scholarly journals Phenotypic Assays for Detection of AmpC and MBL Producers among the Clinical Isolates of Multi Drug Resistant Pseudomonas aeruginosa

2018 ◽  
Vol 4 ◽  
pp. 23-31
Author(s):  
Sarita Manandhar ◽  
Sarashwoti Adhikari ◽  
Sujeeb Rajbhandari
Keyword(s):  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Drug Resistant ◽  
Antibiotic Susceptibility Testing ◽  
Cross Sectional

Objectives: In order to determine the prevalence of multi-drug resistance along with AmpC and metallo-β-lactamase producing P. aeruginosa, a six month cross-sectional study was carried out at Shahid Gangalal National Heart Center.Methods: A total of 756 clinical specimens were analyzed for bacteriological profile. The bacterial isolates were identified by cultural and biochemical techniques. Antibiotic susceptibility testing of the isolates was performed by Kirby-Bauer disc diffusion method. MDR isolates were screened and tested for MBL and AmpC production. Ceftazidime resistant isolates were tested for MBL and Cefoxitin resistant isolates for AmpC.Results: Among all the clinical samples analyzed, P. aeruginosa was detected in 75 samples (9.92%). Antibiotic susceptibility testing showed Imipenem as the most effective drug with susceptibility of 76% followed by Piperacillin-Tazobactam (74.7%) and Piperacillin (41.3%). Out of 75 P. aeruginosa isolates, 53 (70.6%) of them were found to be resistant to at least three out of four anti-pseudomonal agents, thus were considered as MDR. Out of 53 multi-drug resistant P. aeruginosa (MDRPA), all were resistant to ceftazidime whereas 85% (45/53) were resistant to cefoxitin. Out of 53 isolates, 11 (20.75%) showed positive result for MBL. Similarly, 7 out of 45 i.e. 13.2% were found to be AmpC producers.Conclusion: This study signified the high prevalence of MDRPA which is an alarming rate. Also multiple β-lactamase producing P. aeruginosa were detected which can further complicate the treatment options. Regular monitoring of antibiotic susceptibility and rational use of antibiotics would be helpful in eliminating the outbreaks of multiple β-lactamase producing MDRPA.

Carbapenem resistance among common Enterobacteriaceae Clinical Isolates in part of North-East India

2021 ◽  
Vol 19 ◽  
Author(s):  
Mohan Sharma ◽  
Pankaj Chetia ◽  
Minakshi Puzari ◽  
Nakul Neog ◽  
Upasana Phukan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Treatment Options ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
North East

Background: Enterobacteriaceae, the normal dwellers in the human intestine, are commonly associated with a variety of community acquired and nosocomial infections. Emerging trend of antibiotic resistance among these strains is a notable issue globally; more serious threat is the resistance against the available last resort antibiotics- the carbapenems. Objective: The objective of our study was intended to determine the burden of resistance towards common antibiotic classes, so as to address the gap of drug resistance prevalence data, among the Enterobacteriaceae isolates obtained from the health settings in this region. Methodology: A cross-sectional study was done with inclusion of clinical isolates collected from varied sources, from health settings in upper Assam. The isolates were identified based on standard methods of morphology study and biochemical tests. The identified isolates were then subjected to antibiotic susceptibility testing by following Kirby-Bauer disc diffusion method and the result interpreted as per the CLSI guidelines. The resistance of the reported carbapenem resistant isolates was confirmed by minimum inhibitory concentration (MIC) determination using commercial E-strip kit. Results: Among the enterobacterial isolates Klebsiella spp. accounted the majority, followed by Escherichia coli, Citrobacter spp., Shigella spp. and others. Multi-drug resistance (MDR) was noted among 67.6% isolates; however, carbapenem resistance was confirmed in 18.9% of the total Enterobacteriaceae isolates. Conclusion: Higher prevalence of resistance towards carbapenems, among the Enterbacteriaceae isolates of upper Assam seems to be upcoming threat to the region, limiting the treatment options in future.

scholarly journals Phenotypical and Genotypical Comparison of Clostridium difficile Isolated from Clinical Samples: Homebrew DNA Fingerprinting versus Antibiotic Susceptibility Testing (AST) and Clostridial Toxin Genes

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Javid Sisakhtpour ◽  
Fatemeh Savaheli Moghadam ◽  
Sepideh Khodaparast ◽  
Nima Khoramabadi ◽  
Ashraf Mohabati Mobarez
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Dna Fingerprinting ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Inhibitory Concentration ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Antibiotic Susceptibility Testing ◽  
Anaerobic Culture ◽  
Toxin Genes

