scholarly journals Extended Spectrum β-Lactamase (ESBL) Producing Multidrug Resistant Gram-Negative Bacteria from Various Clinical Specimens of Patients Visiting a Tertiary Care Hospital

2018 ◽  
Vol 4 ◽  
pp. 1-8
Author(s):  
Albert Ghimire ◽  
Bipesh Acharya ◽  
Reshma Tuladhar
Keyword(s):  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Clinical Specimens ◽  
Extended Spectrum ◽  
Esbl Producers

Objectives: The purpose of this study was to assess multidrug resistance and Extended Spectrum β-Lactamase (ESBL) production in Gram negative bacterial pathogens.Methods: The study included clinical specimens sent for routine culture and antibiotic susceptibility testing. A total of 469 different clinical specimens were processed according to the standard methodology. The isolates were identified by standard microbiological procedures and subjected to antimicrobial susceptibility testing by modified Kirby-Bauer disk diffusion method. Production of ESBL was determined by combined disk method.Results: Of the total sample processed, 80 (17.0%) Gram negative bacteria were isolated and 82.5% of them were multidrug resistant (MDR). From the total MDR isolates, 47% were ESBL positive. The higher rate of growth among Intensive Care Units (ICUs) patients was found statistically significant. Higher prevalence of MDR isolates was observed in blood and pus specimens. The majority of the ESBL producers were Escherichia coli (38.7%). Higher rate of ESBL producers was detected from blood (55.6%). Polymyxin B, imipenem and amikacin were the most effective antibiotics against Acinetobacter spp. and Pseudomonas aeruginosa whereas imipenem, amikacin, meropenem were the most effective antibiotics against Enterobacteriaceae.Conclusion: Higher prevalence of ESBL producing MDR Gram negative pathogens in hospitalized patients indicates these bacteria are important health care associated pathogens and requires proper infection control measures that check the transfer of MDR and β-lactamase producing bacterial pathogens among the hospitalized patients.

Prevalence and Antibiogram of Extended-Spectrum Beta-Lactamase Producing Gram-negative Bacteria Isolated from Septicemic Neonates in a Tertiary Care Hospital

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 171-175
Author(s):  
Tania Rahman ◽  
Momtaz Begum ◽  
Sharmeen Sultana ◽  
SM Shamsuzzaman
Keyword(s):  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Blood Samples ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

Background: In recent years, Extended-spectrum beta-lactamase (ESBL) producing microorganisms have complicated treatment of infections due to resistance of ESBL producing strains to a wide range of antimicrobials. Objective: Target of this study was to determine the prevalence of ESBL producing gramnegative bacteria in neonatal sepsis cases and to reveal the antimicrobial susceptibility pattern of those isolated ESBL producers. Materials and Methods: This cross sectional study was carried out in Dhaka Medical College Hospital (DMCH) over a period of 12 months from January to December in 2016. Following isolation and identification of gram-negative bacteria from blood samples of suspected septicemic neonates, antimicrobial susceptibility test was performed by Kirby Bauer disk-diffusion method and ESBL producers were detected by Double Disk Synergy (DDS) test. Results: Among 52 Gram-negative bacteria isolated from 106 blood samples, 34.61% ESBL producers were detected and Enterobacter spp. (45%) was predominant followed by Klebsiella pneumoniae (33.33%). None of the ESBL producers was resistant to colistin and tigecycline. All ESBL producing Acinetobacter baumannii, 77.78% and 66.67% of ESBL producing Enterobacter spp and Klebsiella spp. respectively showed resistance to meropenem. All ESBL producers were resistant to piperacillintazobactam. Conclusion: Appropriate measures should be taken to prevent the spread of ESBL producing strains by combining strategies for infection prevention, control and rational use of antibiotics. KYAMC Journal Vol. 11, No.-4, January 2021, Page 171-175

scholarly journals Detection of Extended Spectrum Beta-lactamase (ESBL) Producing Gram Negative Bacteria from Clinical Specimens of Sir Salimullah Medical College and Mitford Hospital.

