scholarly journals A Study on Prevalence of Extended Spectrum Beta-lactamases Gene (CTX-M, TEM & SHV) Producing Enterobacteriaceae Members Isolated from Different Clinical Specimens at Tertiary Care Hospital, Uttarakhand

2020 ◽  
Vol 14 (4) ◽  
pp. 2619-2626
Author(s):  
Hitendra Singh ◽  
Umesh ◽  
Vinita Rawat ◽  
Nidhi Negi ◽  
Sunil Kumar
Keyword(s):  
Drug Resistance ◽  
Multiplex Pcr ◽  
Tertiary Care ◽  
Antimicrobial Drug ◽  
Multi Drug Resistance ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Antimicrobial Drug Resistance ◽  
Extended Spectrum ◽  
Group 1

Extended spectrum b-lactamases (ESBLs) are one of the major enzymes responsible for antimicrobial drug resistance in bacterial isolates. The objective of this study was to find out the ESBL genes (blaTEM, blaSHV and blaCTX-M) in Enterobacteriaceae. This study was conducted from November 2013 to October 2015. The identification of Enterobacteriaceae isolates & antimicrobial drug resistance was done by conventional standard microbial methods. Further genotypic detection of ESBL was done by multiplex PCR. Results: Among 942 Enterobacteriaceae isolates, 332 (35.24%) isolates was ESBL producers. We observed high prevalence of ESBL enzyme in Klebsiella pneumonia (59.09%). These isolate revealed high resistance to co-trimoxazole, fluoroquinolones and aminoglycosides. Out of 48 randomly selected isolates, ESBL genes were identified in 45 isolates which were found resistant to third generation cephalosporins. Single CTX-M gene noticed in 29 strains of Escherichia coli (E. coli), 02 strains of Klebsiella pneumoniae, and 01 strain of Proteus mirabilis. Occurrence of Combination of the genes e.g., (blaTEM+blaCTX-M), (blaSHV+blaCTX-M), (blaTEM+blaSHV+blaCTX-M) was detected in 08, 01 and 04 isolates respectively. Multiplex PCR in CTX-M carrying isolates revealed the presence of blaCTX-M group-1. The most common blaCTX-M group-1 was observed in all isolates of family Enterobacteriaceae. Antimicrobial drug resistance is a major problem of concern now a day. Studies like this will be helpful to knowing the burden of multi drug resistance as well as formulating antibiotics policy for a particular region.

scholarly journals A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sulochana Manandhar ◽  
Raphael M. Zellweger ◽  
Nhukesh Maharjan ◽  
Sabina Dongol ◽  
Krishna G. Prajapati ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Global Public Health ◽  
Gram Negative ◽  
E Coli ◽  
Extended Spectrum ◽  
High Prevalence

Abstract Background Multi-drug resistance (MDR) and extensive-drug resistance (XDR) associated with extended-spectrum beta-lactamases (ESBLs) and carbapenemases in Gram-negative bacteria are global public health concerns. Data on circulating antimicrobial resistance (AMR) genes in Gram-negative bacteria and their correlation with MDR and ESBL phenotypes from Nepal is scarce. Methods A retrospective study was performed investigating the distribution of ESBL and carbapenemase genes and their potential association with ESBL and MDR phenotypes in E. coli, Klebsiella spp., Enterobacter spp. and Acinetobacter spp. isolated in a major tertiary hospital in Kathmandu, Nepal, between 2012 and 2018. Results During this period, the hospital isolated 719 E. coli, 532 Klebsiella spp., 520 Enterobacter spp. and 382 Acinetobacter spp.; 1955/2153 (90.1%) of isolates were MDR and half (1080/2153) were ESBL producers. Upon PCR amplification, blaTEM (1281/1771; 72%), blaCTXM-1 (930/1771; 53%) and blaCTXM-8 (419/1771; 24%) were the most prevalent ESBL genes in the enteric bacilli. BlaOXA and blaOXA-51 were the most common blaOXA family genes in the enteric bacilli (918/1771; 25%) and Acinetobacter spp. (218/382; 57%) respectively. Sixteen percent (342/2153) of all isolates and 20% (357/1771) of enteric bacilli harboured blaNDM-1 and blaKPC carbapenemase genes respectively. Of enteric bacilli, Enterobacter spp. was the most frequently positive for blaKPC gene (201/337; 60%). The presence of each blaCTX-M and blaOXA were significantly associated with non-susceptibility to third generation cephalosporins (OR 14.7, p < 0.001 and OR 2.3, p < 0.05, respectively).The presence of each blaTEM, blaCTXM and blaOXA family genes were significantly associated with ESBL positivity (OR 2.96, p < 0.001; OR 14.2, p < 0.001 and OR 1.3, p < 0.05 respectively) and being MDR (OR 1.96, p < 0.001; OR 5.9, p < 0.001 and OR 2.3, p < 0.001 respectively). Conclusions This study documents an alarming level of AMR with high prevalence of MDR ESBL- and carbapenemase-positive ESKAPE microorganisms in our clinical setting. These data suggest a scenario where the clinical management of infected patients is increasingly difficult and requires the use of last-resort antimicrobials, which in turn is likely to intensify the magnitude of global AMR crisis.

