scholarly journals Microbial landscape in hospital patients with new coronavirus disease (COVID-19), antibiotic resistance comparison vs. Pre-covid stage: a prospective study

2021 ◽  
Vol 28 (5) ◽  
pp. 14-28
Author(s):  
Marina G. Avdeeva ◽  
Makka I. Kulbuzheva ◽  
Sergey V. Zotov ◽  
Yelena V. Zhuravleva ◽  
Alina V. Yatsukova

Background. The new coronavirus infection has manifested untypically compared to other acute respiratory agents, posing a major challenge to researchers worldwide. Despite low incidence of bacterial complications, microbial coinfection plays an important role in the onset and development of severe COVID-19 to hamper diagnosis, treatment and prognosis.Objectives. A study of microbial landscape in secondary complications of COVID-19 and prevailing microbial-agent antibiotic resistance dynamics in COVID-19 vs. patients with pre-COVID community-acquired pneumonia.Methods. We analysed 1,113 bacterial sputum cultures in COVID-19 patients from 21 hospital of Krasnodar Krai. The study sample comprised 524 strains isolated from COVID-19 patients in bacteriological assays. The comparison sample included 643 positive sputum strains isolated from community-acquired pneumonia patients developing disease in outcome of acute respiratory infection in 2015–2018. The microbial aetiology landscape and strain antibiotic resistance have been compared in COVID-19 vs. patients with community-acquired pneumonia.Results. Gram-negative bacteria predominated in COVID-19 cultures (58%), followed by Gram-positive bacteria (15%) and fungi (27%). Acinetobacter baumannii (35%) and Klebsiella pneumoniae (33%) were about equally represented in Gram-negative flora, Pseudomonas aeruginosa (19%) and other microorganisms were half as common. Streptococcus pneumonia and Staphylococcus aureus accounted for 48 and 15% Gram-positive strains, respectively. Sputum-isolated fungi were mainly identifi ed as Candida albicans (89%). The Streptoccocus pneumoniae detection rate dropped to 7% in 2020 relative of other flora, which is 10 times less vs. pre-COVID rates, whilst the fungal rate increased dramatically. Antibiotic resistance increased in most isolated microbial strains.Conclusion. A Gram-negative-dominated aetiology of lower respiratory tract lesions, as well as higher risk of fungal and other opportunistic coinfections should be taken into account in patient treatment for a complicated coronavirus infection. A higher antibiotic resistance is induced by active indication-ignorant use of antibiotics, including pre-hospital treatment. A suitable treatment regimen in COVID-19 should avoid undue antibiotic prescriptions in every patient.

2017 ◽  
Vol 34 (3) ◽  
pp. 128-134
Author(s):  
Md Abdus Salam ◽  
Md Robed Amin ◽  
Quazi Tarikul Islam

Introduction: Pneumonia is a worldwide, serious threat to health and an enormous socio-economic burden for health care system. According to recent WHO data, each year 3-4 million patients die from pneumonia. The clinical presentations and bacterial agents responsible for community acquired pneumonia (CAP) varies according to geography and culture.Methods: A cross sectional observational study conducted among the 53 consecutive patients with a clinical diagnosis of CAP in admitted patient in the department of Medicine, DMCH, during January 2010 to December 2010. Hematological measurements (TC of WBC, Hb%, ESR, platelet count), blood culture, chest X-ray P/A view, sputum for Gram staining and culture sensitivity, sputum for AFB, blood urea and random blood sugar were done in all cases. ELISA for IgM antibody of Mycoplasma pneumoniae and Chlamydia pneumoniae were done in sputum culture negative cases.Results: The mean (±SD) age was 38.9±17.3 years and Male female ratio was 3:1. Fever, chest pain and productive cough were the most common clinical features. The mean (±SD) respiratory rate was 23.0±2.8 /minute . COPD and DM were found in 17.0% and 5.7% of patients respectively . Blood culture was found positive in only 1.9% of the study patients. Gram positive Cocci 62.26%, Gram negative Bacilli 9.43%, mixed Gram positive cocci and Gram negative bacilli 11.32% and Gram negative Cocco Bacilli 1.9% were observed and in 15.03 % cases, no bacteria could be seen. Sputum culture revealed 53.8% streptococcus pneumoniae, 26.9% Klebsiella pneumonia as predominant organism. Mycoplasma pneumoniae and Chlamydia pneumoniae were found in 7.4% and 3.7% respectively by serological test. For Streptococcus pneumoniae, sensitive antibiotics were Amoxyclav and Levofloxacin. For Gram negative bacilli and coccobacilli, more sensitive antibiotics were Meropenem, Ceftriaxone, and Clarithromycin. The best sensitive drug were found meropenem. The mean (±SD) duration of hospital stay was 5.0±1.7 days with ranging from 3 to 10 days.Conclusion: Region based bacteroiological diagnosis of Cap is important for selecting the best and sensitive drugs for complete cure.J Bangladesh Coll Phys Surg 2016; 34(3): 128-134