2017 ◽  
Vol 10 (1) ◽  
pp. 8-12
Author(s):  
Shikha Paul ◽  
Sanya Tahmina Jhora ◽  
Prashanta Prasun Dey ◽  
Bilkis Ara Begum
Keyword(s):  
Tertiary Care ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Gram Negative ◽  
Clinical Specimens ◽  
Extended Spectrum Beta Lactamase ◽  
Medical College ◽  
Extended Spectrum ◽  
Esbl Producers

Detection of Extended spectrum beta lactamase (ESBL) enzyme producing bacteria in hospital settings is vital as ESBL genes are transmissible. This study was carried out to determine the distribution of ESBL producing gram negative isolates at a tertiary care hospital in Dhaka city which deals with the patients hailing from relatively low socioeconomic status.Onehundred and twenty four gram negative bacteria isolated from different clinical specimens from outpatient and inpatient departments of Sir Salimullah Medical College and Mitford Hospital (SSMC & MH) were tested for ESBL by E test ESBL method in the department of microbiology of Sir Salimullah medical college (SSMC) from March 2013 to August 2013.Out of 124 gram negative bacteria 69 (55.65%) were positive for ESBL. Among the ESBL producers, Esch.coli was the highest (46.38%) which was followed by Serratia spp (11.59%), Enterobacter spp (10.14%), Proteus spp, (8.70%), Acinetobacter spp.(7.24%) and Klebsiella spp.(5.79%). Out of 32 Esch.coli isolated from outpatient department, 10 (31.25%) were positive for ESBL. On the other hand out of 27 Esch. coli isolated from inpatient department, 22 (81.48%) were positive for ESBL. The difference was statistically significant (p<0.001).So the present study reveals that the distribution of ESBL producers is more among the hospitalized patients than the patients of the community.Bangladesh J Med Microbiol 2016; 10 (1): 8-12

scholarly journals Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Confirmatory Test ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Esbl Producers

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.

scholarly journals Detection of TEM and CTX-M Genes in Escherichia coli Isolated from Clinical Specimens at Tertiary Care Heart Hospital, Kathmandu, Nepal

Diseases ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 15
Author(s):  
Ram Shankar Prasad Sah ◽  
Binod Dhungel ◽  
Binod Kumar Yadav ◽  
Nabaraj Adhikari ◽  
Upendra Thapa Shrestha ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Bacterial Isolates ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
Clinical Specimens ◽  
E Coli ◽  
Esbl Producers

Background: Antimicrobial resistance (AMR) among Gram-negative pathogens, predominantly ESBL-producing clinical isolates, are increasing worldwide. The main aim of this study was to determine the prevalence of ESBL-producing clinical isolates, their antibiogram, and the frequency of ESBL genes (blaTEM and blaCTX-M) in the clinical samples from patients. Methods: A total of 1065 clinical specimens from patients suspected of heart infections were collected between February and August 2019. Bacterial isolates were identified on colony morphology and biochemical properties. Thus, obtained clinical isolates were screened for antimicrobial susceptibility testing (AST) using modified Kirby–Bauer disk diffusion method, while ESBL producers were identified by using a combination disk diffusion method. ESBL positive isolates were further assessed using conventional polymerase chain reaction (PCR) to detect the ESBL genes blaTEM and blaCTX-M. Results: Out of 1065 clinical specimens, 17.8% (190/1065) showed bacterial growth. Among 190 bacterial isolates, 57.4% (109/190) were Gram-negative bacteria. Among 109 Gram-negative bacteria, 40.3% (44/109) were E. coli, and 30.2% (33/109) were K. pneumoniae. In AST, 57.7% (n = 63) Gram-negative bacterial isolates were resistant to ampicillin and 47.7% (n = 52) were resistant to nalidixic acid. Over half of the isolates (51.3%; 56/109) were multidrug resistant (MDR). Of 44 E. coli, 27.3% (12/44) were ESBL producers. Among ESBL producer E. coli isolates, 58.4% (7/12) tested positive for the blaCTX-M gene and 41.6% (5/12) tested positive for the blaTEM gene. Conclusion: Half of the Gram-negative bacteria in our study were MDR. Routine identification of an infectious agent followed by AST is critical to optimize the treatment and prevent antimicrobial resistance.

scholarly journals Multidrug resistant, extensively drug resistant and pan drug resistant gram negative bacteria at a tertiary care centre in Bhubaneswar

2019 ◽  
Vol 6 (2) ◽  
pp. 567 ◽  
Author(s):  
Dipti Pattnaik ◽  
Subhra Snigdha Panda ◽  
Nipa Singh ◽  
Smrutilata Sahoo ◽  
Ipsa Mohapatra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Extensively Drug Resistant ◽  
Resistant Strains ◽  
Drug Resistant Strains ◽  
Esbl Producers

