Community acquired pneumonia-current scenario among immunocompromised patients in a tertiary care hospital

2016 ◽  
Vol 5 (01) ◽  
pp. 4715
Author(s):  
A. V. Sowmya* ◽  
G. Jayalakshmi ◽  
David Agatha
Keyword(s):  
Diabetes Mellitus ◽  
Antimicrobial Therapy ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
Polymicrobial Infection ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Immunocompromised Patients ◽  
Drug Resistant ◽  
Etiologic Agents

Pneumonia is a common illness accounting for majority of hospitalizations worldwide with significant mortality and morbidity. Antimicrobial therapy, being the main stay of treatment, the choices of antibiotics depends on the nature of the etiologic agents and the host factors. The current study was aimed to identify the bacterial & fungal etiologic agents of Community Acquired Pneumonia (CAP) in Immunocompromised (IC) patients, with their antimicrobial resistant pattern and to analyze the associated immunocompromised states. Various respiratory samples from study group of 75 immunocompromised patients with features of pneumonia were collected, processed and the isolates were identified with their antimicrobial susceptibility& resistance pattern according to CLSI guidelines. The results were analyzed statistically. Diabetes mellitus is the most common immunocompromised state (48%) associated with CAP. Monomicrobial and polymicrobial infection rates were 80.36% and 19.64% respectively. Gram negative pathogens and fungal pathogens were identified in 60% and 25.37% of culture positive cases respectively. Diabetes mellitus is commonly found in association with polymicrobial infection (19.44%) and fungal infection (16.66%). Drug resistant strains comprise about 75% of MRSA strains, 72.72 % of ESBL producers and 3.44% of Amp C producers. As the number of elderly people with associated IC state is on rise, with change in the pattern of microbial etiologic agents causing CAP, a prior knowledge of the host and microbial factors will help in formulating empirical antimicrobial therapy and proper treatment thereby curbing the spread of infections by drug resistant pathogens and the associated morbidity and mortality.

scholarly journals Nosocomial Multi-Drug-Resistant Acinetobacter Infections - Clinical Findings, Risk Factors and Demographic Characteristics

2009 ◽  
Vol 3 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Rubina Lone ◽  
Azra Shah ◽  
SM Kadri ◽  
Shabana Lone ◽  
Shah Faisal
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care ◽  
Specific Pattern ◽  
Demographic Characteristics ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Drug Resistant

Recently, Acinetobacter emerged as an important pathogen and the rate of isolation has increased since the last two decades worldwide. Objectives of the present study were to see the incidence of Acinetobacter infection at a tertiary care hospital at Kashmir, India, demographic features of the infections, species identification and antibiotic sensitivity and resistance pattern of the isolates. The clinical samples submitted to Microbiology laboratory at SKIMS over a period of 2 years (June, 2001 to June, 2003) were investigated. Identification, speciation and antibiotyping were performed for the isolates of Acinetobacter recovered from clinical samples including urine, pus, sputum, blood, CSF and other body fluids. Clinical and demographic characteristics were studied retrospectively. Out of a total of 5352 infected samples, 258 (4.8%) were found to be due to Acinetobacter. The organism was responsible for 76 (39.64%) cases of urinary tract infection and 38 (29.45%) cases of wound infection and was most prevalent in the intensive care unit (29.84%). A. baumannii was the most predominant species. Prolong hospital stay, Mechanical ventilation and Intensive Care Units were found to be potential risk factors. High level of resistance was recorded for Ampicillin (86.3%), Cefazolin (93.2%) Gentamicin (61.5%), Cefotaxime (65.8%), Ceftriaxone (61.5%) and Ciprofloxacin (69.2%). Although no specific pattern during antibiotyping was observed, but most of them were multi-drug resistant. Nosocomial infections by multi-drug-resistant Acinetobacter have emerged as an increasing problem especially in the intensive care units of the hospital. The analysis of risk factors and susceptibility pattern will be useful in understanding epidemiology of this organism in a hospital setup. Key words: Acinetobacter, Nosocomial infection, Antibiotyping, Multi-drug resistant   doi: 10.3329/bjmm.v3i1.2969 Bangladesh J Med Microbiol 2009; 03 (01): 34-38

scholarly journals Antibiotic resistance pattern among aerobic bacterial isolates from osteomyelitis cases attending a Tertiary care hospital of North India with special reference to ESBL, AmpC, MBL and MRSA production

