scholarly journals Procalcitonin levels in patients with suspected sepsis

2021 ◽  
Vol 12 (11) ◽  
pp. 108-112
Author(s):  
Tribeni Goswami ◽  
Renu Mathew ◽  
Marina Thomas ◽  
Reena Anie Jose ◽  
Anjali Jacob ◽  
...  
Keyword(s):  
Early Recognition ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Care Hospital ◽  
Gram Positive ◽  
Suspected Sepsis ◽  
Gram Negative ◽  
Culture Positivity ◽  
Blood Culture Positivity ◽  
Gram Negative Bacteremia

Background: Procalcitonin (PCT) was found to be a valuable and reliable biomarker for sepsis, especially in critical care patients for whom early recognition and prompt treatment could reduce mortality. Aims and Objectives: This study was aimed at correlating the levels of PCT as diagnostic marker for sepsis in relation to the culture positivity of various samples from blood, respiratory, urine, and exudates from patients admitted in a tertiary care hospital. Materials and Methods: Results of PCT level along with bacterial culture results of blood, respiratory, urine, and exudates were analyzed from 780 patients for a period of 1 year. Results: High PCT values ranging from 0.52 to 200 ng/ml were found in 331 patients admitted with suspected sepsis. Out of 135 cases of sepsis, 85 had blood culture positivity alone and 50 had culture positivity in blood and in other sites with the same organism. Among the 85 cases of bloodstream infections, in which no localized infections were identified, the median PCT was 33 for Gram-negative bacteremia, which was significantly higher as compared with a median of 16 for Gram-positive cocci. In UTI with bacteremia, the median PCT was 45.34 and in UTI without bacteremia, it was 5. Conclusion: From this study, we concluded that PCT values may be useful to distinguish Gram-negative and Gram-positive bacteremia, and furthermore, a high PCT value for patients with UTI may be helpful in predicting bacteremia.

scholarly journals Study of prevalence and antimicrobial susceptibility pattern of blood culture isolates from a tertiary care hospital of North India

2018 ◽  
Vol 6 (12) ◽  
pp. 4046 ◽  
Author(s):  
Asifa Nazir ◽  
Ifshana Sana ◽  
Bushra Yousuf Peerzada ◽  
Tabindah Farooq
Keyword(s):  
Blood Culture ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Culture Positive

Background: Bacterial bloodstream infections (BSIs) are important causes of morbidity and mortality world-wide. The choice of antimicrobial therapy for bloodstream infections is often empirical and based on the knowledge of local antimicrobial activity profiles of the most common bacteria causing such infections. The objective of the study was to determine the pattern of bacterial isolates from the blood cultures in a teaching hospital and determine their antibiotic resistance and provide guidelines for choosing an effective antibiotic therapy in cases of septicaemia.Methods: The etiological and antimicrobial susceptibility profile of blood cultures over a period of one year at a tertiary care hospital was studied. Blood culture positive isolates were identified by BacT/Alert3D, an automated blood culture system, while as identification of the isolates from these samples and their antimicrobial sensitivity testing was performed with Vitek2 Compact.Results: There were 2231 blood culture samples, of which 565 (25.3%) were identified to be culture positive. Out of 565 positive cultures, 447 (79.1%) showed bacterial growth; Gram positive were 306 (54.2%) and Gram negative were 141 (24.9%). Candida species were isolated from 118 (20.9%) of positive samples. The most frequently identified Gram-positive bacteria were Coagulase-negative staphylococci 208 (67.9%) and the most common Gram-negative isolates were Acinetobacter species 89 (63.1%). The most sensitive drugs for gram-positive isolates were vancomycin, and linezolid while as gram-negative isolates showed 100% sensitivity to colistin and tigecycline.Conclusions: This study reveals a significant prevalence of bacterial isolates in blood and it highlights the need for periodic surveillance of etiologic agent and antibiotic susceptibility to prevent further emergence and spread of resistant bacterial pathogens.

scholarly journals Asymptomatic Bacteriuria among Pregnant Women Attending Tertiary Care Hospital in Lucknow, India

2021 ◽  
pp. 1-8
Author(s):  
Naimshree Sonkar ◽  
Malay Banerjee ◽  
Suman Gupta ◽  
Absar Ahmad
Keyword(s):  
Haemoglobin Level ◽  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli

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.

