was established that in the structure of pathogens of exacerbations of seasonal rhinitis S. aureus prevailed. It was isolated from 34 samples of biological material from the nose, which accounted for 69.4% of all examined cases of rhinitis. Staphylococcus spp. (6.1%) and Streptococcus spp. (24.5%) among the isolated strains of S. aureus, 27 (79.4%) had the ability to form a biofilm. A feature associated with antibiotic resistance is the ability of strains of microorganisms to form a biofilm, in which they acquire enhanced ability to survive under adverse environmental factors, including the use of drugs. Results and discussion. In our research we showed that more than 80% of film-forming strains were found to be susceptible to ciprofloxacin, amoxicillin / clavulanic acid and azithromycin. 4 (14.8%) are methicillin-resistant. Resistance to methicillin was detected simultaneously with resistance to ciprofloxacin (3 cases) and to azithromycin (2 cases), 1 strain was resistant to gentamicin and 2 – to tetracycline. 1 of the methicillin-resistant strains of S. aureus was multidrug-resistant (showed resistance to all studied antibiotics). Among non-biofilm strains, more than 80% of the strains were also sensitive to ciprofloxacin, amoxicillin / clavulanic acid and azithromycin. Sensitivity to tetracycline was low in both groups (42-63% sensitive). Conclusion. The prevalence of antibiotic resistance among clinical strains of opportunistic bacteria, unfortunately, shows an increasing trend. This requires constant monitoring of susceptibility to antimicrobial drugs in order to develop schemes of rational antibiotic therapy, taking into account the individualized approach to patients. In this sense, it is promising when studying the biological properties of clinical isolates to determine not only the resistance to antibiotics, but also their ability to form a biofilm

Antibiotic Molecules Efficacy in Pediatric Bacterial Infections

2018 ◽  
Vol 69 (4) ◽  
pp. 915-920
Author(s):  
Petronela Cristina Chiriac ◽  
Vladimir Poroch ◽  
Alina Mihaela Pascu ◽  
Mircea Daniel Hogea ◽  
Ileana Antohe ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Streptococcus Pneumoniae ◽  
Klebsiella Pneumoniae ◽  
Clavulanic Acid ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Penicillin G ◽  
Acute Therapy ◽  
Amoxicillin Clavulanic Acid

The antibiotic resistance of microorganisms involved in pediatric infections represents a significant cause of healthcare-associated infections (HAIs), and is also a matter of management, requiring specific intervention. The aim of the study was to evaluate the efficacy of some antibiotic molecules on pathogens isolated from patients admitted in a pediatric hospital. We carried out a descriptive study on a group of 411 patients admitted to the Sf. MariaClinical Emergency Hospital for Children Iasi, between January 1st and March 31st, 2016. Bacterial infections were most prevalent in the age group of 0-1 year (54.98% of the total isolates). Most affected by multidrug-resistant bacterial infections services were: general pediatrics (24.08% of the total isolates), then the intensive care unit (19.95%), surgical wards (14.84%), and acute therapy (11.43%). The germs were isolated from pathological samples: most often pus (23.85%), hypo-pharyngeal aspiration (21.65%), conjunctival secretion (12.42%), and ear secretion (9.48%). Penicillin G and oxacillin were inefficient in 30.26% of the Staphylococcus aureus strains, while erythromycin in 18.42%. Antibiotic resistance of Streptococcus pneumoniae was observed for penicillin G in 7.14% of the strains, while for erythromycin in 13.09%. Klebsiella pneumoniae strains were resistant to amoxicillin + clavulanic acid in 35.85% of the cases, and to cefuroxime, ceftazidime, ceftriaxone, cefepime in 33.96%. Our study highlighted that Staphylococcus aureus was resistant to penicillin G and oxacillin in more than one-third of the isolates, Streptococcus pneumoniae was resistant to penicillin G and erythromycin, and Klebsiella pneumoniae to amoxicillin + clavulanic acid and 1st, 2nd and 3rd generation cephalosporins. Continuing antibioresistance monitoring is crucial in order to promote appropriate guidelines in antibiotic prescription, which could result in decreasing HAIs� rates.

Is perioperative antibiotic necessary in straightforward implant placement procedures?