scholarly journals To determine antimicrobial susceptibility and biofilm production among coagulase negative staphylococci at a tertiary care hospital

2021 ◽  
Vol 8 (3) ◽  
pp. 230-234
Author(s):  
Naga Sri Latha Bathala ◽  
M Sasidhar ◽  
S Kusuma Bai
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Susceptibility ◽  
Biofilm Formation ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional

CoNS are gaining importance due to increase in resistance rates to betalactam antibiotics and multi drug resistance. Although specific virulence factors are not as clearly established, it seems clear that factors such as bacterial polysaccharide components, and ability to form biofilm are involved in attachment and/or persistence of bacteria on foreign materials. Biofilms usually result in persistent infections that cannot be easily resolved with standard antibiotic treatments; therefore, the biofilm formation ability and the resistance to antimicrobial therapy can be intimately related. A prospective cross-sectional study was done on purely isolated CoNS from various clinical samples from both out patients and inpatients. All the test strains were subjected to antimicrobial susceptibility testing. The ability to produce biofilm was detected by tube adherence method. Among 193 CoNS isolates 156 were from inpatients and 37 were from out patients. Methicillin resistant was seen in 80.31%. Of the total, 40.41% showed moderate biofilm formation by tube adherence method. 23.32% of isolates did not form biofilm. All the isolates from blood samples showed moderate (20/26) and strong (6/26) biofilm formation. Among non biofilm producers 66.67% were MS CoNS isolates and 33.33% were MRCoNS. 94.59% of biofilm producers were MRCoNS and 5.41% were MSCoNS. Production of biofilm was relatively more (1.16) among CoNS isolates of IPD than OPD.  As Coagulase negative Staphylocooci are exhibiting multi drug resistance and are able to form biofilm, these organisms causing a major challenge for the physicians. Hence, such problems can be prevented by detection of biofilm producers and appropriate antibiotic doses modification. The issue of antibiotic resistance among CoNS needs to be addressed through a more rational use of existing antibiotics as well as the development of new antimicrobial agents.

PROPORTION OF ESBL AND CARBAPENEMASE PRODUCING ENTEROBACTERIACEAE CAUSING BLOODSTREAM INFECTIONS AND SHOWING MULTI DRUG RESISTANCE IN INFECTED PATIENTS IN TERTIARY CARE HOSPITAL AT AGARTALA, TRIPURA

2021 ◽  
pp. 28-30
Author(s):  
Lija Ghosh ◽  
Arun B ◽  
Puja Ghosh ◽  
Tapan Majumdar
Keyword(s):  
Drug Resistance ◽  
Bloodstream Infection ◽  
Tertiary Care Hospital ◽  
Culture Media ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Biochemical Tests ◽  
North East

BACKGROUND: Enrerobacteriaceae species are the major leading cause of bloodstream infections in many developing countries. Moreover, ESBL and Carbapenemase-producing Enterobacteriaceae species are often associated with high resistance to a wide class of antibiotics. There are few studies regarding the bloodstream infections causing by Enterobacteriaceae with the production of Extended-spectrum β-lactamases and Carbapenemase enzymes in Tripura, North-East India. This study aimed to determine the “ proportion of ESBL and carbapenemase-producing Enterobacteriaceae causing bloodstream infection and showing Multi-drug resistance (MDR) in infected patients'' in Tertiary care Hospital at Agartala, Tripura. METHOD: Blood samples were collected from all indoor and outdoor patients suspected of Bloodstream infection. Then specimens were inoculated in various culture media after that with this culture isolates we performed gram staining and many biochemical tests (as per CLSI guidelines) to identies the Enterobacteriaceae species. And the production of β-lactamases and Carbapenemase was conrmed by the combined disk test and Modied Hodge method. RESULTS: In this study out of 760 samples processed in the laboratory 77 (10.13%) was tested positive for bacteremia from which 42 (54.54%) blood specimens were infected by Enterobacteriaceae. The members of the Enterobacteriaceae family isolated in patient samples are E.coli (22/42, 52.38%), K. pneumoniae (11/42, 52.38%) others are Enterobacter spp. (8/42, 52.38%) and S.typhi(1/42, 2.38%). In all 42 Enterobacteriaceae species, 17 (40.47%) isolates were found ESBL positive on antibiotic screening which is conrmed by Combined disc diffusion test, and out of 17 Beta-lactamase producers 8 (47.05%) were E. coli, 5 (29.41%) were K. pneumoniae and 4 (23.52%) were Enterobacter spp. And among 42 isolates of Enterobacteriaceae 16 (38.09%) isolates showed Carbapenemase producers, in that 8 (50%) were E.coli, 5 (31.25%) were K. pneumoniae, and 3 (18.75%) were Enterobacter spp. CONCLUSION: This study aims to provide an early, rapid, and effective phenotypic method for identifying Multi-drug resistant (MDR) Bloodstream infections (BSIs) causing by the species of the Enterobacteriaceae family

