Carbapenem resistance among common Enterobacteriaceae Clinical Isolates in part of North-East India

2021 ◽  
Vol 19 ◽  
Author(s):  
Mohan Sharma ◽  
Pankaj Chetia ◽  
Minakshi Puzari ◽  
Nakul Neog ◽  
Upasana Phukan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Treatment Options ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
North East

Background: Enterobacteriaceae, the normal dwellers in the human intestine, are commonly associated with a variety of community acquired and nosocomial infections. Emerging trend of antibiotic resistance among these strains is a notable issue globally; more serious threat is the resistance against the available last resort antibiotics- the carbapenems. Objective: The objective of our study was intended to determine the burden of resistance towards common antibiotic classes, so as to address the gap of drug resistance prevalence data, among the Enterobacteriaceae isolates obtained from the health settings in this region. Methodology: A cross-sectional study was done with inclusion of clinical isolates collected from varied sources, from health settings in upper Assam. The isolates were identified based on standard methods of morphology study and biochemical tests. The identified isolates were then subjected to antibiotic susceptibility testing by following Kirby-Bauer disc diffusion method and the result interpreted as per the CLSI guidelines. The resistance of the reported carbapenem resistant isolates was confirmed by minimum inhibitory concentration (MIC) determination using commercial E-strip kit. Results: Among the enterobacterial isolates Klebsiella spp. accounted the majority, followed by Escherichia coli, Citrobacter spp., Shigella spp. and others. Multi-drug resistance (MDR) was noted among 67.6% isolates; however, carbapenem resistance was confirmed in 18.9% of the total Enterobacteriaceae isolates. Conclusion: Higher prevalence of resistance towards carbapenems, among the Enterbacteriaceae isolates of upper Assam seems to be upcoming threat to the region, limiting the treatment options in future.

scholarly journals Menace to the ultimate antimicrobials among commonEnterobacteriaceaeclinical isolates in part of North-East India

2019 ◽  
Author(s):  
Mohan Sharma ◽  
Pankaj Chetia ◽  
Minakshi Puzari ◽  
Nakul Neog ◽  
Amrit Borah
Keyword(s):  
Treatment Options ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
North East India ◽  
North East ◽  
Therapeutic Decision Making

AbstractIntroductionEnterobacteriaceae, the normal dwellers in the human intestine, commonly associated with a variety of community acquired and nosocomial infections. Emerging trend of antibiotic resistance among these strains is a notable issue globally; more serious threat is the resistance against the available last resort antibiotics- the carbapenems. Our study thus intended to determine the burden of resistance towards this ultimate antimicrobial class, so as to assist in the empiric therapeutic decision making process and to search for alternate options.Materials and MethodsOur study was a cross-sectional study with inclusion of clinical isolates collected from varied sources, from health settings in upper Assam. The isolates were identified based on standard methods of morphology study and biochemical tests. The identified isolates were then subjected to antibiotic susceptibility testing following Kirby-Bauer disc diffusion method and the result interpreted as per the CLSI guidelines. The resistance of the reported carbapenem resistant isolates was confirmed by minimum inhibitory concentration (MIC) determination using commercial E-strip kit.ResultsAmong the enterobacterial isolatesKlebsiellaspp. accounted the majority, followed byEscherichia coli,Citrobacterspp.,Shigellaspp. and others. Multi-drug resistance (MDR) was noted among 67.6% isolates; however, carbapenem resistance was confirmed in 18.9% of the totalEnterobacteriaceaeisolates.ConclusionHigher prevalence of resistance towards the last resort antimicrobial, carbapenems, among theEnterbacteriaceaeisolates of upper Assam seems to be upcoming threat to the region, limiting the treatment options in future.

