scholarly journals ISOLATION AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF MICROORGANISMS CAUSING INTRA-ABDOMINAL INFECTIONS AT TERTIARY CARE HOSPITAL OF NORTHERN INDIA

Author(s):  
PARMINDER SINGH ◽  
RITU GARG ◽  
HARIT KUMAR ◽  
RINKU

Objective: The objective of the study is to find out the resistance pattern of pathogenic organisms isolated from intra-abdominal infection (IAI). Methods: A total of 500 samples were collected from suspected IAIs of patients reporting to the hospital and cultured. Identification of the isolates was done using standard identification protocol. Antimicrobial susceptibility was performed by Kirby-Bauer disc diffusion method and interpretation was done using Central Laboratory Standard Institute guidelines. Results: Out of 500 samples, 170 were culture positive and 330 showed no growth. Gram-negative organisms (n=127) outnumbered the Gram-positive organisms (n=23). Among the Gram-negative organisms, Escherichia coli (n=67) was the most commonly isolated bacilli followed by Klebsiella sp. (n=32), Pseudomonas sp. (n=25), Acinetobacter baumannii (n=18), and Klebsiella oxytoca (n=05). Among Gram-positive organisms Staphylococcus aureus (n=17) and Enterococcus spp (n=06) isolates of were grown in culture. Among Gram-negative bacilli, Imipenem followed by Gentamicin was the most effective drug but in Acinetobacter spp. The second most effective drug was Tigecycline. Among Gram-positive isolates, Linezolid was the most effective drug. Conclusion: Prompt starting of empirical antimicrobials based on the local susceptibility pattern, followed by modification of treatment in accordance with the antimicrobial susceptibility report can significantly reduce the morbidity and the mortality associated with IAIs.

2021 ◽  
pp. 65-67
Author(s):  
Hemendra K Sharma ◽  
Niketa Gupta ◽  
Mahesh Yadav ◽  
Aruna Vyas ◽  
Rajni Sharma

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


Author(s):  
Abigail R. Sopia ◽  
Pushpa Innocent D. Joseph ◽  
M. Kalyani ◽  
B. Ananthi ◽  
Suresh Dhanaraj ◽  
...  

Genital infections and subsequent vaginosis diagnosed through high vaginal swab in women is caused due to fungi or bacteria. The presented study focused on determining the types, numbers and antibacterial susceptibility pattern of aerobic bacteria causing vaginosis in 147 female patients attending infertility centre in Chennai, Tamil Nadu, India. Candida spp. caused 17% of infections with 15.7% of vaginosis caused by E.coli, Klebsiella spp., Acinetobacter spp., Citrobacter spp. and Gram positive cocci – Methicillin Sensitive Staphylococcus aureus (MSSA), Coagulase Negative Staphylococci(CONS), Staphylococcus aureus and Enterococcus spp. causing 12.9% of vaginitis in the study population. A total of 20 different antibiotics – cell wall inhibitors, protein synthesis inhibitors and nucleic acid synthesis inhibitors; were tested to determine the response of bacterial isolates by Kirby-Bauer disc diffusion method. The study result determined that the most effective drug for treating Gram positive bacterial vaginitis as per CLSI guidelines based on susceptibility pattern as: Linezolid(100%), Gentamycin(91.6%), Amikacin(87.5%),Erythromycin(79.2%), Co-Trimoxazole(72.2%), Ciprofloxacin(65.6%) and least Chloramphenicol(44.3%). High level gentamycin(83.3%) was found to be effective in treating Enterococci. The descending order of susceptibility of Gram negative aerobacteria causing vaginitis as per CLSI guidelines are: Amikacin(87.5%), Gentamycin(82.5%), Cefoperazone sulbactam (76.3%), Ciprofloxacin(68.5%), Ceftazidime(62.5%) and least Amoxyclav(25%).All Gram negative bacteria tested were susceptible to– Imipenem and Meropenem as well as Chloramphenicol. Ceftriaxone (87.5%) and Nitrofurantoin(72.3%) among other antibiotics was effective against Gram negative bacteria while all Enterobacteriaceae members were found to be resistant to tetracycline.