scholarly journals Evaluation of Drug Resistance and Treatment Outcomes among TB Patients with Diabetes Mellitus at Tertiary Care Hospital of Sindh, Pakistan

2021 ◽  
pp. 39-46
Author(s):  
Kahaf Khan ◽  
Ayaz Ali Unar ◽  
Khalida Unar ◽  
Faraz Qurban Rajper ◽  
Mirza Tasawar Baig
Keyword(s):  
Diabetes Mellitus ◽  
Drug Resistance ◽  
Treatment Outcomes ◽  
Tertiary Care Hospital ◽  
Local Population ◽  
Tertiary Care ◽  
Previous History ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Patients With Diabetes

The objective of the study is to evaluate of drug resistance and treatment outcomes among tuberculosis patients with diabetes mellitus at tertiary care hospital of Sindh, Pakistan.  Tuberculosis (TB) is considered as very dangerous infectious disease caused by Mycobacterium tuberculosis orother tubercle bacilli pathogen affects the lungs and it can be spread from person to person through very minute droplet released by infected person via coughing or sneezing. Descriptive cross-sectional study was carried out at different Tuberculosis setting located at tertiary care hospital of Sindh, Pakistan for the period of 10 months. Tuberculosis OPD is considered as major health care facility for the TB, MDR-TB and XDR-TB patients for the local population and peripheries. Total 389 samples were collected through purposive sampling techniques. From the given data, there were 209 Males and 180 females, all participants belong to different areas, so 216 patients belong to rural areas, 121 study participants were house wives, 134 were employed and 41 were have their own business. From the clinical data, 229 participants shown positive response with TB smear test, whereas; 156 participants had positive results with TB culture test. 247 patients had previous history of Tuberculosis, 120 had developed drug resistance and 24 had developed multi-drug resistance (MDR). 312 patients were recently diagnosed with Diabetes mellitus and they had one year of duration of diabetes. Complication of tuberculosis developed among 113 patients and complication of diabetes developed among 194 participants. 39 people were using oral therapy for the management of diabetes and 341 participants had successfully completed their therapy and cured whereas 2 patients were died due to complication It was concluded from the current research that there were many chances for developing drug resistance and multi-drug resistance among the patients suffering from co-morbid including tuberculosis along with Diabetes mellitus. Proper counseling should be conducted, in order to reduce the complication of either type of disease.

scholarly journals Gram Negative Extended Spectrum Beta-Lactamase Producing Bacteria Prevalence in Jouf Region Tertiary Care Hospital, Saudi Arabia

2021 ◽  
Author(s):  
Javid Iqbal Rather ◽  
Zahoor Mohi ud din ◽  
Farkhanda N. Syed ◽  
Mir Haris ◽  
Mudasar Nabi ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Control Measures ◽  
Clinical Samples ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Infection Control Measures ◽  
Antimicrobial Sensitivity ◽  
Extended Spectrum

Extended Spectrum beta lactamase producing pathogens are reported in many clinical samples and pose an emerging threat health. To find the prevalence of ESBL producing Enterobactriacea pathogens isolated from inpatients (Medical and Surgical Wards; Hospital stay > 72 h) admitted to Prince, Mutib, Hospital Sakaka, Jouf. A total of 1043 Enterobactriacea were isolated during April 2015 to October 2016 study period. Vitek -2 compact (biomeriux Leon, France) was used for identification and antimicrobial sensitivity (AST) test. A Total of 115/1043 (11.02%) ESBL producing pathogens were isolated from urine 15.07% (n=242), sputum 13.6 % (n=220), wound 10.8% (n=287) and blood 5.4 % (n=294). Klebsiella pneumonia is most dominant followed by E coli and Proteus miribilis. Cephamycins and carbapenems were found most effective (100% sensitivity) against the pathogens isolated. The aminoglycosides, beta lactams and Fluroquinolnes class of antibiotics, microorganisms have gained the resistance of 20%, 22.7%, 40-70% respectively. The infection control measures should be taken seriously and making of effective use of antibiotics is need of hour.

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