Evaluating the Saliva of Burn ICU Patients for Resistant Infections Harbor Metallo-β-Lactamase Genes

2020 ◽  
Vol 41 (3) ◽  
pp. 647-651 ◽  
Author(s):  
Amir Emami ◽  
Neda Pirbonyeh ◽  
Abdolkhalegh Keshavarzi ◽  
Abdollah Bazargani ◽  
Somayeh Hassanpour ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Cross Sectional ◽  
Data Set ◽  
Gram Negative ◽  
Fermenting Bacteria ◽  
Infection Source

Abstract Pseudomonas aeruginosa and Acinetobacter baumannii are the bacteria which increasingly account for nosocomial infections. Due to high virulence, the rate of Multi-Drug Resistance (MDR) and limited availability of new agents, these infections create significant clinical burdens, making it important to identify the possible sources of their occurrence. The aim of this study was to assess non-lactose fermenting bacteria and their metallo-β-lactamase (MBLs) genes expression in the Burn Intensive Care Unit (BICU) patients’ saliva samples. This cross-sectional study was conducted from 2017 to 2018 on 124 saliva samples of BICU patients. Identified isolates were evaluated for drug susceptibility by disc diffusion method. MBLs production isolates were detected by Modified Hodge test and Imipenem-EDTA Combined disk. MBLs related genes were evaluated by polymerase chain reaction (PCR). A total of 86 Gram negative non-lactose fermenting bacteria (38; A. baumannii) and (48; P. aeruginosa), were detected. All of the A. baumannii isolates were resistant to Carbapenems, while more than 90% of them were sensitive to Colistin. However, the highest sensitivity in P. aeruginosa isolates was related to Carbapenems and Colistin. More than 95% of A. baumannii and 32% of P. aeruginosa were detected MDR. MBLs production was confirmed in 9 (33.33%) P. aeruginosa and 18 (66.67%) A. baumannii isolates. The blaVIM was the most prevalent gene, while this gene was detected in all of MBLs positive strains. This study confirmed the prevalence of carbapenemase producer Gram-negative bacilli in the saliva of BICU patients. The results of the present study provide a new data set about saliva infection source that could lead to the proper antibiotic regimen and better control of drug resistance.

scholarly journals Phenotypic Assays for Detection of AmpC and MBL Producers among the Clinical Isolates of Multi Drug Resistant Pseudomonas aeruginosa

2018 ◽  
Vol 4 ◽  
pp. 23-31
Author(s):  
Sarita Manandhar ◽  
Sarashwoti Adhikari ◽  
Sujeeb Rajbhandari
Keyword(s):  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Drug Resistant ◽  
Antibiotic Susceptibility Testing ◽  
Cross Sectional

Objectives: In order to determine the prevalence of multi-drug resistance along with AmpC and metallo-β-lactamase producing P. aeruginosa, a six month cross-sectional study was carried out at Shahid Gangalal National Heart Center.Methods: A total of 756 clinical specimens were analyzed for bacteriological profile. The bacterial isolates were identified by cultural and biochemical techniques. Antibiotic susceptibility testing of the isolates was performed by Kirby-Bauer disc diffusion method. MDR isolates were screened and tested for MBL and AmpC production. Ceftazidime resistant isolates were tested for MBL and Cefoxitin resistant isolates for AmpC.Results: Among all the clinical samples analyzed, P. aeruginosa was detected in 75 samples (9.92%). Antibiotic susceptibility testing showed Imipenem as the most effective drug with susceptibility of 76% followed by Piperacillin-Tazobactam (74.7%) and Piperacillin (41.3%). Out of 75 P. aeruginosa isolates, 53 (70.6%) of them were found to be resistant to at least three out of four anti-pseudomonal agents, thus were considered as MDR. Out of 53 multi-drug resistant P. aeruginosa (MDRPA), all were resistant to ceftazidime whereas 85% (45/53) were resistant to cefoxitin. Out of 53 isolates, 11 (20.75%) showed positive result for MBL. Similarly, 7 out of 45 i.e. 13.2% were found to be AmpC producers.Conclusion: This study signified the high prevalence of MDRPA which is an alarming rate. Also multiple β-lactamase producing P. aeruginosa were detected which can further complicate the treatment options. Regular monitoring of antibiotic susceptibility and rational use of antibiotics would be helpful in eliminating the outbreaks of multiple β-lactamase producing MDRPA.

scholarly journals Prevalence and Determinant of Depression among Multi-Drug Resistance Tuberculosis: Study in Dr. Kariadi General Hospital

2020 ◽  
Vol 40 (2) ◽  
pp. 88-96
Author(s):  
Mahalul Azam ◽  
Arulita Ika Fibriana ◽  
Fitri Indrawati ◽  
Indah Septiani
Keyword(s):  
Drug Resistance ◽  
General Hospital ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Multi Drug Resistance ◽  
P Value ◽  
Cross Sectional ◽  
Depression Status ◽  
Prevalence Of Depression ◽  
Mdr Tb