2020 ◽  
Author(s):  
Elçin Bedeloğlu ◽  
Mustafa Yalçın ◽  
Cenker Zeki Koyuncuoğlu
Keyword(s):  
Clavulanic Acid ◽  
Dental Implant ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Implant Failure ◽  
Control Group ◽  
Implant Placement ◽  
Significant Difference ◽  
Amoxicillin Clavulanic Acid ◽  
Experimental Group

The purpose of this non-random retrospective cohort study was to evaluate the impact of prophylactic antibiotic on early outcomes including postoperative pain, swelling, bleeding and cyanosis in patients undergoing dental implant placement before prosthetic loading. Seventy-five patients (45 males, 30 females) whose dental implant placement were completed, included to the study. Patients used prophylactic antibiotics were defined as the experimental group and those who did not, were defined as the control group. The experimental group received 2 g amoxicillin + clavulanic acid 1 h preoperatively and 1 g amoxicillin + clavulanic acid twice a day for 5 days postoperatively while the control group had received no prophylactic antibiotic therapy perioperatively. Data on pain, swelling, bleeding, cyanosis, flap dehiscence, suppuration and implant failure were analyzed on postoperative days 2, 7, and 14 and week 12. No statistically significant difference was detected between the two groups with regard to pain and swelling on postoperative days 2, 7, and 14 and week 12 ( p >0.05), while the severity of pain and swelling were greater on day 2 compared to day 7 and 14 and week 12 in both groups ( p =0.001 and p <0.05, respectively). Similarly, no significant difference was found between the two groups with regard to postoperative bleeding and cyanosis. Although flap dehiscence was more severe on day 7 in the experimental group, no significant difference was found between the two groups with regard to the percentage of flap dehiscence assessed at other time points. Within limitations of the study, it has been demonstrated that antibiotic use has no effect on implant failure rates in dental implant surgery with a limited number of implants. We conclude that perioperative antibiotic use may not be required in straightforward implant placement procedures. Further randomized control clinical studies with higher numbers of patients and implants are needed to substantiate our findings.

Evaluation of Parental Knowledge, Attitudes and Practices Regarding Antibiotic Use in Acute Upper Respiratory Tract Infections in Children in a Tertiary Care Hospital in Turkey

2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

scholarly journals Phenotypic and Genotypic Detection of Methicillin Resistant Staphylococcus aureus in Health Care Workers and Its Containment in a Tertiary Care Hospital, in South India

2021 ◽  
Author(s):  
Shamim Rahman ◽  
Ragini Ananth Kashid
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Meca Gene ◽  
Control Measures ◽  
Care Hospital ◽  
Beta Lactam ◽  
Accurate Identification ◽  
Mortality And Morbidity ◽  
Sensitivity Pattern ◽  
Hospital Infection Control

MRSA causes nosocomial and community based infections. It is associated with significant mortality and morbidity. Resistance in MRSA is encoded by mecA gene. Anterior nares are the ecological niche of Staphylococcus aureus. HCWs who are colonized with MRSA, act as agents of cross contamination of hospital and community acquired MRSA. Treating MRSA infections is a therapeutic challenge as it is resistant to beta lactam group of drugs. Therefore, there is a need for rapid and accurate detection of MRSA carriage in HCWs and to understand its antibiotic susceptibility pattern.The objective of the present study is to estimate the occurrence of MRSA in HCWs, using phenotypic and genotypic methods. A prospective study for six months was conducted after obtaining Institutional Ethical Committee clearance. Anterior nasal swabs of those HCWs who gave informed consent were taken processed for culture and sensitivity as per standard protocol. To detect MIC for oxacillin, E-strip method was used. mecA gene detection was done by PCR. A total of 300 HCWs were sampled.14.66% (44/300) of the isolates were identified as Staphylococcus aureus, of which 10 isolates were detected as MRSA. The overall isolation rate of MRSA is 3.33 %(10/300). MRSA carriage was high amongst nurses (5/59, 8.47%), followed by doctors (4/105, 3.80%).Antibiotic sensitivity pattern showed that highest resistance was to penicillin (75%) followed by amoxiclav (70.45 %).9 MRSA isolates were detected as mecA gene positive by PCR. MRSA carriers were decontaminated successfully with 2% mupirocin ointment and 2% chlorhexidine shampoo. This study reiterates the need for rapid and accurate identification of HCWs who have nasal colonization with MRSA, for reinforcing hospital infection control measures and decontamination protocol. This will help prevent the spread of MRSA in our community.

