scholarly journals 2018-2019 Antimicrobial Resistance Pattern in Bacterial Pneumonia at Dr. Soedarsono Hospital Pasuruan

2020 ◽  
Vol 2 (1) ◽  
pp. 41-48
Author(s):  
Felicia Susanto ◽  
◽  
Catur Purnamawati ◽  
Devvi Riasari ◽  
◽  
...  

Pneumonia is the ninth most common disease in dr. Soedarsono Pasuruan Region General Hospital. The resistance of Klebsiella pneumoniae to third-generation Cephalosporins and Streptococcus pneumonia to Penicillin were the topics discussed on World Health Organization’s (WHO) global report for antimicrobial resistance. This study purpose is to analyze the microbial pattern and antimicrobial resistance of bacterial pneumonia from sputum culture. This is a descriptive retrospective study with a total of 59 requests for sputum culture which included a clinical diagnosis of pneumonia. There are 37 male (63%) and 22 female (37%) with the most age group was adult (18-59 years) 39 people (66%) included in this study. Gram-negative bacteria are more common as the cause of pneumonia than gram-positive. Gram-negative bacteria that caused pneumonia in this study are Klebsiella pneumoniae (25.4%), Acinetobacter baumannii (15.3%), dan Enterobacter cloacae complex (15.3%). Gram-positive are Staphylococcus haemolyticus (11.9%), Staphylococcus aureus (8.5%), and Staphylococcus epidermidis (8.5%). The most antimicrobial resistance in gram-negative bacteria is Ampicillin (94.3%) and gram-positive bacteria are Benzylpenicillin (94.1%). The number resistance of Penicillin in gram-negative and gram-positive was high; therefore empirical therapy for pneumonia still uses broad-spectrum antimicrobial like beta-lactam.

2020 ◽  
Author(s):  
Nusrat Abedin ◽  
Abdullah Hamed A Alshehri ◽  
Ali M A Almughrbi ◽  
Olivia Moore ◽  
Sheikh Alyza ◽  
...  

Antimicrobial resistance (AMR) has become one of the more serious threats to the global health. The emergence of bacteria resistant to antimicrobial substances decreases the potencies of current antibiotics. Consequently, there is an urgent and growing need for the developing of new classes of antibiotics. Three prepared novel iron complexes have a broad-spectrum antimicrobial activity with minimum bactericidal concentration (MBC) values ranging from 3.5 to 10 mM and 3.5 to 40 mM against Gram-positive and Gram-negative bacteria with antimicrobial resistance phenotype, respectively. Time-kill studies and quantification of the extracellular DNA confirmed the bacteriolytic mode of action of the iron-halide compounds. Additionally, the novel complexes showed significant antibiofilm activity against the tested pathogenic bacterial strains at concentrations lower than the MBC. The cytotoxic effect of the complexes on different mammalian cell lines show sub-cytotoxic values at concentrations lower than the minimum bactericidal concentrations.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yasmine H. Tartor ◽  
Norhan K. Abd El-Aziz ◽  
Rasha M. A. Gharieb ◽  
Hend M. El Damaty ◽  
Shymaa Enany ◽  
...  