Backgrouds: Multi-drug resistance tuberculosis (MDR-TB) adds the burden of tuberculosis (TB). Depression is a common comorbidity in TB patients. Prevalence of depression among MDR-TB patients was higher, i.e. 11-70%. Prevalence of depression among TB patients in Dr. Kariadi General Hospital was 51.9%. Previous study reported the determinants related to the depression in MDR-TB patients. This study explored the prevalence of depression in MDR-TB patients and its determinants. Methods: This study was a cross-sectional study conducted from July-August 2019. Data consisted of primary and secondary data from Dr. Kariadi General Hospital patients. Sample in this study involved 72 respondents, over 16 years old from 151 registered MDR-TB patients. Depression status was determined using Depression Anxiety Stress Scales obtained from the medical record. Subjects’ characteristics and determinants were collected from primary as well as secondary data. Descriptive data were presented in proportion. Chi-square test continued by Binary logistic regression was performed to determine the association between depression status and its determinants. A P-value

scholarly journals Genome-Wide Identification of Carbapenem-Resistant Gram- Negative Bacterial (CR-GNB) Isolates Retrieved From Hospitalized Patients in Bihar, India

2021 ◽  
Author(s):  
Namrata Kumari ◽  
Mukesh Kumar ◽  
Amit Katiyar ◽  
Abhay Kumar ◽  
Pallavi Priya ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Cross Sectional ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Genome Wide ◽  
Synergy Test ◽  
Global Threat

Abstract Carbapenemase-producing clinical isolates are becoming more common over the world, posing a severe public health danger, particularly in developing nations like India. Carbapenem-resistant Gram-negative bacterial (CR-GNB) infection has become a fast-expending global threat with limited antibiotic choice and significant mortality. The aim of this study was to highlight the carbapenem-resistance among clinical isolates of hospital admitted patients in Bihar, India. A cross-sectional study was conducted with 101 clinical isolates of E. coli, K. pneumoniae, A. baumannii, and P. aeruginosa. All GNB isolates were tested for their antimicrobial susceptibility using double disc synergy test / modified hodge test (DDST/MHT) and subsequently confirmed carbapenemase-producing isolates were evaluated for carbapenem-resistance genes using whole-genome sequencing (genotypically) method. The overall percentage of carbapenem-resistance among GNB was (17/101) 16.83%. The AMR analysis demonstrates a significantly high prevalence of blaCTX−M followed by blaSHV, blaTEM, blaOXA and blaNDM β-lactams carbapenem-resistance genes among clinical isolates of GNB. Co-occurrence of carbapenemase-encoding genes with blaNDM was found in 70.6% of carbapenemase-producing isolates. Our study highlights the mechanism of carbapenem-resistance to curb the overwhelming threat posed by emergence of drug-resistance in India.

scholarly journals Bacterial Etiology of Wound Exudates in Tertiary Care Cancer Patients and Antibiogram of the Isolates

2020 ◽  
Vol 13 ◽  
pp. 117863372095207
Author(s):  
Kiran Duwadi ◽  
Sujan Khadka ◽  
Sanjib Adhikari ◽  
Sanjeep Sapkota ◽  
Pabitra Shrestha
Keyword(s):  
Staphylococcus Aureus ◽  
Pathogenic Bacteria ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Biochemical Tests ◽  
Cross Sectional