2017 ◽  
Vol 61 (5) ◽  
Author(s):  
Michael A. Pfaller ◽  
Michael D. Huband ◽  
Paul R. Rhomberg ◽  
Robert K. Flamm

ABSTRACT Omadacycline is a broad-spectrum aminomethylcycline in late-stage clinical development for the treatment of acute bacterial skin and skin structure infections and community-acquired pneumonia as an oral and an intravenous once-daily formulation. In this study, omadacycline and comparators were tested against 69,246 nonduplicate bacterial isolates collected prospectively during 2010 and 2011 from medical centers in Asia-Pacific (11,397 isolates), Europe (23,490 isolates), Latin America (8,038 isolates), and North America (26,321 isolates). Omadacycline was tested by broth microdilution following Clinical and Laboratory Standards Institute M07-A10 (2015) methods. A total of 99.9% of Staphylococcus aureus isolates were inhibited by ≤2 μg/ml of omadacycline (MIC50/90, 0.12/0.25 μg/ml), including 100.0% of methicillin-susceptible S. aureus isolates and 99.8% of methicillin-resistant S. aureus isolates. Omadacycline potencies were comparable for Streptococcus pneumoniae (MIC50/90, 0.06/0.06 μg/ml), viridans group streptococci (MIC50/90, 0.06/0.12 μg/ml), and beta-hemolytic streptococci (MIC50/90, 0.06/0.12 μg/ml) regardless of species and susceptibility to penicillin. Omadacycline was active against Enterobacteriaceae and was most active against Escherichia coli (MIC50/90, 0.5/2 μg/ml), Enterobacter aerogenes (MIC50/90, 2/4 μg/ml), Klebsiella oxytoca (MIC50/90, 1/4 μg/ml), and Citrobacter spp. (MIC50/90, 1/4 μg/ml). Omadacycline was active against Haemophilus influenzae (MIC50/90, 1/1 μg/ml) regardless of β-lactamase status and against Moraxella catarrhalis (MIC50/90, 0.12/0.25 μg/ml). The potent activity of omadacycline against Gram-positive and Gram-negative bacteria indicates that omadacycline merits further study in serious infections in which multidrug resistance and mixed Gram-positive and Gram-negative infections may be a concern.


2008 ◽  
Vol 28 (5) ◽  
pp. 505-508 ◽  
Author(s):  
Kwok Hong Chu ◽  
Wai Yee Choy ◽  
Chi Chung William Cheung ◽  
Ka Shun Fung ◽  
Hon Lok Tang ◽  
...  

Background Peritoneal dialysis (PD)-related infections are the major cause of technique failure. Exit-site infections (ESI) can be prevented by local application of antibiotics. Mupirocin (M) is the most extensively studied drug for this application. Long-term use can result in the development of resistance. Gentamicin (G) is an attractive alternative, with both gram-positive and gram-negative activities. We studied the comparative efficacy of G cream versus M ointment in the prevention of PD-related infections in a Chinese cohort. Methods This was a prospective study of adult PD patients of the Princess Margaret Hospital, Hong Kong. Patients were excluded if they had active infection, recent ESI or peritonitis, history of allergy to either drug, or were unable to apply the drug or give consent. Patients were taught to apply the drug daily to the exit site after routine exit-site care. Records were tracked prospectively during hospital admissions and clinic follow-ups. Results 95 patients were recruited; 14 discontinued the study. The ESI rates were 0.38 and 0.20 episodes/patient-year for the G group and the M group respectively ( p = 0.36). Gram-positive ESI rates were 0.18 and 0 episodes/patient-year for the G group and the M group respectively. Gram-negative ESI rates were 0.20 episodes/patient-year for both groups ( p = 0.62). The overall peritonitis rates were similar in the two groups ( p = 0.91). Discussion In addition to good perioperative care and strict exit-site care, local antibiotic application can prevent ESI. Mupirocin has been extensively studied and shown to be effective. Similar if not superior effects of G cream have been demonstrated. In this study, neither antibiotic gave significantly better results in the prevention of either ESI or peritonitis. Conclusions Both gentamicin and mupirocin were effective as prophylaxis for ESI. Longer study is required to determine the long-term efficacy and the potential beneficial effect on the prevention of peritonitis.