Background: Multidrug resistance has emerged as a challenge in health care settings. Again increasing prevalence of multidrug resistant (MDR), extensively drug resistant (XDR) and pan drug resistant (PDR) gram negative bacteria is making the condition more critical because of limited options of antibiotics, increasing morbidity, mortality and hospital stay of the patients. The present study is carried out with an aim to estimate the prevalence of MDR, XDR, PDR gram negative bacteria in a tertiary care hospital.Methods: Total of 912 gram negative bacterial isolates obtained from various samples of indoor patients in a tertiary care hospital, were studied over a period of six months. The bacteria were identified by conventional methods. Antibiotic sensitivity testing was done by Kirby Bauer disc diffusion method. Minimum inhibitory concentration (MIC) of antibiotics for the resistant isolates were detected by Vitek-2 automated method. MDR, XDR and PDR were determined according to the definitions suggested by European Centre for Disease Prevention and Control (ECDC), and Centers for Disease Control and Prevention (CDC). Prevalence of extended spectrum beta lactamase (ESBL) producers was estimated.Results: Out of 912 isolates, prevalence of MDR, XDR and PDR were 66.12%, 34.32% and 0.98% respectively. Prevalence of MDR and XDR were higher in ICUs than clinical wards (p<0.0001). Prevalence of ESBL producers was 48.4%.Conclusions: The study highlights increased prevalence of multidrug resistant and extensively drug resistant strains in our hospital. Stringent surveillance, proper implementation of hospital infection control practices and antimicrobial stewardship will help in limiting the emergence and spread of drug resistant strains.

scholarly journals Detection and genetic characterization of extended-spectrum beta-lactamases producers in a tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 253-258 ◽  
Author(s):  
Suryarashmi Sahoo ◽  
Sarita Otta ◽  
Bichitrananda Swain ◽  
Subrat Kumar Kar
Keyword(s):  
Klebsiella Oxytoca ◽  
Tertiary Care ◽  
Conventional Polymerase Chain Reaction ◽  
Diffusion Method ◽  
Care Hospital ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing organisms inactivate extended beta-lactam antibiotics and monobactams and also exhibit coresistance to many other classes of antibiotics. The present study was carried out to assess the prevalence of the ESBLs and to determine the most prevalent genotype in our hospital. MATERIALS AND METHODS: All clinically significant Gram-negative isolates were identified, and their antimicrobial susceptibility testing was done by Kirby–Bauers' disc diffusion method. ESBL detection was confirmed by minimal inhibitory concentration method using agar dilution technique for those who screened positive by ceftazidime (30 μg) disc. Further, the established ESBL-positive isolates were subjected to genotyping for bla TEM, bla CTX-M, and bla SHV genes by using conventional polymerase chain reaction. RESULTS: Escherichia coli was the most common (28.84%) Gram-negative bacillus followed by Klebsiella pneumoniae (18.07%), while Pseudomonas spp. (9.61%) was the most commonly identified nonfermenter. ESBL production was detected in 160 (30.8%) isolates. Klebsiella oxytoca (46.7%) followed by E. coli (44%) were the common ESBL producers. Most predominant ESBL gene was bla TEM, found in 122 (76.25%) isolates. Combinations of two genes were seen in 109 (68.1%) isolates, the most common (43.12%) combination being blaTEM and blaCTX-M. In this study, 16 (10%) strains had all the three types of genes. Most of the isolated Gram-negative bacilli (GNB) were sensitive to amikacin, imipenem, and colistin. CONCLUSION: In our study, the 30.8% of GNB were ESBL producers. This is the only study that shows that TEM is the most prevalent ESBL genotypes in our area. Of concern is a good number of isolates showing all three patterns of genes (TEM, SHV, and CTX-M). Amikacin, imipenem, and colistin were the most useful antibiotics in our setup.

scholarly journals Frequency of ESBL in Surgical Site Infection at a Tertiary Care Hospital

2014 ◽  
Vol 1 (2) ◽  
pp. 25-29 ◽  
Author(s):  
M Saiful Islam ◽  
M Abdullah Yusuf ◽  
M Badrul Islam ◽  
Waseka Akhter Jahan
Keyword(s):  
Surgical Site Infection ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Site Infection ◽  
Klebsiella Species ◽  
Gram Negative ◽  
E Coli ◽  
Pseudomonas Species ◽  
Esbl Producers