Introduction: Patients with malignancies frequently develop infections as a result of surgical procedures and fungating wounds leading to pus formation. This cross-sectional study was conducted to explore the bacteriological spectra of infections of various cancer sites and their antibiotic sensitivity patterns among the patients visiting minor operation theatre (OT) of B.P. Koirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. Methods: Over a period of 3 months from September to November 2018, a total of 183 wound exudates and pus samples were collected and analyzed by standard microbiological procedures. Isolates were identified based on the colony characters, Gram staining and an array of biochemical tests. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion technique according to criteria set by CLSI, 2016. Methicillin resistance in Staphylococcus aureus was tested with the help of cefoxitin using disc diffusion method. Results: Out of the 183 samples, 149 (81.4%) were culture positive. Among 13 different isolates identified, S. aureus (43.0%) was predominant followed by E. coli (14.0%). Higher incidence of bacteria was seen among the males (52.3%), in the age group 51 to 60 years (26.8%) and among the patients undergoing surgical intervention to deal with cancer (34.2%). The prevalence of wound infection was significantly affected by gender, age, and treatment regimen ( P < .01). Out of the total 68 S. aureus isolates, 38 (44.1%) were deemed as Methicillin-resistant Staphylococcus aureus (MRSA). Among the 158 isolates, 85 (53.8%) were multi-drug resistant (MDR). Cefepime was the most effective antibiotic for Gram positive isolates whereas both imipenem and meropenem were found to be equally more effective for Gram negative isolates. Conclusion: This study suggests that patients with malignancies harbor pathogenic bacteria; therefore, prudent use of antibiotics is essential to prevent the emergence of MDR pathogens.

scholarly journals Bacterial Tonsillitis and Antimicrobial Resistance Profiles Among Children Within Five Years of Age At Hargeisa Group of Hospital, Somaliland: A Cross-Sectional Study

2021 ◽  
Author(s):  
Hamda Hussein Darod ◽  
Addisu Melese ◽  
Mulugeta Kibret ◽  
Wondemagegn Mulu
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
School Attendance ◽  
Bacterial Species ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of

Abstract Background Tonsillitis is the third most frequently diagnosed infection in the pediatrics age group around the world. It causes significant morbidity and loss of school attendance in children. The emergence of drug resistance in bacterial tonsillitis is getting higher every year. However, data on the drug resistance profiles of bacterial causes of tonsillitis among children within five years of age is not available in Somaliland.Therefore; this study determined the bacterial causes of tonsillitis and their antimicrobial resistance profiles among children within five years of age at Hargeisa Group of Hospital, Somaliland. Methods A cross-sectional study was conducted from March to July 2020. A total of 374 children within five years of age were included using convenient sampling method. Throat swabs were collected from children, processed and bacterial species were identified using standard bacteriological procedures. Antimicrobial susceptibility was done using disc diffusion method. Data on demographic variables and clinical profiles were collected using structured questionnaires. Logistic regression analysis was computed to identify factors associated with bacterial tonsillitis. P-values < 0.05 were taken as statistically significant. Results The median age of children included in the study was 4 years. Overall, 120(32.1%)(95% CI 27.4–36.8%) of children had culture confirmed bacterial tonsillitis. Of them,23(19.2%) had mixed infections.The most frequent bacterial isolates were Streptococcus pyogenes 78(55%), Staphylococcus aureus 42 (29%) and Streptococcus pneumoniae 10(7%). Isolates revealed 83.3–100 % rate of resistance to ampicillin. S. aureus was resistant to clarithromycin (38%) while 60% of S. pneumoniae isolates were resistant to gentamicin. The overall multidrug resistance (MDR) was 50.4% and 52.6% of S.pyogenes and 60% of S.pneumoniae were MDR. History of tonsillitis(AOR = 0.12; 95% CI = 0.06–0.21), difficulty of swallowing(AOR = 6.99; 95% CI = 3.56–13.73), weight loss (AOR = 0.33; 95% CI = 0.186–0.597) and attending school (AOR = 2.98; 95% CI = 1.64–5.42) were found to be associated with tonsillitis among children within five years of age. Conclusions Bacterial tonsillitis with high degree of ampicillin resistance, mixed infections and MDR isolates are major concerns in children within five years of age at Hargeisa, Somaliland. Therefore, treatment of cases should be guided by regular culture and antimicrobial susceptibility testing to prevent disease consequences and critical drug resistance.

