scholarly journals MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

2017 ◽  
Vol 10 (6) ◽  
pp. 78
Author(s):  
Bhuvaneshwari Gunasekar
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Multiple Antibiotic Resistance ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Mar Index ◽  
Surgery Department

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of  surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

scholarly journals Gram-negative bacilli causing infections in an intensive care unit of a tertiary care hospital in Istanbul, Turkey

2014 ◽  
Vol 8 (05) ◽  
pp. 597-604 ◽  
Author(s):  
Seniha Senbayrak Akcay ◽  
Asuman Inan ◽  
Simin Cevan ◽  
Ayse Nilufer Ozaydın ◽  
Naz Cobanoglu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Chi Square ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
E Coli

Introduction: This study aimed to demonstrate the changing epidemiology of infecting microorganisms and their long-term resistance profiles and to describe the microbiological point of view in anti-infective management of intensive care unit (ICU) patients. Methodology: A total of 5,690 isolates of Gram-negative bacilli were included in this study. Antibiotic susceptibility was tested using the disk diffusion method and Vitek 2 system. Chi-square tests were used for hypothesis testing. Results: The most frequently isolated organisms were A. baumannii (37.3%), P. aeruginosa (30.3%), Enterobacter spp. (10.4%), E. coli (10.4%), and Klebsiella spp. (8.9%). A. baumannii was the most frequently isolated organism from the respiratory tract (43.4%); the susceptibility rates for imipenem and meropenem decreased to 7% and 6% (p < 0.0001), respectively. The percentage of multidrug-resistant (MDR) A. baumannii isolates continuously increased from 18.7% in 2004 to 69% in 2011 (p < 0.0001), whereas MDR P. aeruginosa isolates increased from 1.5% to 22% (p < 0.0001). Carbapenem-resistant Klebsiella isolates emerged in 2010 and increased to 20% in the next year. The rates of ESBL-producing Enterobacteriaceae in the ICU was very high in 2011 – 50% for E. coli and 80% for Klebsiella strains. Conclusion: The most common isolated Gram-negative bacillus in our study was A. baumannii and that the prevalence of MDR isolates has increased markedly over. Accordingly, the comparison of antibiotic resistance of other pathogens in 2004 and 2011 displayed an increasing trend. These data imply the urgent need for new and effective strategies in our hospital and in the region.

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 Epidemiology and Resistance Levels of Enterobacteriaceae Isolates from Urinary Tract Infections Expressed as Multiple Antibiotic Resistance (MAR) Indices

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Márió Gajdács
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Urine Samples ◽  
Diffusion Method ◽  
Care Hospital ◽  
Multiple Antibiotic Resistance ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Aims: To assess the epidemiology of UTIs affecting inpatients and outpatients and the antibiotic resistance levels, expressed as multiple antibiotic resistance (MAR) indices from the isolated species at a tertiary-care hospital in Hungary, during a 10-year study period. Study Design: Retrospective microbiological study. Place and Duration of Study: 1st of January 2008 - 31st of December 2017 at the University of Szeged, which is affiliated with the Albert Szent-Györgyi Clinical Center, a primary- and tertiary-care teaching hospital in the Southern Great Plain of Hungary. Methodology: Antimicrobial susceptibility testing (AST) was performed using disk diffusion method and when appropriate, E-tests on Mueller–Hinton agar (MHA) plates. The multiple antibiotic resistance (MAR) index of the isolates was determined. Results: During the 10-year study period, the Institute of Clinical Microbiology received 21,150 urine samples from outpatient clinics and 19,325 samples from inpatient departments that turned out to be positive for a significant urinary pathogen. Out of the positive urine samples, E. coli represented the overwhelming majority of all positive urine samples. The resistance levels in inpatient isolates were higher than in the outpatient isolates (average MAR indices: 0.347 vs. 0.410, 0.267 vs. 0.435 and 0.318 vs. 0.473 for the E. coli/Klebsiella, CES and Proteae group, respectively). Conclusion: As the therapeutic options are becoming increasingly limited in the current antibiotic resistance climate, more effort should be put into the prudent use of antibiotics and the development of novel antimicrobial agents.