2017 ◽  
Vol 5 (2) ◽  
pp. 482
Author(s):  
Razia Khatoon ◽  
Shameem Ahmad Khan ◽  
Noor Jahan
Keyword(s):  
Antibiotic Resistance ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Drug Resistant ◽  
Bacterial Isolates ◽  
Gram Negative ◽  
Antibiotic Resistance Pattern

Background: Osteomyelitis is a common cause of morbidity in developing countries. Its treatment comprises of surgical debridement of all necrotic bone and soft tissue along with use of appropriate antimicrobial therapy. Treatment is becoming increasingly troublesome due to rise in drug resistant isolates in osteomyelitis cases. The present study was done to determine the antibiotic resistance pattern among aerobic bacterial isolates from osteomyelitis cases.Methods: 125 samples from osteomyelitis cases were aerobically cultured and isolates from culture positives were identified by standard procedures. Antimicrobial susceptibility testing was done by Kirby Bauer disk diffusion method. Staphylococcal isolates were screened for methicillin resistance and Gram negative bacilli were screened and confirmed for ESBL, AmpC and MBL production.Results: Out of 125 samples cultured, 20 were culture negative and 105 were culture positive giving rise to 120 isolates (58 Gram positive and 62 Gram negative organisms). The prevalence of methicillin resistant staphylococcal (MRS) isolates, ESBL, AmpC and MBL producers was found to be 43.1%, 51.6%, 24.2% and 14.5% respectively. All the resistant isolates were multidrug resistant, with MRS being 100% sensitive only to vancomycin, linezolid and teicoplanin, ESBL and AmpC producers being 100% sensitive only to imipenem and colistin, and MBL producers being 100% sensitive only to colistin.Conclusions: Antibiotic therapy on the basis of antibiotic susceptibility pattern helps the clinician to choose appropriate drugs leading to successful treatment and prevention of emergence and dissemination of drug resistant isolates.

scholarly journals Antibiotic Resistance Pattern of Bacteria Isolated from Nosocomial Infection in Internal Surgery and Neurosurgery Intensive Care Unit (NICU) at a Tertiary Care Hospital in Tehran, Iran

2017 ◽  
Vol 14 (3) ◽  
pp. 1095-1102 ◽  
Author(s):  
Mohammad Javad Hosseini ◽  
Mohamad Kiarsi ◽  
Reza Golmohammadi ◽  
Reza Sadripour
Keyword(s):  
Antibiotic Resistance ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Drug Resistant ◽  
Antibiotic Resistance Pattern

ABSTRACT: Today, many studies doneregarding the antibiotic resistance showthose patients in intensive care units (ICUs) are more likely to develop drug resistant pathogens.Pathogens are the major cause of nosocomial infections in intensive care units. Knowledge of antibiotic resistance of pathogens in the hospital is very important for treatment. The recent study aims at identifying drug resistant pathogens and antibiotic resistance pattern in the intensive care units of a tertiary care hospital in Tehran. In other words, the main purpose of the recent study is understanding the degree to which the resistant bacteria, which cause nosocomial infections is spreading in the ICUs of a tertiary care hospital and to determine the antibiotic- resistance pattern of these bacteria in the ICUs of that hospital. The recent research is a retrospective and cross-sectional study that has been conducted on the files of all patients who were hospitalized in ICUs, internal surgery, and neurosurgery sections of Baqiyatallah Hospital in Tehran in a five-year period (March 2009 to February 2015) and who were diagnosed with nosocomial infection caused by resistant bacteria. According to the results of this research, most of the separated bacteria were: Acinetobacterbaumannii 39.45%, Pseudomonas aeruginosa 20.69% and the most common location for infection was respiratory tract (67.11%). Also the most common pathogen was Acinetobacterbaumannii which is resistant to most antibiotics.