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 Microbiological Screening and Antimicrobial Sensitivity Profiling of Wound Infections in a Tertiary Care Hospital of Bangladesh

2020 ◽  
pp. 101-106
Keyword(s):  
Wound Infection ◽  
Primary Care Physicians ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Antimicrobial Sensitivity

Wound infection is a major problem in hospitals in developing countries. Wound infection causes morbidity and prolonged hospital stay thus this prospective study was conducted for a period of seven months (January 2019 to July 2019). A total of 217 specimens (wound swabs and pus exudates) from wound infected patients in a Tertiary Care Hospital in Bangladesh. A retrospective study of the microbiological evaluation was done by cultural growth as well as Gram staining and biochemical examination to identify the bacterial isolates. Finally, the antimicrobial vulnerability testing was performed by Kirby-Bauer disc diffusion conventional method. A total of 295 samples were tested. Out of which 217 (73.5%) were found culture positive. E. coli was the most predominant gram-negative isolates whereas Staphylococcus aureus and Coagulase-negative Staphylococcus were the most commonly isolated gram-positive organisms. Antimicrobial sensitivity profile of bacterial isolates revealed imipenem, meropenem, amikacin, and nitrofurantoin to be the most effective antimicrobials against gram-negative isolates, whereas imipenem, meropenem, amikacin, nitrofurantoin, amoxiclav, and gentamicin were the most effective drugs against gram-positive isolates. The result of this examination contributes to the identification of basic causative microbes involved in wound infection and findings of antibiotic susceptibility patterns can be helpful for primary care physicians to optimize the treatment modalities, articulate policies for empiric antimicrobial therapy, and to minimize the rate of infection among wound infected patients.

Evaluation of in vitro susceptibility of Gram-positive pathogens from a tertiary care hospital in Singapore to a novel oxazolidinone, tedizolid, by a gradient diffusion method and broth microdilution

2018 ◽  
Vol 72 (2) ◽  
pp. 181-184
Author(s):  
Saugata Choudhury ◽  
Lee Kar Mun ◽  
Esme Ng Chu Xuan ◽  
Lee Shin Jia ◽  
Shawn Vasoo ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Care Hospital ◽  
Broth Microdilution ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
In Vitro Susceptibility ◽  
Gradient Diffusion

We compared the in vitro antimicrobial activities of tedizolid and linezolid on the Sensititre broth microdilution system for Gram-positive cocci isolates (n=146) from skin and skin structure infections and bloodstream infections, bronchoalveolar lavage and sputum. These pathogens included 40 methicillin-resistant Staphylococcus aureus, 38 coagulase-negative staphylococci, 20 Enterococcus faecalis and 48 beta-haemolytic Streptococcus spp. Susceptibility was simultaneously determined for 48 vanA vancomycin-resistant enterococci isolates 2013–2016 from rectal swabs (23 E. faecalis and 25 E. faecium, of which 4 were linezolid-non-susceptible). MIC90s for tedizolid were fourfold to eightfold lower than linezolid on the Sensititre and ranged from 0.12 to 0.5 µg/mL for the different pathogen groups. All isolates were susceptible to tedizolid except two vanA E. faecium strains (MICs of 1 and 2 µg/mL, respectively). Categorical and essential agreement for tedizolid were 99.48% and 92%, respectively, between Liofilchem gradient diffusion and Sensititre methods. Overall, the drug exhibited excellent activity against the surveyed Gram-positive pathogens.

scholarly journals Epidemiology and microbiology of Gram-negative bloodstream infections in a tertiary-care hospital in Beijing, China: a 9 -year retrospective study

2020 ◽  
Author(s):  
Zhixin Liang ◽  
Qiang Zhu ◽  
Minghui Zhu ◽  
Chunyan Li ◽  
Lina Li ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Resistance Rates ◽  
Beijing China

Abstract Background Gram-negative bacterial bloodstream infections (BSIs) are serious diseases associated with high morbidity and mortality. The following study examines the incidence, clinical characteristics and microbiological features, drug resistance situations and mortality associated with gram-negative BSIs at a large Chinese tertiary-care hospital in Beijing, China. Methods A retrospective cohort study of patients with gram-negative BSIs was performed between January 1, 2010, and December 31, 2018, at the Chinese People's Liberation Army General Hospital. The patients’ data were collected and included in the reviewing electronic medical records. Results A total of 6867 episodes of gram-negative BSIs occurred among 3199 patients over 9 years, and there were 3032 significant BSI episodes 77% of these cases were healthcare-associated, while 23% were community-associated. The overall incidence of gram-negative BSIs fluctuated from 2.30 to 2.55 episodes per 1000 admissions over 9 years. Malignancy was the most common comorbidity and indwelling central intravenous catheter was the most common predisposing factor for gram-negative BSI. Escherichia coli were the major pathogen (34.3%), followed by Klebsiella pneumoniae (23.3%) and other bacterial pathogens (9.9%). The resistance rates of Escherichia coli and Klebsiella pneumoniae to penicillins were more than 90%. and the resistance rates of Acinetobacter baumannii to the most antibiotic were more than 70% include the Carbapenem. The resistance of ESBLs-producing Escherichia coli to the most antibiotic was higher than non-ESBLs producing Escherichia coli but to Carbapenems(0.7% VS 5.1%). The rates of Carbapenems resistance of ESBLs-producing Klebsiella pneumoniae and non-ESBLs producing Klebsiella pneumoniae were 32.8% and 8.1%. The rates of Carbapenems resistance of Enterobacter cloacae and Pseudomonas aeruginosa were 1.4% and 27.8% respectively. Between 2010 and 2018, the overall mortality of gram-negative BSIs decreased from 11.41–9.05%(X2 = 6.95, P = 0.434). Moreover, the mortality in the ICU decreased from 27.03–14.93%(X2 = 9.61, P = 0.212), while in the general ward fluctuated from 8.85–8.13% that without obvious decrease change(X2 = 9.29, P = 0.232). Conclusions The mortality of gram-negative BSIs have showed downward trends. carbapenem antibiotics is still consider the best treatment for patients with Gram-negative BSIs except Acinetobacter baumannii.