#3: Gram-Negative Antibacterial Resistance Prevalence at a Tertiary Care Hospital in Central America

2021 ◽  
Vol 10 (Supplement_2) ◽  
pp. S16-S17
Author(s):  
Keerti Dantuluri ◽  
Jeanne Forrester ◽  
Lisette Castro Benincasa ◽  
Sofia Posadas ◽  
Fabiola Quiñónez ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Central America ◽  
Clinical Care ◽  
National Laboratory ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Diffusion Method ◽  
Care Hospital ◽  
Drug Resistant ◽  
Gram Negative

Abstract Background Latin America has some of the highest rates of multi-drug resistant gram-negative bacteria worldwide. However, local surveillance registries to compare rates of resistance among countries are lacking, particularly in Central America. Awareness of local resistance patterns in this region is critical to improve antibiotic use and patient outcomes. We sought to measure the prevalence of resistant gram-negative bacilli (GNB) at a tertiary hospital in Guatemala. Methods We retrospectively conducted a single-center study to measure the percentage of GNB that were non-susceptible to various antibiotics between April and October of 2017. All cultures (blood, urine, cerebrospinal fluid, and other body fluids) were collected as part of routine clinical care during the study period. Duplicate isolates, defined as multiple specimens with the same organism from the same patient, were excluded. Antibiotic susceptibility testing was performed by disk diffusion method. Bacterial isolates were categorized as susceptible, intermediate, or resistant based upon the Clinical Laboratory Standard Institute 27th edition per guidance from the National Laboratory of Guatemala. Results A total of 969 unique gram-negative isolates from 818 patients were included. Urine was the most common culture type. The most frequently isolated bacteria were Escherichia coli and Klebsiella species. The percentage of GNB which were non-susceptible to individual antibiotics are detailed in Table 1. Of the isolates tested, 12 – 66% of GNB were non-susceptible to cephalosporins, 7 – 31% were non-susceptible to carbapenems, and 14 – 44% were non-susceptible to fluroquinolones. Conclusions The prevalence of multi-drug resistant GNB is high in Escuintla, Guatemala. Continued surveillance is vital to guide judicious and appropriate empiric antibiotic use in the setting of rising rates of antibiotic resistance. Local and regional resistance rates are known to vary, underlying the importance of developing more regional and national antibiotic resistance surveillance networks within Guatemala and other countries in Central America where there is a paucity of data.

scholarly journals 99. Effectiveness of Antibiotic Prophylaxis Among Patients Undergoing Elective Transurethral Resection of the Prostate in the Era of Antibiotic Resistance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S179-S180
Author(s):  
Thana Khawcharoenporn ◽  
Pimjira Kanoktipakorn
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Prophylactic Antibiotics ◽  
Care Hospital ◽  
Extended Spectrum Beta Lactamase ◽  
Observational Cohort

Abstract Background Data existing on effectiveness of antibiotic prophylaxis (AP) for transurethral resection of the prostate (TURP) are limited in the era of antibiotic resistance. Methods A 4-year prospective observational cohort study was conducted among patients undergoing TURP in an academic tertiary-care hospital during 2016–2019. Patients were excluded if pre-operative (pre-op) urine cultures were not sent or grew mixed (&gt;2) organisms, or they had pre-op urinary tract infection (UTI) or lost follow-up after TURP. Appropriateness of AP was defined as 1) correct dosing and duration and narrowest spectrum according to the hospital AP guidelines and local epidemiology and 2) being active against uropathogens isolated from the pre-op culture. Primary outcome was the rate of UTI within 30 days post TURP compared between appropriate antibiotic prophylaxis (AAP) and inappropriate antibiotic prophylaxis (IAP) groups. Results 342 patients were screened and 61 were excluded. Of the 281 patients included, 139 (49%) received AAP and 142 (51%) received IAP. The reasons for IAP were prescribing too broad-spectrum antibiotics (57%), inactive antibiotics (41%) and incorrect dosing (2%). Pre-op urine cultures were no growth in 148 patients (53%). Among the 133 positive urine cultures with 144 isolates, Escherichia coli (52%) was the most commonly isolated. Thirty-one percent of these 144 isolates produced extended-spectrum beta-lactamase (ESBL) and 23 (16%) isolates were multidrug-resistant. The resistant rates of Enterobacteriaceae were 73% for ciprofloxacin, 65% for TMP-SMX and 46% for ceftriaxone. The two most commonly prescribed prophylactic antibiotics were ceftriaxone (51%) and ciprofloxacin (34%). The rate of UTI within 30 days post-TURP was significantly higher in IAP group compared to AAP group (47% vs 27%; P&lt; 0.001). Prescribing inactive prophylactic antibiotics was the independent factor associated with 30-day post-TURP UTI (adjusted odds ratio 2.88; P=0.001). Conclusion Appropriate antibiotic prophylaxis significantly reduced UTI within 30 days of elective TURP. Obtaining pre-op urine culture and prescribing an active prophylactic agent are critical for preventing post-TURP UTI in the era of antibiotic resistance. Disclosures All Authors: No reported disclosures

scholarly journals Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Confirmatory Test ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile. Methods A cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers. Conclusion Multidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