scholarly journals Novel Antibiotic Combinations of Diverse Subclasses for Effective Suppression of Extensively Drug-Resistant Methicillin-Resistant Staphylococcus aureus (MRSA)

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Shumyila Nasir ◽  
Muhammad Sufyan Vohra ◽  
Danish Gul ◽  
Umm E Swaiba ◽  
Maira Aleem ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clavulanic Acid ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Methicillin Resistant ◽  
Development Of Resistance ◽  
Amoxicillin Clavulanic Acid ◽  
Combination Antibiotics ◽  
Time Kill

The emergence of multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), the chief etiological agent for a range of refractory infections, has rendered all β-lactams ineffective against it. The treatment process is further complicated with the development of resistance to glycopeptides, primary antibiotics for treatment of MRSA. Antibiotic combination therapy with existing antimicrobial agents may provide an immediate treatment option. Minimum inhibitory concentrations (MICs) of 18 different commercially available antibiotics were determined along with their 90 possible pairwise combinations and 64 triple combinations to filter out 5 best combinations. Time-Kill kinetics of these combinations were then analyzed to find collateral bactericidal combinations which were then tested on other randomly selected MRSA isolates. Among the top 5 combinations including levofloxacin-ceftazidime; amoxicillin/clavulanic acid-tobramycin; amoxicillin/clavulanic acid-cephradine; amoxicillin/clavulanic acid-ofloxacin; and piperacillin/tazobactam-tobramycin, three combinations were found to be collaterally effective. Levofloxacin-ceftazidime acted synergistically in 80% of the tested clinical MRSA isolates. First-line β-lactams of lower generations can be used effectively against MRSA infection when used in combination. Antibiotics other than glycopeptides may still work in combination.

scholarly journals Results from the Survey of Antibiotic Resistance (SOAR) 2015–17 in Turkey: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints

2020 ◽  
Vol 75 (Supplement_1) ◽  
pp. i88-i99
Author(s):  
D Torumkuney ◽  
A Tunger ◽  
B Sancak ◽  
A Bıçakçıgil ◽  
B Altun ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Antibiotic Susceptibility ◽  
Low Dose ◽  
Empirical Therapy ◽  
Antibiotic Use ◽  
High Dose ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections ◽  
First Time ◽  
Higher Doses

Abstract Objectives To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2015–17 from Turkey. Methods MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. Results A total of 179 S. pneumoniae and 239 H. influenzae isolates were collected. Few (27.9%) pneumococci were penicillin susceptible by CLSI oral or EUCAST low-dose breakpoints, but by EUCAST high-dose or CLSI IV breakpoints 84.4% were susceptible. The most active antibiotics (excluding penicillin IV) by CLSI breakpoints were fluoroquinolones (98.9% of isolates susceptible), ceftriaxone (83.2%), amoxicillin (78.8%) and amoxicillin/clavulanic acid (78.8%). Pneumococcal susceptibility to amoxicillin and amoxicillin/clavulanic acid was lower using EUCAST low-dose breakpoints (49.7%), although susceptibility increased when using EUCAST high-dose (57.0%–58.1%) and PK/PD (78.8%–87.7%) breakpoints. Twenty-three H. influenzae isolates were β-lactamase positive, with 11 characterized as β-lactamase negative and ampicillin resistant following EUCAST criteria and 5 by CLSI criteria. Generally antibiotic susceptibility was high using CLSI breakpoints: ≥92.9% for all antibiotics except ampicillin (87% by CLSI and EUCAST breakpoints) and trimethoprim/sulfamethoxazole (67.4% and 72% by CLSI and EUCAST breakpoints, respectively). Susceptibility using EUCAST breakpoints (where these are published) was similar, except for cefuroxime (oral) with 3.8% of isolates susceptible. PK/PD breakpoints indicated low susceptibility to macrolides (5.9%–10%) and cefaclor (13%). The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. Conclusions Antibiotic susceptibility of S. pneumoniae was generally low, which is in keeping with evidence of inappropriate and high antibiotic use in Turkey. H. influenzae susceptibility was high. These data are important for empirical therapy of CA-RTIs.