Background: Infection caused by ESBL in the surgical site infection is very alarming. Objective: The purpose of the present study was to see the status of ESBL bacteria isolated from surgical site infection with their antimicrobial sensitivity pattern.Methodology: This cross sectional study was conducted in the Department of Microbiology at Dhaka Medical College, Dhaka from January, 2005 to December, 2005 for a period of one (1) year. All the patients presented with surgical site infections at any age with both sexes were included a study population. Detection of extended spectrum beta lactamase producing Gram negative bacteria was done by using disc diffusion method and was confirmed by E- test ESBL method. Sensitivity pattern of ESBL producers were observed against quinolone and fluoroquinolones. ESBLs are the enzymes capable of hydrolyzing all penicillin, monobactam and cephalosporins except cephamycin, but inactive against imipenem.Result: A total number of 92 surgical wound samples were collected of which 68(73.9%) samples were culture positive. Interestingly, most of the E. coli was ESBL positive (55.0%). Klebsiella species was 33.1% ESBL positive. ESBL positivity of Proteus and Pseudomonas species were low (11.1%). Among the isolated Pseudomonas species, 1(6.67%) of the 15 strains isolated from wound swab was ESBL producers. ESBL positivity was significantly found in surgically wound samples (p=0.0001). Among the ESBL producers, all the E. coli, Klebsiella species, Proteus species and Pseudomonas species were resistant to amoxicillin, cephradine, ceftriaxone, aztreonam, ceftazidime and cefotaxime. All the Gram negative bacteria were sensitive to imipenam. Conclusion: A considerable numbers of ESBL producing bacteria were detected from surgical wound.DOI: http://dx.doi.org/10.3329/jcamr.v1i2.20514 Journal of Current and Advance Medical Research Vol.1(2) 2014: 25-29

scholarly journals MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

2017 ◽  
Vol 10 (6) ◽  
pp. 78
Author(s):  
Bhuvaneshwari Gunasekar
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Multiple Antibiotic Resistance ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Mar Index ◽  
Surgery Department

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of  surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

scholarly journals Genotypic Detection and Characterization of Adhesins in Clinical Escherichia coli Isolates

2020 ◽  
pp. 84-93
Author(s):  
M. Y. Iliyasu ◽  
I. Mustapha ◽  
H. Yakubu ◽  
H. M. Shuaibu ◽  
A. F. Umar ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Strong Relationship ◽  
Multidrug Resistant ◽  
Luria Bertani ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Virulence Determinants ◽  
Gram Negative ◽  
Virulence Markers ◽  
Significant Alignment

Background of Study: Many virulence determinants contribute to the pathogenicity of Gram negative bacteria, like Escherichia coli, which is the most common cause of many infections worldwide such as urinary tract infection (UTI), profuse diarrhoea and septicaemia. Aim: To determine the genotypic characteristics of adhesin-producing E. coli isolates from clinical specimens. Place and Duration of Study: Conducted at the Infectious diseases hospital Bayara, Bauchi state, Nigeria, between February to March, 2019. Methods: A total of twelve (12) Gram negative bacterial isolates were selected based on the ability to grow on Luria-Bertani (LB) agar medium containing 100 µg/ml ampicillin. The isolates were from urine, stool, and blood specimens. The isolates were screened for multidrug resistant pattern according to Kirby-Bauer disc diffusion method. Adhesion factors, Fimbrial adhesin (fimH) and Invasive plasmid adhesin (ipaH) was genotyped by conventional PCR and sequenced. Results: All the isolates were resistant to Ampicillin, Cephalothin, Erythromycin, Fusidic acid, Novobiocin and Oxacillin, but sensitive to Augmentin, Colistin sulphate and Imipenem. Presence of fimH and ipaH genes were observed in nine isolates that expressed strong relationship with. Multidrug resistance (MDR). The fimH was the most prevalent found in urine, stool and blood isolates. Most of the adhesion genes sequence (61.8%) in this study had significant alignment (95 to 100% homology) with E.coli genome in the NCBI database. Conclusion: This study revealed the role of adhesin as virulence markers in MDR Gram negative bacteria and FimH is one of the commonest gene in MDR E.coli pathotypes.

Sign in / Sign up

Export Citation Format

Share Document