PROPORTION OF ESBL AND CARBAPENEMASE PRODUCING ENTEROBACTERIACEAE CAUSING BLOODSTREAM INFECTIONS AND SHOWING MULTI DRUG RESISTANCE IN INFECTED PATIENTS IN TERTIARY CARE HOSPITAL AT AGARTALA, TRIPURA

2021 ◽  
pp. 28-30
Author(s):  
Lija Ghosh ◽  
Arun B ◽  
Puja Ghosh ◽  
Tapan Majumdar
Keyword(s):  
Drug Resistance ◽  
Bloodstream Infection ◽  
Tertiary Care Hospital ◽  
Culture Media ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Biochemical Tests ◽  
North East

BACKGROUND: Enrerobacteriaceae species are the major leading cause of bloodstream infections in many developing countries. Moreover, ESBL and Carbapenemase-producing Enterobacteriaceae species are often associated with high resistance to a wide class of antibiotics. There are few studies regarding the bloodstream infections causing by Enterobacteriaceae with the production of Extended-spectrum β-lactamases and Carbapenemase enzymes in Tripura, North-East India. This study aimed to determine the “ proportion of ESBL and carbapenemase-producing Enterobacteriaceae causing bloodstream infection and showing Multi-drug resistance (MDR) in infected patients'' in Tertiary care Hospital at Agartala, Tripura. METHOD: Blood samples were collected from all indoor and outdoor patients suspected of Bloodstream infection. Then specimens were inoculated in various culture media after that with this culture isolates we performed gram staining and many biochemical tests (as per CLSI guidelines) to identies the Enterobacteriaceae species. And the production of β-lactamases and Carbapenemase was conrmed by the combined disk test and Modied Hodge method. RESULTS: In this study out of 760 samples processed in the laboratory 77 (10.13%) was tested positive for bacteremia from which 42 (54.54%) blood specimens were infected by Enterobacteriaceae. The members of the Enterobacteriaceae family isolated in patient samples are E.coli (22/42, 52.38%), K. pneumoniae (11/42, 52.38%) others are Enterobacter spp. (8/42, 52.38%) and S.typhi(1/42, 2.38%). In all 42 Enterobacteriaceae species, 17 (40.47%) isolates were found ESBL positive on antibiotic screening which is conrmed by Combined disc diffusion test, and out of 17 Beta-lactamase producers 8 (47.05%) were E. coli, 5 (29.41%) were K. pneumoniae and 4 (23.52%) were Enterobacter spp. And among 42 isolates of Enterobacteriaceae 16 (38.09%) isolates showed Carbapenemase producers, in that 8 (50%) were E.coli, 5 (31.25%) were K. pneumoniae, and 3 (18.75%) were Enterobacter spp. CONCLUSION: This study aims to provide an early, rapid, and effective phenotypic method for identifying Multi-drug resistant (MDR) Bloodstream infections (BSIs) causing by the species of the Enterobacteriaceae family

scholarly journals Antibiogram of Escherichia coli Isolated from Avian Colibacillosis in Chitwan District of Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 52-60 ◽  
Author(s):  
D.B. Thapa ◽  
A. Chapagain
Keyword(s):  
Escherichia Coli ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Biochemical Tests ◽  
Isolation And Identification ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
E Coli ◽  
Mar Index ◽  
Avian Disease

A cross-sectional study was conducted at National Avian Disease Investigation Laboratory, Chitwan to determine antibiogram of Escherichia coli isolated from avian colibacillosis cases of broilers and layers in Chitwan. One hundred and sixty (95 from broilers and 65 from layers) liver samples were collected aseptically during postmortem. Samples were taken purposively from dead birds showing lesions perihepatitis, pericarditis, air-saculitis, omphalitis and egg peritonitis. Isolation and identification were made by examination of cultural characteristics of E. coli in MacConkey’s agar, Eosin methylene blue (EMB) agar, Gram’s staining and biochemical tests. Antibiogram of identified E. coli isolate was evaluated against six antibiotics of six different groups by disk diffusion method following CLSI guidelines. One hundred and three E. coliisolates (73 from broilers and 30 from layers) were isolated from one hundred and sixty samples. Highest resistance was observed against Ampicillin (100%) followed by Co-trimoxazole (86.40%), Doxycycline (46.60%), Levofloxacin (45.63%), Nitrofurantoin (26.21%) and Amikacin (10.68%). Nearly about all (96.12%) isolates from 103 isolated E. coli isolates showed multidrugs resistance to two or more than two antimicrobials. All multidrug resistance isolates showed 16 different patterns with each isolate being resistance to at least two drugs. The multiple antibiotic resistance indexing ranged from 0.2 to 0.8 and proportion of isolates with MAR index greater than 0.2 was 96.12%. Int. J. Appl. Sci. Biotechnol. Vol 8(1): 52-60    

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