scholarly journals ARBEKACIN – A RAY OF HOPE TO FIGHT AGAINST MDR AND XDR GRAM-NEGATIVE BACTERIA IN A SCIENTIFIC AND COST-EFFECTIVE WAY IN INDIAN SCENARIO

Author(s):  
SOMA SARKAR ◽  
DIPANKAR SARKAR ◽  
ANJUM NAMHATA ◽  
MANIDEEPA SENGUPTA

Objective: The objective of the study was to see the in vitro activity of arbekacin, a novel aminoglycoside, against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacilli (GNB) so that it can become a good alternative as empirical treatment for severe sepsis. Methods: Identification and antibiotic sensitivity testing of the GNB isolated from the clinical samples were done using the VITEK-II system in a tertiary care hospital, Kolkata. MDR and XDR strains were selected by their definitions and molecular characterization was done by multiplex polymerase chain reaction. The minimum inhibitory concentration (MIC) value of arbekacin was detected by the E-test strip and compared with other aminoglycosides. Results: A total of 140 drug-resistant strains including ESBL- and carbapenemase-producing GNB were selected for the study. Arbekacin showed reduced values of MIC50 and MIC90 compared to other aminoglycosides for most of the drug-resistant GNB. Conclusion: Hence, in this drug-resistant era, arbekacin with the advantage of a single daily dose can be used as an empirical choice in severe sepsis as monotherapy or in combination with other antibiotics such as colistin or polymyxin to fight against MDR and XDR bugs.

Author(s):  
Kirti Hemwani ◽  
P. S. Nirwan ◽  
Preeti Shrivastava ◽  
Abhiraj Ramchandani

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.


Author(s):  
Sumitra Kumari Sanju Pannu ◽  
Anjli Gupta Geeta Tinna ◽  
B.P. Sharma

This study was conducted with an objective to find the prevalence of extended spectrum betalactamase (ESBL) and metallo betalactamase (MBL) in Acinetobacter species. It was conducted in the Department of Microbiology, Sardar Patel Medical college, Bikaner from Feb 2018 to Feb.2019. in various clinical specimens including urine, pus, blood, vaginal swabs, respiratory samples, and various body fluids were processed Acinetobacter species isolates were identified by standard protocols. Antibiotic sensitivity testing for all isolates was done using Kirby-Bauer disc diffusion method. Disc potentiation test was performed to check ESBL and MBL production in these bacteria. Maximum ESBL and MBL positive isolates of Acinetobacter species were observed among E.T. tube samples. Early detection, stringent antibiotic policies, and compliance towards infection control practices are the best defenses against this organisms.


Author(s):  
Rohit Kumar ◽  
Jagarti . ◽  
Mrinmoy Sarma ◽  
Gautam Shalini

Background: The increasing frequency of MRSA infections and rapidly changing patterns in antimicrobial resistance, led to renewed interest in the usage of Macrolides-Lincosamide-Streptogramin B (MLSB) antibiotics to treat Staphylococcus aureus infection. Clindamycin is an important drug used in the treatment of MRSA and MSSA infection. The aim of this study was to determine inducible and constitutive clindamycin resistance among clinical isolates of Staphylococcus aureus by D-test.Methods: During a period of 6 months from July 2018 to December 2018, a total of 100 Staphylococcus aureus isolated from different clinical samples were subjected to routine antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Methicillin-resistance was determined by using the cefoxitin (30 µg) disc. Incidence of MLSBc and MLSBi in Staphylococcus aureus isolates by D-test as per CLSI guidelines.Results: Out of 100 isolates of Staphylococcus aureus obtained from 350 clinical samples, 70(70%) were found to be MRSA and 30(30%) were MSSA. Among 100 Staphylococcus aureus isolates, 40% isolates showed MLSBi resistance, 28% isolates showed MLSBc resistance, 6% isolates showed MS phenotype and 26% isolates showed Sensitive phenotype. MLSBc and MLSBi were found to be higher in MRSA as compared to MSSA (21%, 27% and 7%, 10% respectively). All clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing.Conclusions: Continuous surveillance of the MLSB resistance is important and required before the prescription of clindamycin to treat MRSA infections.


Author(s):  
Sreedevi Hanumantha ◽  
Deepti S. Patil ◽  
Trupti B. Naik ◽  
Vijaykumar Mane

Chronic dacryocystitis is an infection of the lacrimal sac and occurs due to obstruction of the nasolacrimal duct. It is an important cause of ocular morbidity in India. Objective: 1) To identify various species of aerobic bacteria causing chronic dacryocystitis 2) To determine the antibiotic sensitivity pattern of these bacterial species. At a tertiary care hospital in Belagavi, Karnataka, over two year period, a cross-sectional study was conducted among 60 patients suffering from chronic dacryocystitis. Samples obtained were subjected to microbiological culture and antibiotic sensitivity testing was done on identified isolates. Statistical analysis was done using Microsoft office excel 2010. The Maximum (31.67%) number of patients who belonged to the age group of 45-50 years Female were predominantly affected 50 (83.3%). Majority i.e. 53 (88.34%) had unilateral eye involvement. Of 67 samples collected 42 (62.68%) were culture positive. Gram-positive cocci (65.22%) were the predominant cause of bacterial infection than Gram-negative bacilli (34.78%). Among Gram-positive cocci, Staphylococcus aureus (30.43%) and Streptococcus pneumoniae (21.73%) and among Gram-negative bacilli. Pseudomonas aeruginosa and Klebsiella aerogenes (10.86% each) were the predominant isolates. The most effective antimicrobial agents for Gram-positive cocci were Gentamicin and Vancomycin (93.33% each) and for Gram-negative bacilli were Ticarcillin/Clavulanic acid (87.25%), Ticarcillin, Imipenem, and Ceftazidime/Clavulanic acid (81.25% each). The present study highlights the need for detection of specific etiological agents and their antibiotic sensitivity which will enable the clinician in efficient patient management and avoid irrational antibiotic use.