Author(s):  
Garima Gautam ◽  
Sanjib Gogoi ◽  
Sonal Saxena ◽  
Ravinder Kaur ◽  
Megh Singh Dhakad

AbstractNitrofurantoin is the first-line drug in the treatment of uncomplicated urinary tract infections (UTIs) and its use has increased exponentially in recent years. Objectives This study aims to determine the susceptibility pattern of nitrofurantoin in gram-negative urinary isolates and to evaluate their bacteriological and epidemiological profile along with co-existing resistance to other important urinary antimicrobials. Material and Methods This was a retrospective study conducted in a tertiary care hospital in New Delhi in which 500 gram-negative bacterial urinary isolates were evaluated. Records of antimicrobial susceptibility were reviewed from July to September 2019. Antimicrobial susceptibility was performed using the Kirby–Bauer disk diffusion method on Mueller Hinton agar and interpreted using CLSI 2019. Test for extended spectrum β-lactamase (ESBL) producers was done using double disk approximation test. Statistical Analysis Data analysis was performed using the SPSS windows version 25.0 software. Results Out of total 500 isolates, 20.17% (94) isolates were resistant (R) to nitrofurantoin and 9.01% (42) were found to be intermediate (I). Highest resistance was seen in Klebsiella sp. (44.61%) and Escherichia coli (8.12%). About 28.82% of the I/R isolates were of the pediatrics age group and most of the isolates belonged to females (64.69%). High resistance was also seen against ampicillin (92.30%), cefazolin (88.46%), ceftazidime (73.0%), and fluoroquinolones (65.38%). Carbapenemase co-resistance was seen in 57.15% isolates whereas ESBL production was seen in 30.76% of E. coli and 12.06% of Klebsiella sp. Conclusion Increase in multidrug resistance uropathogens along with a near absence of novel oral antibiotics has led to increased consumption of nitrofurantoin since its resistance has increased.


2021 ◽  
pp. 56-59
Author(s):  
Indira Ananthapadmanab asasmy ◽  
Shambhavi . G. K. ◽  
C.H. Srinivasa Rao

Background: Ocular infections are one of the major causes of visual impairment around the world. Infections can either be due to single microbe or polymicrobial. it is essential to know the specic etiology of the infection for the effective management of ocular infections. This study aims to identify microbes responsible for common ocular infections and to determine its antibiotic susceptibility to commonly used antibiotics used in clinical practice. Clinical Methods: A hospital based cross sectional study included 290 patients attending the ophthalmology department of a tertiary care hospital. After a thorough clinical examination samples were taken and were subjected to Grams' stain, culture methods, biochemical tests for the identication of the microbe. Antibacterial susceptibility test was performed using Kirby Bauer disc diffusion method. Results: Among 290 patients, the common clinical conditions include conjunctivitis 108 (37.24%), keratitis 37 (12.76%), dacryocytitis 53 (18.28%), blepharitis 52 (17.93%), trauma 24 (8.28%), infective uveitis 10(3.45%) and endophthalmitis 6(2.07%). Among the total ocular infections 146(50.34%) were positive for culture. Among the total isolated, 110(75.34%) were Gram positive and 36(24. 66%) were Gram negative. The Gram positive bacteria isolated showed highest sensitivity to ciprooxacin (86.36%) followed by gentamycin (82.72%) and clindamycin (80%). The Gram negative bacteria showed high resistance to tetracycline 7(19.44%), followed by amoxicillin-clavulanic acid (30.56%). Conclusion: The most common ocular infection is conjunctivitis followed by dacryocystitis which is most commonly caused by Staphylococcus aureus, which showed high resistance to Amoxcillin, Tetracycline and Erythromycin. To prevent the emergence of antimicrobial resistance, it is necessary to perform antimicrobial susceptibility testing before initiating antibiotics in clinical practice.


2021 ◽  
pp. 1-8
Author(s):  
Naimshree Sonkar ◽  
Malay Banerjee ◽  
Suman Gupta ◽  
Absar Ahmad

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.


Author(s):  
Aparna Pandey ◽  
Prachi Shaw ◽  
Aamir Johar

Objective: Chronic osteomyelitis is the infection and inflammation of the bone. Inappropriate use of antibiotics and multidrug resistance has raised the morbidity and mortality rate in chronic osteomyelitis. This study aims to determine the bacterial profile and antimicrobial susceptibility patterns of chronic osteomyelitis with special mention to various resistant mechanisms. Methods: The study is a prospective design. Hundred (100) clinically diagnosed cases of chronic osteomyelitis of all age group and both sex admitted in a tertiary care hospital at central India, in one year were included. Samples like pus, sinus discharge or exudates were collected aseptically and sent for microbiological investigation. Antimicrobial susceptibility of bacterial isolates to the commonly used antibiotics was done by using modified Kirby Bauer disc diffusion method. Results: The aerobic bacteriological study of chronic osteomyelitis showed Staphylococcus aureus is being continued to be major etiological agent followed by Pseudomonas aeruginosa and Staphylococcus epidermidis. Gram-positive isolates were sensitive to linezolid, teicoplanin while gram-negative isolates were sensitive to colistin, ciprofloxacin in the majority. The disease occurs mostly due to traumatic injuries commonly affecting the middle age group. In present study prevalence of methicillin-resistant Staphylococci aureus and β Lactamase producing (ESBL, Amp-C and MBL) gram-negative bacilli is found to be on the higher side. Conclusion: It has been the major cause of morbidity for a long time. The emerging multidrug-resistant strain is a major concern for the treatment. Identification of causative isolates and using a judicious selection of antibiotics will help the clinician in starting the empirical treatment accordingly would limit the multidrug resistance strains in the hospital as well as the community.