2010 ◽  
Vol 63 (9-10) ◽  
pp. 643-647 ◽  
Author(s):  
Milan Rancic ◽  
Lidija Ristic ◽  
Ivana Stankovic

Introduction. This study was aimed at analyzing the site, kind and type of infection which develop in patients having lung cancer at hospital treatment. Material and methods. Clinical data of the patients hospitalized for lung cancer were analyzed at the Clinic for Lung Diseases and Tuberculosis in Knez Selo in the period from January 2002 till December 2007. A great number of patients (1296-75.9%) had non-small cell lung cancer. In 1708 patients with lung cancer, 773 febrile episodes were recorded, i.e. 687 states of infections. Results. Most of the infections were recorded in the tracheobronchial tree (60.9%). The infection was confirmed microbiologically in 38% of infectious states. Predominant Gram positive pathogens were Staphylococcus aureus and Streptococcus, but among Gram negative pathogens there were Escherichia coli and Haemophilus influenzae. Discussion. A significantly better therapy response to antibiotics was found in the group of patients where microbiological agents were isolated (p<0.05). The predominant site of infection in the patients with lung cancer is the tracheobronchial tree without a significant difference between frequency of Gram positive and Gram negative pathogens.


2020 ◽  
Vol 7 (1) ◽  
pp. 39-45
Author(s):  
M. Mishyna ◽  
M. Gonchar ◽  
O. Logvinova ◽  
H. Isaieva ◽  
M. Basiuk

DISTRIBUTION OF THE CAUSATIVE AGENTS OF RESPIRATORY TRACT INFECTIONS IN CHILDREN. Mishyna М., Gonchar M., Logvinova O., Isaieva H., Basiuk M. The study aimed to investigate prevalence of microorganisms depending on the site of isolation and disease. The study involved 48 children aged 1 year to 17 years. Acute bronchitis (54, 17%), community-acquired pneumonia (CAP) (33, 33%), bronchial asthma (12, 50%) were diagnosed. Were isolated 173 strains of microorganisms. Gram-positive microorganisms were detected 106 strains (61, 3%), Gram-negative microorganisms - 49 strains (28, 3%), fungi - 18 strains (10, 4%). We investigated 100 samples from nose (nasal swabs), pharynx (throat swabs) and sputum. In 83 cases were isolated Gram-positive microorganisms, in 36 cases were isolated Gram-negative microorganisms, in 18 cases - fungi. Analysis reviled that Staphylococcus aureus most often isolated from patients with acute bronchitis; Gram-negative microorganisms most often detected from throat swabs, comparing with microorganisms detected from nose swabs and sputum. Keywords: microorganisms, biofilms, respiratory diseases, children.   Анотація ПОШИРЕНІСТЬ ЗБУДНИКІВ ІНФЕКЦІЙ ДИХАЛЬНИХ ШЛЯХІВ У ДІТЕЙ. Мішина М.М, Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Метою дослідження було вивчити переважання умовно-патогенних мікроорганізмів, які викликають захворювання органів дихання у дітей, в залежності від місця виділення та захворювання. У дослідженні було 48 дітей у віці від 1 року до 17 років. Пацієнти були з такими діагнозами: гострі бронхіти (54, 17%), негоспітальні пневмонії (33, 33%), бронхіальна астма (12, 50%). Було виділено 173 штама умовно-патогенних мікроорганізмів. Грампозитивних мікроорганізмів було виділено 106 штамів (61, 3%), грамнегативних мікроорганізмів – 49 штамів (28, 3%), грибів – 18 штамів (10, 4%). Було досліджено 100 зразків з зіву, носу, мокротиння. Грампозитивні мікроорганізми були виділені з 83 зразків, грамнегативні – з 36 зразків, гриби – з 18 зразків. Проведене дослідження довело, що Staphylococcus aureus найчастіше виділявся у пацієнтів з гострими бронхітами. Грамнегативні мікроорганізми частіш за все виділялись зі зразків із зіву в порівнянні з мазками з носу та мокротинням. Ключові слова: мікроорганізми, біоплівки, захворювання органів дихання, діти.   Абстракт РАСПРОСТРАНЕННОСТЬ ВОЗБУДИТЕЛЕЙ ИНФЕКЦИЙ ДЫХАТЕЛЬНЫХ ПУТЕЙ У ДЕТЕЙ. Мішина М.М., Гончарь М. О., Логвінова О.Л., Ісаєва Г.О., Басюк М.А. Целью исследования было изучить преобладание условно-патогенныхмикроорганизмов, вызывающих заболевания органов дыхания у детей, в зависимости от места забора материала и заболевания. Исследование включало 48 детей в возрасте от 1 года до 17 лет. Пациенты находились с такими заболеваниями: острые бронхиты (54, 17%), внегоспитальные пневмонии (33, 33%), бронхиальная астма (12, 50%). Всего было выделено 173 штамма условно-патогенных микроорганизмов. Грамположительных микроорганизмов было выделено 106 штаммов (61, 3%), грамотрицательных микроорганизмов – 49 штаммов (28, 3%), грибов – 18 штаммов (10, 4%). Было исследовано 100 образцов из зева, носа, мокроты. Грамположительные микроорганизмы были выделены из 83 образцов, грамотрицальные – из 36 образцов, грибы – из 18 образцов. В ходе исследования было доказано, что Staphylococcus aureus чаще всего выделялся от пациентов с острыми бронхитами. Грамотрицательные микроорганизмы чаще всего выделялись из мазков из зева по сравнению с мазками из носа и мокротой. Ключевые слова: микроорганизмы, биопленки, заболевания органов дыхания, дети.