Background. Clostridium (Clostridioides) difficile is recognized as the major cause of healthcare antibiotic-associated diarrhea. We surveyed a molecular epidemiological correlation between the clinical isolates from two general hospitals in Iran through clustering toxigenic types and antibiotic susceptibility testing (AST) accuracy. Methods. Study population included 460 diarrhoeic specimens from inpatients with a history of antibiotic therapy. All samples underwent enriched anaerobic culture, confirmed by detection of gluD gene with PCR. Toxin status and AST were assessed by the disk diffusion method (DDM) and minimal inhibitory concentrations (MICs) of metronidazole, vancomycin, and rifampin. C. difficile outbreak was analyzed through conventional PCR by tracing toxin genes and Homebrew pulsed-field gel electrophoresis (PFGE) for characterizing isolates within our healthcare systems. Results. A total of 29 C. difficile strains were isolated by enriched anaerobic culture from the clinical samples. Among them, 22 (4.8%) toxigenic profiles yielded toxins A and B (tcdA, tcdB) and binary toxins (cdtA, cdtB). The minimum inhibitory concentration (MIC) was 18.1% and 9% for vancomycin and metronidazole, and all isolates were susceptible to rifampicin and its minimum inhibitory concentration was at <0.003 μg/mL. The most dominant toxigenic and antibiotic-resistant “pulsotype F” was detected through PFGE combined with multiple Clostridial toxigenic pattern and AST. Conclusions. DNA fingerprinting studies represent a powerful tool in surveying hypervirulent C. difficile strains in clinical settings. Resistance to vancomycin and metronidazole, as first-line antibiotics, necessitate accomplishment of proper control strategies and also prescription of tigecycline as a more appropriate option.

scholarly journals Prevalence of constitutive and inducible clindamycin resistance among clinical isolates of Staphylococcus aureus in a tertiary care institute in North India

2017 ◽  
Vol 5 (7) ◽  
pp. 3120
Author(s):  
Jeevan Shetty ◽  
Zarrin Afroz
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Antibiotic Susceptibility Testing ◽  
Sensitivity Testing ◽  
Inducible Clindamycin Resistance

Background: Clindamycin is an important drug used in the treatment of Methicillin Sensitive Staphylococcus aureus (MSSA) as well as in Methicillin-resistant Staphylococcus aureus (MRSA) infections. This drug is widely used in the treatment of skin and soft tissue infections caused by them. Therapeutic failure caused by macrolide-lincosamine-streptogramin B constitutive and inducible clindamycin resistance (MLSBc and MLSBi) is being more commonly reported.Methods: The present study was conducted over a period of six months from October 2016 to March 2017 to know the incidence of MLSBc and MLSBi in Staphylococcus aureus (S. aureus) isolates obtained in our hospital by D-test as per CLSI guidelines. A total of 130 isolates of S.aureus were obtained from different clinical specimens which included pus/ wound swab (n=266), urine (n=577), sputum (n=225), blood (n=221), throat swab (n=71), ear/eye discharge (n=21), high vaginal swab (n=20) and body fluids (n=50). All the isolates were subjected to antibiotic sensitivity testing by Kirby Bauer’s disc diffusion method. Amoxyclav, Erythromycin, Clindamycin, Co-trimoxazole, Tetracycline, Ofloxacin, Gentamicin, Linezolid and Vancomycin were the antibiotics used.Results: Out of 130 (8.9%) isolates of S. aureus obtained from 1451 clinical samples, 82 (63.1%) were found to be MSSA and 48 (36.9%) were MRSA. Among S. aureus, 43 (33.1%) isolates showed MLSBc resistance, 22 (16.9%) isolates showed MLSBi resistance and 20 (15.4%) isolates showed MS phenotype. The remaining 45 (34.6%) isolates remained sensitive to Erythromycin. Among MSSA, MLSBc were observed in 18 (22%) isolates and MLSBi in 9 (11%) while in MRSA, MLSBc were observed in 25 (52.1%) isolates and MLSBi in 13 (27.1%) isolates. Almost all clinical isolates showed 100% sensitivity to Vancomycin and Linezolid in routine antibiotic susceptibility testing. Both MLSBc and MLSBi resistance was significantly higher (p<0.05) in MRSA than in MSSA.Conclusions: The study emphasizes the importance of conducting D test along with routine antibiotic susceptibility testing for better utilization of clindamycin in S. aureus infections.

scholarly journals Study of antibiotic resistance profiling of Staphylococcus aureus isolated from clinical specimens of the patients attending a tertiary teaching hospital from Chhattisgarh