2021 ◽  
Vol 8 (3) ◽  
pp. 910
Author(s):  
Vijayakumar A. B. ◽  
Yerriswamy Parvatha Reddy ◽  
Suphala B. ◽  
Ananya Gopalakrishnan ◽  
Vinod Kumar C. S.

Background: Osteomyelitis has been continuing as the most important cause of morbidity among patients with bone infections. Constant change in the trend of organisms involved and resistance pattern has made management of osteomyelitis cases difficult. With this background present study aimed to look for the changing trends of microorganisms involved in osteomyelitis and their antimicrobial susceptibility pattern.  Methods: A total of 100 cases studied over a period of two years. Samples collected were processed by standard microbiological techniques and antimicrobial testing was done as per the clinical and laboratory Standards Institute guidelines. Results: Among 100 cases, 62 were males and 38 were females, with the mean age of all the patient was 51.6±12.32 years. 64% of the patient were diabetic patients. Long bones are most involved with trauma (45%) as risk factor. Staphylococcus aureus (24.2%) predominant pathogen isolated followed by Pseudomonas aeruginosa (21.2%) and Acinetobacter baumannii (16.7%). Antibiotic sensitivity testing of gram positive organisms showed hundred percent sensitivity to vancomycin and gram negative bacteria showed highest sensitivity to cefoperazone+sulbactam, piperacillin+tazobactam, meropenem and imipenem.  Conclusions: Osteomyelitis caused by methicillin resistant staphylococcus aureus and carbapenem resistance gram negative bacteria is a serious concern. Since multidrug resistant strains have emerged in osteomyelitis cases, emphasis should be given for hygiene and targeted antibiotherapy.   


2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai

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.


Author(s):  
Vijayashree V. ◽  
Saikeerthana D. ◽  
Prabha P.

Background: The genus Klebsiella of Enterobacteriaceae family is ubiquitous in nature. They cause many nosocomial infections like pneumonia, urinary tract infections, wound infections, bacteremia and septicemia. Multidrug resistance is seen in Klebsiella which serves as the most common cause of increased morbidity and mortality. This study reveals the prevalence and antibiotic sensitivity pattern of Klebsiella species from various clinical samples. The primary objectives are as follows: To isolate and characterize Klebsiella species from various clinical samples. To study the antibiotic susceptibility pattern of Klebsiella isolates.Methods: This prospective study was conducted in our tertiary care hospital during the period from August 2019 to October 2019. A total of 3521 samples were tested during this period. The samples include blood, sputum, urine, and pus.Results: Out of the total samples tested,1106 samples were showing the growth of the organisms. Among this,351 were identified as Klebsiella species and the highest rate of isolation of Klebsiella species is from the sputum sample and also the same was reported high in medical wards. The study also shows that the isolation of Klebsiella species shows male preponderance when compared to females. The antibiotic sensitivity pattern was done by Kirby-Bauer's disc diffusion method and the sensitivity was noted to be higher to amikacin and ciprofloxacin.Conclusions: Thus, this study shows the prevalence rate of Klebsiella species and sensitivity pattern of Klebsiella, which may help select appropriate antibiotics and prevent overuse and misuse of antibiotics.


2015 ◽  
Vol 3 (2) ◽  
pp. 101-105 ◽  
Author(s):  
D Sharma ◽  
N Vyas ◽  
P Sinha ◽  
A Mathur

Background: Non fermenting gram negative bacilli (NFGNB) are usually considered to be non pathogenic commensals of little significance, however, data suggest that they are remarkable because of antimicrobial resistance; propensity to cause outbreaks and complex epidemiology. This study was conducted to find out the prevalence and sensitivity pattern of NFGNB from various clinical samples.Methods: A total of 519 samples were received from patients suspected of having hospital acquired infections (HAI), admitted in Sawai Man Singh Hospital, Jaipur, India. Organisms grown on culture were subjected to phenotypic identification along with antimicrobial sensitivity testing by Kirby Bauer’s disc diffusion method.Results: Among 366 culture positive samples, 94 (25.6%) NFGNB were isolated. Maximum pevalence prevalence was found in burn ward i.e. 76.7 % followed by surgical wards 71.0%, surgical ICUs 69.6% and medical ICUs 68.0 %. Highest yield was found in pus/wound samples (95.5%) while it was only 23.7% in blood samples. Pseudomonas aeruginosa was the most common isolate (48.9%), followed by Acinetobacter baumannii (33%), Stenotrophomonas maltophilia (13.8%) and Burkholderia cepacia complex (4.3%). P.aeruginosa and A. baumanii strains were most sensitive to Meropenem. S.maltophilia showed maximum sensitivity with ticarcillin/ clavulanic acid and B. cepacia complex with Piperacillin/ Tazobactam.Conclusion: Isolation of NFGNB and their antibiotic susceptibility pattern should be regarded with all seriousness in clinical practice and epidemiology because they are emerging nosocomial pathogens and by being resistant to multiple antibiotics, their prevalence not only limits the treatment options but also act as a reservoir of drug resistance genes.Nepal Journal of Medical Sciences Vol.3(2) 2014: 101-105


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