Impact of simplified therapeutic guidelines on antibiotic prescriptions: a prospective multicentre comparative study

2019 ◽  
Vol 75 (3) ◽  
pp. 747-755
Author(s):  
Pierre-Marie Roger ◽  
Ingrid Peyraud ◽  
Michel Vitris ◽  
Valérie Romain ◽  
Laura Bestman ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Third Generation ◽  
Therapeutic Guidelines ◽  
Amoxicillin Clavulanic Acid ◽  
The Impact ◽  
Third Generation Cephalosporins

Abstract Objectives We studied the impact of simplified therapeutic guidelines (STGs) associated with accompanied self-antibiotic reassessment (ASAR) on antibiotic use. Methods Prospective antibiotic audits and feedback took place at 15 hospitals for 12 months, allowing STGs with ≤15 drugs to be devised. STGs were explained to prescribers through sessions referred to as ASAR. Optimal therapy was defined by the conjunction of a diagnosis and the drug specified in the STGs. Analysis of consumption focused on critical drugs: amoxicillin/clavulanic acid, third-generation cephalosporins and fluoroquinolones. Results We compared prescriptions in five hospitals before (n = 179) and after (n = 168) the implementation of STGs + ASAR. These tools were associated with optimal therapies and amoxicillin/clavulanic acid prescriptions [adjusted odds ratio (AOR) 3.28, 95% CI 1.82–5.92 and 2.18, 95% CI 1.38–3.44, respectively] and fewer prescriptions for urine colonization [AOR 0.20 (95% CI 0.06–0.61)]. Comparison of prescriptions (n = 1221) from 10 departments of three clinics with STGs + ASAR for the first quarters of 2018 and 2019 revealed that the prescriptions by 23 ASAR participants more often complied with STGs than those by 28 other doctors (71% versus 60%, P = 0.003). STGs alone were adopted by 10 clinics; comparing the prescriptions (n = 311) with the 5 clinics with both tools, we observed fewer unnecessary therapies in the latter [AOR 0.52 (95% CI 0.34–0.80)]. The variation in critical antibiotic consumption between 2017 and 2018 was −16% for the 5 clinics with both tools and +20% for the other 10 (P = 0.020). Conclusions STGs + ASAR promote optimal antibiotic therapy and reduce antibiotic use.

scholarly journals Antimicrobial Sensitivity Pattern in the Mixed Intensive Care Unit in a Tertiary Care Hospital of Eastern Nepal

2020 ◽  
Vol 2 (2) ◽  
pp. 9-15
Author(s):  
Niraj Kumar Keyal ◽  
Mahendra Shrestha ◽  
Partima Sigdel Ghimire
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Sensitivity Pattern

 Background: Empirical antibiotics are used in the intensive care unit based on developing countries’ guidelines due to a lack of a bacteriological profile of individual ICU and institution policy. Therefore, this study was conducted to know the antibiogram of the intensive care unit and to make institution policy for antibiotic use in ICU. Materials and methods: It was a prospective descriptive cross-sectional study conducted in the mixed surgical and medical intensive care unit of a tertiary care hospital for one year in 625 patients. Various clinical samples were collected aseptically and organisms were identified by the cultural characteristics, morphology, gram stain, and different biochemical test. Antimicrobial susceptibility was done with a disc diffusion test. Data collection was done in a preformed sheet that included all tested antibiotic and demographic variables. Statistical analysis was done by using statistical package for the social sciences. The result was presented as frequency and percentage. Results: Out of 625 samples, 135(22%) showed growth in culture. Among them, 96(71%) and 39(29%) were gram-negative bacilli and gram-positive cocci respectively. The tracheal aspirate was the most common type of specimen which comprised 49(36.29%) isolates. The most common organism was Staphylococcus aureus which accounts for 27(20%) isolates, followed by Acinetobacter baumanni 25(18.51%), Klebsiella pneumoniae 22(16.29%) and Pseudomonas aeurignosa 21(15.55%). The incidence of multidrug-resistant and extended drug resistance was 44(32.5%) and 45(33%) respectively. Meanwhile, the incidence of methicillin-resistant staphylococcus aureus was 70%. However, in the case of Acinetobacter baumannii and Enterobacteriaceae, all were sensitive to polymyxin B and meropenem. Conclusion:Antibiotics should be prescribed based on the antibiogram of individual intensive care units that can decrease antibiotic resistance. Polymyxin B and meropenem can be prescribed for gram-negative bacilli and vancomycin for Staphylococcus aureus.

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