2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Javeria Gul ◽  
Iffat Javed ◽  
Sohaila Mushtaq ◽  
Muhammad Saeed Anwar

Background: The emergence and spread of antibiotic resistant bacteria causing infection is a great health issue for clinicians. The problem of multidrug resistant (i.e. resistant to at least three groups of antimicrobial) is becoming more and more threatening. The rate of resistance among Gram negative bacteria especially non fermenters are increasing to all available antibiotic groups. Objectives: The aim of study was to detect the pattern of antimicrobial susceptibility in non-fermenter Gram negative bacilli (NFGNB) in a tertiary care hospital (Postgraduate Medical Institute, Lahore). Study Design: Descriptive study. Settings: The study was conducted in Pathology Department, Postgraduate medical institute (PGMI), Lahore. Study Period: Six months from August 2014 to December 2014. Material and Methods: Non-fermenter Gram negative bacteria were collected from various clinical specimen including blood, pus, urine, fluid aspirates and respiratory tract in a period of six months in pathology department, PGMI. All non-fermenter Gram negative isolates were identified up to species level by standard laboratory procedures using API (Analytical profile index) 20 NE (non-enterobacteriaceae). Antimicrobial susceptibility testing of non-fermenter Gram negative isolates were performed by modified Kirby Bauer disk diffusion method as recommended in CLSI. Results: Out of the total 51 samples the most commonly isolated NFGNB were Acinetobacterbaumanni and Burkholderiacepacia (16 each) followed by Pseudomonas aeruginosa (7), Pseudomonas luteola (5), Stenotrophomonasmaltophilia (4), Pseudomonas fluorescens (2) and Pseudomonas stutzeri(1). Conclusion: The study showed that rate of multidrug resistance increased in non-fermenter Gram negative organisms.


Author(s):  
K. Sathyavathy ◽  
B. Kiran Madhusudhan

The aim of the study was to investigate the antimicrobial susceptibility pattern of Klebsiella species from different clinical samples at Sree Balaji Medical College and Hospital, India. Overall 189 samples out of 980 non repetitive clinical samples obtained from wound/pus, urine, sputum swab and blood by disc diffusion method and identified as Klebsiella and analysed. Out of total 189 Klebsiella isolates, 76 out of 155 K. pneumoniae (49%) were resistant and none out of 34 Klebsiella oxytoca (0%) showed resistance to cefotaxime and ceftazidime by disc diffusion method. Antimicrobial susceptibility testing of Klebsiella exhibited 100% resistance to Ampicillin. The present study highlights the need for the continued monitoring of antimicrobial susceptibility patterns of important bacterial pathogens, so that rational antibiotic policies can be formulated.


2018 ◽  
Vol 5 (2) ◽  
pp. 366 ◽  
Author(s):  
Mandira Sarkar ◽  
Jagadananda Jena ◽  
Dipti Pattnaik ◽  
Bandana Mallick

Background: Nonfermentative gram-negative bacilli (nonfermenters) have emerged as a major concern for nosocomial infections. They exhibit resistance not only to the beta-lactam and other group of antibiotics but also to carbapenems. This study was undertaken to know the prevalence of nonfermenters from clinical samples along with their antimicrobial susceptibility profile.Methods: A cross-sectional study over a period of 21 months in the microbiology laboratory of a tertiary care hospital was done. Clinical samples were processed by conventional bacteriological methods for isolation and identification. Susceptibility testing was done by Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute.Results: 411 nonfermenters (13.18%) were isolated from 3116 culture positive clinical samples. Out of these nonfermenters, most were Acinetobacter baumannii (51.34%) followed by Pseudomonas aeruginosa (42.09%), Burkholderia cepacia complex (4.38%) and others (2.19%). Others included Burkholderia pseudomellei, Acinetobacter lwoffii and Stenotrophomonas maltophilia. Highest sensitivity to gentamicin and amikacin were shown by A. baumannii and P. aeruginosa respectively while both were mostly resistant to ceftriaxone. Burkholderia and Stenotrophomonas species showed 100% sensitivity to cotrimoxazole. A. baumannii was the most prevalent nonfermenter in intensive care units.Conclusions: Timely identification of nonfermenters and monitoring their susceptibility patterns will help in proper management of infections caused by them. Improved antibiotic stewardship and infection control measures should be implemented to prevent nosocomial infections and spread of drug resistant nonfermenters.


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