AEROBIC BACTERIOLOGICAL PROFILE WITH ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF PUS SAMPLES AT A TERTIARY CARE HOSPITAL IN JAIPUR

2021 ◽  
pp. 65-67
Author(s):  
Hemendra K Sharma ◽  
Niketa Gupta ◽  
Mahesh Yadav ◽  
Aruna Vyas ◽  
Rajni Sharma
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Gram Negative ◽  
Inappropriate Use ◽  
Antimicrobial Susceptibility Pattern

Background: Pyogenic infections can be caused by various microorganisms and may co-exist as poly microbial infections which require antibiotic therapy. The inappropriate use of antibiotics has led to major problems of MDRO's contributing to morbidity and mortality. Even though the bacteriological prole of pus samples in many studies remain the same, antimicrobial susceptibility pattern of these isolates has shown a lot of variation. This study was conducted to assess bacteriological prole of pus samples and their antimicrobial susceptibility pattern Materials and Methods:Aretrospective study was carried out from April to June 2021. 540 pus culture aerobic bacterial isolates were included. The samples were cultured on Blood and MacConkey agar. After aerobic incubation at 37oC for 18-24 hrs, organisms were identied by conventional bacteriology methods as per laboratory protocol and antimicrobial susceptibility was tested by Kirby Bauer disc diffusion method as per CLSI 2020 guideline. Results: Out of 540 pus isolates , 452(83.7%)were gram negative bacili and 88(16.3%) were gram positive cocci Pseudomonas spp. 173(31.9%), was most common gram negative isolate while S.. aureus 66(12.19%) was most common Gram positive isolate. Most of gram negative isolates were susceptible to Imipenem and Polymyxin and gram positive isolates to vancomycin and linezolid . Conclusion: To combat resistance irrational use of antibiotics should be avoided. Also regular surveillance helps in implementing better therapeutic strategies to reduce morbidity and mortality

scholarly journals TO STUDY ANTIBIOTIC SENSITIVITY PATTERN OF NONFERMENTATIVE GRAM NEGATIVE BACILLI FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL, JAIPUR.

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Kirti Hemwani ◽  
P. S. Nirwan ◽  
Preeti Shrivastava ◽  
Abhiraj Ramchandani
Keyword(s):  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Polymyxin B ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Pathogenic Potential ◽  
Gram Negative ◽  
Sensitivity Pattern

Background: Nonfermentative gram negative bacilli (NFGNB) frequently considered as commensals or contaminants but the pathogenic potential of nonfermenters has been proved beyond doubt. They are resistant to commonly used antimicrobials. Aim: This study was undertaken to identify the nonfermenters isolated from various clinical samples and to know their Antibiotic sensitivity pattern. Materials and Methods: The present study was carried out on 150 strains of Nonfermenters isolated from 1200 various non repetitive clinical samples received in Department of Microbiology, NIMS Jaipur. Nonfermenters were identified using a standard protocol and their antibiotic susceptibility testing was performed with the help of the modified Bauer disc diffusion method. Results: Out of 150 nonfermenters isolated, Pseudomonas aeruginosa was the most common isolate 134 (89.33%) followed by Acinetobacter baumannii 16 (10.67%). Among all clinical samples Pus and Wound Discharge yield maximum isolates of NFGNB i.e. 54 (36%) % followed by sputum (39.0%). Most sensitive drug against NFGNB was Polymyxin-B (100%) followed by Imipenem (86 %) and Amikacin (71.33 %). Conclusion: Nonfermenters have a great potential to survive in a hospital environment so implementation of antibiotic stewardship programs and strict infection control practices will be required to prevent or slow down their emergence and spread. Keywords:  Nonfermenters,  Polymyxin-B, Pseudomonas, Acinetobacter.