IMPACT OF SOCIO-DEMOGRAPHIC VARIABLES AND MORBID CONDITIONS ON PERCEIVED MENTAL HEALTH COMPONENTS USING SF-36 QUESTIONNAIRE

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
S. K. Sharma ◽  
V. P. Shrotriya ◽  
D. Imtiaz ◽  
S. B. Gupta
Keyword(s):  
Mental Health ◽  
Diabetes Mellitus ◽  
Social Functioning ◽  
Tertiary Care ◽  
Perceived Health ◽  
Subjective Assessment ◽  
Care Hospital ◽  
Sf 36 ◽  
The Social ◽  
The Impact

<bold>Introduction:</bold> Perceived Health is a subjective assessment of the physical as well as mental health and includes so many aspects as mentioned in SF-36 form that are difficult to capture clinically such as incipient disease, physiological, psychological reserves and social functions. To assess the impact of Diabetes Mellitus, Hypertension and other socio-demographic factors on the Social Functioning component of mental health of the patients attending a tertiary care hospital in Bareilly. <bold>Material and Methods:</bold> Perceived health status of the patients was assessed by the Social Functioning dimension of the Mental Component Summary (MCS) using the SF-36 form. <bold>Results:</bold> The presence of both Diabetes Mellitus and Hypertension was associated with lower Social Functioning scores compared to those with diabetes (p = 0.013) and hypertension alone. Age was negatively related with Social Functioning scores (p<0.001) but male gender (p>0.000) and higher income (p<0.424) were all associated with higher Social Functioning scores. Rural subjects were found to have better SF score compared to urban. <bold>Conclusion:</bold> Age, gender and morbidity was found to have profound influence on Social Functioning scoring of the subjects. However, the results should be interpreted in terms of the study’s limitations.

scholarly journals The Prevalence and Antimicrobial Susceptibility Pattern of Gram-Positive Pathogens: Three-Year Study at a Private Tertiary Care Hospital in Mumbai, India

2021 ◽  
Author(s):  
Sweta Shah ◽  
Ritika Rampal ◽  
Pooja Thakkar ◽  
Sushima Poojary ◽  
Shweta Ladi
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Steady Increase ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Gram Positive ◽  
Tract Infections

Abstract Introduction The growing resistance pattern of the gram-positive pathogens along with a steady increase in minimum inhibitory concentration of the currently available antibiotics have led to an increase in morbidity and mortality rates in India. This study aims to access the shifting antibiotic susceptibility paradigm of the gram-positive pathogens in various infections at a tertiary care center. Methods This is a 3-year retrospective observational study which was performed from January 2016 to December 2018 at a tertiary care hospital in Mumbai. All clinically significant gram-positive cocci isolated from a variety of clinical specimens were studied for their prevalence and antimicrobial susceptibility. Results Out of 4,428 gram-positive isolates, Staphylococcus aureus (35.3%) was the commonly encountered pathogen, followed by Enterococcus spp. (32.1%) and coagulase-negative Staphylococcus (CoNS) (25.7%). S. aureus was majorly isolated from skin and soft tissue infections (60.3%), followed by patients with respiratory tract infections (18.2%) and blood stream infections (13%). Among S. aureus, particularly methicillin-resistant S.aureus (MRSA), prevalence increased from 29.5% in 2016 to 35.1% in 2018, with an overall prevalence of 33.6%. All S. aureus isolates were 100% sensitive toward vancomycin, linezolid, tigecycline, and teicoplanin. However, the CoNS isolates showed a higher resistance rate with reduced susceptibility toward linezolid and teicoplanin. High prevalence of resistance was observed across gram-positive isolates with commonly used antibiotics such as ciprofloxacin, levofloxacin, and erythromycin. While the prevalence of linezolid-resistant enterococcus (LRE) was 3.6%, vancomycin (VRE) and teicoplanin resistance among the enterococcus species was as high as 7.7% and 7.5%, respectively. Conclusion Rising methicillin resistance among the Staphylococcal species (MRSA and MR-CoNS) along with reduced susceptibility toward currently available anti-MRSA agents is a matter of serious concern as it limits the therapeutic options for treating multidrug resistant (MDR) gram-positive infections.

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