scholarly journals Aerobacterial Vaginosis among Women Attending an Infertility Clinic at a Tertiary Care Hospital in Chennai, India and Susceptibility Pattern of Isolates

2021 ◽  
Author(s):  
Abigail R. Sopia ◽  
Pushpa Innocent D. Joseph ◽  
M. Kalyani ◽  
B. Ananthi ◽  
Suresh Dhanaraj ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Protein Synthesis Inhibitors ◽  
Gram Positive ◽  
Gram Negative

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.

scholarly journals Neonatal Bacterial Sepsis and Its Susceptibility Pattern in Neonatal Care Unit of Tertiary Care Hospital

2020 ◽  
pp. 106-111
Author(s):  
Abdul Hameed Tunio ◽  
Delijan Mugheri ◽  
Muhammad Khan ◽  
Wasim Sarwar Bhatti ◽  
Abdul Majeed Soomro ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Large Scale ◽  
Tertiary Care ◽  
Research Work ◽  
Antibiotic Sensitivity ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: The drug resistance and pathogens are different in various Hospitals of any country. Very high resistance pattern is observed nowadays to the frequently used antibiotics. The important observation has been noted that most of the doctors do not obtain blood cultures before start of the antibiotics, which becomes competent source of resistance. For the same purpose, this study has been done to find out the responsible microbes causing ailment and their susceptibility towards antibiotics to plan early and effective management. Materials and Methods: A number of 100 new borns admitted in the NICU CMC Children Hospital Larkana with signs and symptoms of sepsis were included in this research work. The study will help in provision of a comprehensive record on microorganisms causing sepsis in the neonates and their antibiotic sensitivity. The epidemiology and presence of neonatal sepsis in particular area makes it more easy and convenient to implement the rationale of empirical antibiotic strategy. Results: From100 neonatal blood samples taken for culture, only 21 proved to be positive which stands 21%. In majority gram positive bacteria were found in (85.71%=18 cases) and gram negative bacteria stood (14.28%=3 cases).Staphylococcus species were found on the large scale (52.38%=11 cases) secondly Streptococcus species (33.33%=7 cases) and the remaining were Escherichia species being least common (14.28%=3 cases). Conclusion: Staphylococcus species provided major share as gram positive bacteria and Escherichia species were found to be major gram negative bacterial population responsible for neonatal sepsis. Profound resistance pattern is seen against widely used antibiotics. It is mandatory to have a routine check over the antibiotic resistance.

scholarly journals Pattern of UTI in Chronic Kidney Disease: Experience from A Tertiary Care Hospital, Bangladesh

2021 ◽  
Vol 20 (1) ◽  
pp. 41-45
Author(s):  
Marina Arjumand ◽  
Golam Mohammad Tayeb Ali ◽  
Pradip Kumar Dutta ◽  
Md Habib Hassan ◽  
Kazi Md Abrar Hasan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Urine Samples ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Gram Positive ◽  
College Hospital ◽  
Cross Sectional ◽  
Gram Negative

Background: Urinary Tract Infection (UTI) is common and higher in prevalence in patients with Chronic Kidney Disease (CKD). To find out the frequency and clinicobacteriological pattern of UTI in CKD patients. Materials and methods: A cross-sectional study was done on 1000 of CKD patients attending Nephrology Department of Chattogram Medical College Hospital (CMCH) a tertiary level hospital in Bangladesh during January to December, 2017. Cleancatch midstream urine samples were collected from study populations irrespective of symptoms. Macroscopic and microscopic examinations were done. Urine samples were then inoculated in Blood agar and Mac’Conkey agar and incubated aerobically at 37 °C for 18-24 hours. Microscopic observations and conventional biochemical tests were done to identify the isolated organisms. Significant growth of organisms in urine was defined as UTI. The isolated organisms were tested for antimicrobial susceptibility by using modified Kirby Bauer technique. Results: The prevalence of UTI was 61.8%. with significant asymptomatic UTI for 28%. Gram-negative organisms were most frequent 564 (93%) with predominant Escherichia coli 399 (64%) followed by Klebsiella 113(18%) and Pseudomonas 39(6%). Among Gram positive isolates, Staphylococcus (6%) was the dominant organism isolated. Regarding antibiotic susceptibility, Gram-negative microorganisms were found to be most sensitive to carbapenem and amikacin whereas Gram-positive microorganisms were most sensitive towards carbapenem, colistin and linezolid. Conclusion: In CKD patients, asymptomatic UTI was detected significantly. E.coli was found to be predominant organisms and resistant towards most of the studied common antibiotics. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 41-45

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