Antimicrobial resistance is a major concern in the dairy industry. This study investigated the prevalence, antimicrobial resistance phenotypes, and genome sequencing of Gram-negative bacteria isolated from clinical (n = 350) and subclinical (n = 95) bovine mastitis, and raw unpasteurized milk (n = 125). Klebsiella pneumoniae, Aeromonas hydrophila, Enterobacter cloacae (100% each), Escherichia coli (87.78%), and Proteus mirabilis (69.7%) were the most prevalent multidrug-resistant (MDR) species. Extensive drug-resistance (XDR) phenotype was found in P. mirabilis (30.30%) and E. coli (3.33%) isolates. Ten isolates (four E. coli, three Klebsiella species and three P. mirabilis) that displayed the highest multiple antibiotic resistance (MAR) indices (0.54–0.83), were exposed to whole-genome sequencing (WGS). Two multilocus sequence types (MLST): ST2165 and ST7624 were identified among the sequenced E. coli isolates. Three E. coli isolates (two from clinical mastitis and one from raw milk) belonging to ST2165 showed similar profile of plasmid replicon types: IncFIA, IncFIB, IncFII, and IncQ1 with an exception to an isolate that contained IncR, whereas E. coli ST7624 showed a different plasmid profile including IncHI2, IncHI2A, IncI1α, and IncFII replicon types. ResFinder findings revealed the presence of plasmid-mediated colistin mcr-10 and fosfomycin fosA5 resistance genes in a K. pneumoniae (K1) isolate from bovine milk. Sequence analysis of the reconstructed mcr-10 plasmid from WGS of K1 isolate, showed that mcr-10 gene was bracketed by xerC and insertion sequence IS26 on an IncFIB plasmid. Phylogenetic analysis revealed that K1 isolate existed in a clade including mcr-10-harboring isolates from human and environment with different STs and countries [United Kingdom (ST788), Australia (ST323), Malawi (ST2144), Myanmar (ST705), and Laos (ST2355)]. This study reports the first emergence of K. pneumoniae co-harboring mcr-10 and fosA5 genes from bovine milk in the Middle East, which constitutes a public health threat and heralds the penetration of the last-resort antibiotics. Hence, prudent use of antibiotics in both humans and animals and antimicrobial surveillance plans are urgently required.


2019 ◽  
Vol 6 ◽  
pp. 89-95
Author(s):  
Neha Gautam ◽  
Rojan Poudel ◽  
Binod Lekhak ◽  
Milan Kumar Upreti

Objectives: This research aims to study the microbial quality of chicken meat available in retail shop of Kathmandu Valley. Methods:  This Study was conducted from June to December 2018 in three different districts of Kathmandu Valley. Samples were collected in sterile plastic bags, labeled properly and stored in an icebox and transported to the Food Microbiology laboratory of Golden Gate International College.  During sample preparation, 25 grams of each sample was taken and transferred to sterile flasks containing 225 ml of buffered peptone water. Potential pathogenic Gram-negative bacteria were isolated by using respective selective media and identified by biochemical test. Antibiotic susceptibility profile of isolates was carried out by Kirby-Bauer disc diffusion method according to CLSI 2017 guideline. Results: Of total 81 chicken meat samples processed; 201 Gram negative bacteria were isolated.  E. coli (100%) was the dominant Gram-negative isolates, followed by Citrobacter spp (62.96%), Pseudomonas spp (40.74%), Proteus spp (19.75%), Salmonella spp (16.04%) and Klebsiella spp (8.64%) respectively. No any multidrug isolates were detected. Conclusion: The study showed that the raw chicken meat samples of Kathmandu valley was highly contaminated with Gram negative potential pathogenic bacteria. Antimicrobial resistance pattern shown by the isolates may indicates that there is not overuse of drug in animals and the less chance of risk of increasing antimicrobial resistance.


2020 ◽  
Vol 64 (10) ◽  
Author(s):  
Po-Yu Liu ◽  
Yu-Lin Lee ◽  
Min-Chi Lu ◽  
Pei-Lan Shao ◽  
Po-Liang Lu ◽  
...  

ABSTRACT A multicenter collection of bacteremic isolates of Escherichia coli (n = 423), Klebsiella pneumoniae (n = 372), Pseudomonas aeruginosa (n = 300), and Acinetobacter baumannii complex (n = 199) was analyzed for susceptibility. Xpert Carba-R assay and sequencing for mcr genes were performed for carbapenem- or colistin-resistant isolates. Nineteen (67.8%) carbapenem-resistant K. pneumoniae (n = 28) and one (20%) carbapenem-resistant E. coli (n = 5) isolate harbored blaKPC (n = 17), blaOXA-48 (n = 2), and blaVIM (n = 1) genes.