Antibiotic Resistance of Enterobacteriaceae Isolated from Fresh Fruits and Vegetables and Characterization of their AmpC β-Lactamases

2019 ◽  
Vol 82 (11) ◽  
pp. 1857-1863 ◽  
Author(s):  
ZAHRA S. AL-KHAROUSI ◽  
NEJIB GUIZANI ◽  
ABDULLAH M. AL-SADI ◽  
ISMAIL M. AL-BULUSHI
Keyword(s):  
Antibiotic Resistance ◽  
Fruits And Vegetables ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Disk Diffusion Method ◽  
Antibiotic Resistant ◽  
Amoxicillin Clavulanic Acid ◽  
Clinically Significant ◽  
Enterobacter Asburiae

ABSTRACT Enterobacteria may gain antibiotic resistance and be potent pathogens wherever they are present, including in fresh fruits and vegetables. This study tested the antibiotic resistance of enterobacteria isolated from 13 types of local and imported fresh fruits and vegetables (n = 105), using the standard Kirby-Bauer disk diffusion method. Phenotypic and genotypic characterizations of AmpC β-lactamases were determined in cefoxitin-resistant isolates. Ten percent of the enterobacteria tested (n = 88) were pansusceptible, 74% were resistant to at least one antibiotic, and 16% were multidrug resistant. Enterobacteria isolates showed the highest antibiotic resistance against ampicillin (66%), cephalothin (57%), amoxicillin–clavulanic acid (33%), cefoxitin (31%), tetracycline (9%), nalidixic acid (7%), trimethoprim (6%), and kanamycin (5%). Three isolates showed intermediate resistance to the clinically important antibiotic imipenem. Escherichia coli isolated from lettuce exhibited multidrug resistance against five antibiotics. Fifteen isolates were confirmed to have AmpC β-lactamase, using the inhibitor-based test and the antagonism test; the latter test confirmed that the enzyme was an inducible type. Four types of ampC β-lactamase genes (CIT, EBC, FOX, and MOX) were detected in eight isolates: four Enterobacter cloacae isolates and one isolate each of Citrobacter freundii, Enterobacter asburiae, Enterobacter hormaechei, and Enterobacter ludwigii. It was concluded that fresh fruits and vegetables might play a role as a source or vehicle for transferring antibiotic-resistant bacteria that might spread to other countries through exportation. The clinically significant AmpC β-lactamase was rarely documented in the literature on bacteria isolated from fruits and vegetables, and to our knowledge, this is the first report on the detection of an inducible type in such commodities.

scholarly journals “ISOLATION AND CHARACTERIZATION OF LACTOSE AND NON- LACTOSE FERMENTING BACTERIA FROM TERTIARY CARE HOSPITAL AND THEIR ANTIMICROBIAL SUSCEPTIBILITY TEST”

2017 ◽  
Vol 10 (2) ◽  
pp. 201
Author(s):  
Kumud Bala ◽  
Ridhima Wadhwa ◽  
Rachana Bohra
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Susceptibility Test ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Gram Negative ◽  
Fermenting Bacteria ◽  
Vitek 2

Objective: The purpose of the present study was to identify the fermenting and non-fermenting gram negative bacteria from the tertiary care hospital.Methods: The conventional method of identification by biochemical analysis and antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method. Furthermore, analysis of microbes was done by Vitek-2.Results: 424strains of lactose fermenting and non-lactose fermenting gram negative bacilli were isolated from 3097 clinical samples. From the total lactose fermenting bacteria Escherichia coli was the predominant isolate accounting for 50.94% specimens, followed by Klebsiella pneumonia 27.59% and Enterobacter 0.47%. From the total non-lactose fermenting gram negative bacilli Acinetobacter baumannii was the predominant isolate accounting for 12.73% specimens followed by Pseudomonas aeroginosa 6.13%, other isolates were Stenotrophomonas maltophilia 1.17% , Burkholderia cepacia 0.94%. In the present study male were more infected than female. The study also showed that lactose fermenting bacteria were more infectious than non lactose-fermenting bacteria and isolates were from urine samples.Conclusion: Both Non-Lactose Fermenting Gram Negative Bacilli and Lactose Fermenting Gram Negative Bacilli were found to be major contaminants, and are important pathogenic bacteria causing wide range of infections in the tertiary care hospital.Keywords: Lactose fermenting gram negative bacteria, Vitek-2, Tertiary Care Hospital, Kirby-Bauer Disc Diffusion, Lactose non-fermenting gram negative bacteria  

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