Author(s):  
N. Jyothsna ◽  
A. Ramya ◽  
K. Abhilash ◽  
Bathsa Liza Johnson

<p class="abstract"><strong>Background:</strong> Our study was done to determine the pattern of antibiotic resistance of various strains of bacteria causing acute tonsillitis.</p><p class="abstract"><strong>Methods:</strong> the study was a randomized cross sectional study. Patients matching the inclusion criteria were included. Duration of study was 6 months.</p><p class="abstract"><strong>Results:</strong> Out of 120 cases, 46 cases showed no bacterial growth (NBG) and 74 cases showed bacterial growth. 42 cases were gram-negative bacterial strain and 32 cases were positive bacterial strain out of 72 bacterial grown cases. A list of 25 antibiotic drugs in gram-negative and 31 drugs in gram-positive strain, their sensitivity and resistance were taken and noted. Among gram-negative bacteria imipenem (71.4%) showed highest sensitivity. Highest antibiotic resistance was seen in ampicillin (85.71%). Least sensitivity is observed in clindamycin, amoxicillin+clavulanic acid with 2.38%. Among gram-positive bacteria, highest sensitivity was noted in cefotaxime (75%). Highest antibiotic resistance was seen in cotrimoxazole (46.8%). Least sensitivity is observed in netilmicin, sulbactam with 3.12%.</p><p class="abstract"><strong>Conclusions:</strong> The number of drugs resistant to the gram-positive bacteria are lesser than number of drugs sensitive, which showed significant difference (p&lt;0.05). Significant difference of antibiotic drugs was not found in gram-negative bacteria. Our study findings helped in appropriate and guarded use of the antibiotic drugs in acute tonsillitis, minimizing the exposure of individuals to antibiotic resistance by choosing an appropriate sensitive drug, therefore improving the quality of therapy.</p>


Author(s):  
Sachin Walchand Shaha

Material and Methods: A Prospective study was performed in the department of Pediatrics in territory care institute for the duration of 8 months. Forty newborns were included in the study group to satisfy including criteria. Before antibiotic treatment, neonates CRP and platelet count were assessed. Data were analyzed by SPSS software. Results: Out of the 40 cases, 22 were male babies, and the rest 18 were female. Blood culture was positive in 19 out of the 40 cases, CRP was positive in 21 cases, and thrombocytopenia was observed in 16 cases.  Klebsiella is the commonest gram organism causing sepsis in the Neonatal Intensive Care Unit. The Gram-positive organisms grown are Coagulase Positive and Coagulase-negative Staphylococci, Group B Beta Hemolytic Streptococcus, and Enterococcus. Out of 16 thrombocytopenia neonatal, 15 shows Gram-negative and 1 shows gram-positive blood culture. Conclusion: Qualitative analysis of C-reactive protein can be used as an early marker of sepsis, especially in resource-limited settings. Although thrombocytopenia occurs predominantly in gram-negative sepsis, there is insufficient evidence to support the use of platelet count to differentiate between gram-positive and gram-negative sepsis. Keywords: CRP, Platelet count,blood cultures, sepsis.


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