2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S59-S60 ◽  
Author(s):  
Niyousha Naderi ◽  
Armin Safdarpour ◽  
Mojdeh Hakemi-Vala ◽  
Hossein Masoomi

Abstract Introduction Burn wound infections are one of the major causes for long-term hospitalization and mortality among patients with thermal injuries. Identifying the bacterial cause of infection and determining the appropriate antibiotic to treat these infections is an important stage in treatment. The aim of this study was to investigate antimicrobial drug resistance in non-fermenting gram-negative bacteria isolated from burn wounds in patients who were admitted to a tertiary burn center. Methods In this prospective study during a six-month period in 2018,100 isolates of non-fermenting gram-negative bacteria were collected from 100 patients with thermal injuries. Antibiotic susceptibility test was performed using the Kirby-Bauer method based on the clinical and laboratory standards institute guidelines. Double-disc synergy test, a phenotypic method, was used to identify strains producing extended-spectrum beta-lactamase (ESBL). Data analyses were performed using SPSS. Results A total of 100 wound samples were examined from 100 patients, 76% were male and 24% were female with a mean age of 33 years (range 1–89 years old). Mean total body surface area burned was 35% (range 1–95%) and mean length of hospital stay was 24 days (range 3–69 days). Eighty five percent of cases were under 50 years old. Overall mortality rate in this study was 17%. The major causes of burn were liquefied natural gas tank explosion (35%) and scalds (19%). Acinetobacter baumannii (A.baumannii) was the most common pathogen followed by Pseudomonas aeruginosa (P.aeruginosa) (60% and 40%, respectively). ESBL producing rate was significantly higher in P.aeruginosa isolates (27.5%) than A.baumannii isolates (3.3%) (P-value < 0.001). Antibiotic resistance pattern of P.aeruginosa showed the highest resistance to ciprofloxacin, amikacin and imipenem (95%), followed by gentamicin (92.9%),ceftazidime(87.50) and piperacillin-tazobactam(85%). Antibiotic resistance pattern of A.baumannii showed the highest resistance to ceftazidime(100%) followed by ciprofloxacin, amikacin, imipenem(98.3%), gentamicin and piperacillin-tazobactam (93.3%). Multiple drug resistance (MDR) rate among A.baumannii and P.aeruginosa was 98.3% and 92.5% respectively, which is higher than previous reports. Conclusions A.baumannii and P.aeruginosa were the most common pathogens identified in this cohort with a significant MDR rate (over 95%). New strategies to control expansion of antimicrobial resistance in burn centers are necessary. Applicability of Research to Practice This study shows the antimicrobial resistance pattern and prevalence of ESBL in burn wounds indicating that further studies requires to identify new strategies to control emerging antimicrobial resistance in burn centers.


Author(s):  
Sotianingsih Sotianingsih ◽  
Samsirun H. ◽  
Lipinwati Lipinwati

Pneumonia is defined as an inflammation of the lungs caused by microorganisms (bacteria, viruses, fungi, parasites). This research aimed to determine the pneumonia-causing bacteria along with the sensitivity and the antibiotic resistance test. This research was a descriptive study with samples of ICU pneumonia patients at Raden Mattaher Regional Hospital during the study period. All samples were consecutively selected. Samples for blood culture were incubated in the BactAlert device, whereas the sensitivity test was then performed using Vitex instruments. Sputum was previously enriched with BHI media and then cultured on culture media, and sensitivity test with the Vitex instruments was carried out. Of the 354 ICU patients during the study period, 30 patients (11.8%) had pneumonia, but only 19 patients could undergo sputum culture. Five of 19 patients were infected with Gram-positive bacteria, and 14 patients were infected with Gram-negative bacteria. The most commonly found bacteria were Klebsiella pneumonia (36.84%), followed by Acinetobacter baumanii (21.05%) and Pseudomonas aeruginosa (10.53%). Gram-negative bacteria obtained from sputum culture in this study were resistant to almost all antibiotic groups, especially penicillin, cephalosporin, quinolone, and tetracycline groups. Gram-positive bacteria obtained from sputum culture in this study were resistant to the penicillin antibiotic. The most commonly found bacteria were Klebsiella pneumonia (36.84%), followed by Acinetobacter baumanii (21.05%) and Pseudomonas aeruginosa (10.53%). The bacteria cultured from the sputum showed multidrug resistance mainly to the penicillin and cephalosporin antibiotic. This research data can be used to consider the treatment of pneumonia patients to decide more appropriate therapy.


2016 ◽  
Vol 9 (3) ◽  
pp. 73 ◽  
Author(s):  
Vahid Boostani ◽  
Farzaneh Dehghan ◽  
Afsaneh Karmostaji ◽  
Nader Zolghadri ◽  
Afsaneh Shafii

<p>Hospital-acquired bacterial pneumonia (HABP) is one of the most important causes of morbidity, mortality and economic problems especially for patients admitted in the intensive care unit (ICU) ward. The aim of this study was to determine the incidence of nosocomial pneumonia in ICU, identify the causative bacteria and their resistance profiles. This cross sectional study was performed on 214 patients who were admitted in the ICU ward of a general hospital requiring mechanical ventilation for at least 48 h. Identification of HABP was based on the clinical signs manifested 48 h or more after admission, new chest X-ray infiltrates and microbiologic examination of endo tracheal secretion. Data were analyzed using SPSS 21 to perform the descriptive statistics. The isolated gram negative bacteria were <em>Klebsiella pneumoniae</em> (50%), <em>Staphylococcus aureus</em> (18.7%), <em>Acinetobacter baumannii</em> (12.5%), <em>Escherichia coli</em> (12.5%) and <em>Pseudomonas aeroginosa</em> (6.3%). The maximum antimicrobial resistance of gram negative bacteria was to Cefazolin (100%) and Ampicillin (84.6%), while antimicrobial resistance to Clindamycin, Azithromycin, Amoxycillin+clavulanate, Trimethoprim+sulfamethoxazole and Ciprofloxacin was 33.3%. No resistance was seen towards carbapenems.The most frequent gram negative isolated bacterium was <em>K. pneumoniae, </em>and maximum antimicrobial resistance rate was observed for Cefazolin and Ampicillin, which is due to betalactamase production.</p>


2018 ◽  
Author(s):  
Stephen Kasenda ◽  
Donnie Mategula ◽  
Geoffrey Elihu Manda ◽  
Tilinde Keith Chokotho

ABSTRACTIntroductionInfections are responsible for up to 85% of deaths in patients with burn injuries. Proper management of infections in patients with burns requires knowledge of local microbial landscape and antimicrobial resistance patterns. Most burns units in low to middle income countries lack this data to guide patient management.Methods and resultsWe conducted a retrospective audit of adult (≥17 years) patient records admitted between at 1st June 2007 and May 2017 at Queen Elizabeth Central Hospital Burns unit in Blantyre Malawi with an index complaint of burn injury. Descriptive statistical analysis was performed to determine antibiotic prescription patterns, microbial isolates and antimicrobial resistance patterns on the 500 patient files that met the inclusion criteria. Cephalosporin’s and Penicillin’s constituted 72.3% of the 328 antibiotic prescriptions given to 212 patients and 84% of all prescriptions were potentially inappropriate. A total of 102 bacterial isolates were identified and a majority (30.4%; n=31) were resistant to Aminoglycosides and Aminocyclitols (23.5%; n=24); seconded by Penicillin’s at 19.6% (n=20). Pseudomonas, staphylococcus and streptococcus species constituted 36.1%, 25% and 16.7% of all resistant bacteria that were isolated and they were thus the most common bacterial isolates. Drug resistance was more common among gram negative bacteria (48.8% versus 26.2%) and a greater proportion of patients (74.1%) that had antibiotic sensitivity testing were affected by drug resistant gram negative bacteria which appear on the World Health Organisation list of priority pathogens.ConclusionThe results of our preliminary study point towards nosocomial gram negative bacteria which appear on the World Health Organisations list of priority pathogens as the more common sources of antibiotic resistance. This scenario is potentially driven by inappropriate antibiotic prescriptions as well as clinical and laboratory diagnostic imprecision in addition to the universally recognised post burn pathophysiological changes of hypermetabolism and immunosuppression. Improvements in the areas of antimicrobial stewardship, diagnostic capacity and burns related research are needed in order to achieve optimal therapeutic outcomes and resource utilisation.


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