2017 ◽  
Vol 5 (11) ◽  
pp. 4808
Author(s):  
Archana Bhimrao Wankhade ◽  
Sanjibkumar Panda ◽  
Riddhi Hathiwala ◽  
Yogendra Keche
Keyword(s):  
Staphylococcus Aureus ◽  
Multidrug Resistance ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Antibiotic Susceptibility Testing ◽  
Microbiological Methods ◽  
Tertiary Teaching

Background: Staphylococcus aureus is a pathogen causing wide spectrum of infections. It has tendency for the development of multidrug resistance thereby exposing the selection of appropriate treatment. Therefore, the present study was undertaken to find out the antibiotic susceptibility pattern of Staphylococcus aureus isolated from various clinical samples in teaching tertiary hospital.Methods: Total 85 Staphylococcus aureus was isolated from clinical samples (pus, urine, sputum and blood) tested. Identification of Staphylococcus aureus was done by standard conventional microbiological methods. Antibiotic susceptibility testing was done by using disk diffusion method as per CLSI guidelines.Results: Staphylococcus aureus was isolated maximum from pus samples followed by urine samples. Antibiotic susceptibility testing showed highest resistance against Penicillin (69%) and Erythromycin (51%) followed by Cotrimoxazole (50%) & Nitrofurantoin (50%). All the strains were sensitive to Vancomycin. Amongst the urine isolates all were sensitive to Norfloxacin. These percentages of sensitivities are characteristically higher in our study than the previous studies in the literature. In addition, out of 85 Staphylococcus aureus isolates, 26 isolates showed sensitivity   to all antibiotics.Conclusions: From the present study we conclude that though the Staphylococcus aureus is usually having multidrug resistance pattern. So regular antimicrobial susceptibility surveillance is essential for area‐wise monitoring of the resistance patterns. This will be beneficial to preserve the effectiveness of antibiotics and for better patient management.

scholarly journals Staphylococcus aureus with inducible clindamycin resistance and methicillin resistance in a tertiary hospital in Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Devi Thapa ◽  
Susil Pyakurel ◽  
Sabita Thapa ◽  
Suresh Lamsal ◽  
Mahesh Chaudhari ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Susceptibility Testing ◽  
Methicillin Resistance ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Antibiotic Susceptibility Testing ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

Abstract Background Staphylococcus aureus is a global public health issue in both community and hospital settings. Management of methicillin-resistant S. aureus (MRSA) infections are tough owing to its resistance to many antibiotics. Macrolide-lincosamide-streptogramin B (MLSB) antibiotics are commonly used for the management of MRSA. This study was aimed to determine the occurrence of inducible clindamycin- and methicillin-resistant S. aureus at a tertiary care hospital in Kathmandu, Nepal. Methods A total of 1027 clinical samples were processed following standard laboratory procedures and antibiotic susceptibility testing of S. aureus was performed by disc diffusion method. MRSA isolates were detected phenotypically using cefoxitin disc, and inducible clindamycin resistance was detected phenotypically using the D-zone test. Results Of 1027 samples, 321 (31.2%) were culture positive, of which 38 (11.8%) were S. aureus. All S. aureus isolates were susceptible to vancomycin, and 25 (67%) of S. aureus isolates were multidrug-resistant. Similarly, 15 (39.5%) of S. aureus were MRSA and 14 (36.5%) were inducible clindamycin-resistant phenotypes. Conclusion Inducible clindamycin and methicillin resistance were common in S. aureus. This emphasizes that the methicillin resistance test and the D-zone test should be incorporated into the routine antibiotic susceptibility testing in hospital settings.

scholarly journals Menace to the ultimate antimicrobials among commonEnterobacteriaceaeclinical isolates in part of North-East India

2019 ◽  
Author(s):  
Mohan Sharma ◽  
Pankaj Chetia ◽  
Minakshi Puzari ◽  
Nakul Neog ◽  
Amrit Borah
Keyword(s):  
Treatment Options ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
North East India ◽  
North East ◽  
Therapeutic Decision Making

AbstractIntroductionEnterobacteriaceae, the normal dwellers in the human intestine, commonly associated with a variety of community acquired and nosocomial infections. Emerging trend of antibiotic resistance among these strains is a notable issue globally; more serious threat is the resistance against the available last resort antibiotics- the carbapenems. Our study thus intended to determine the burden of resistance towards this ultimate antimicrobial class, so as to assist in the empiric therapeutic decision making process and to search for alternate options.Materials and MethodsOur study was a cross-sectional study with inclusion of clinical isolates collected from varied sources, from health settings in upper Assam. The isolates were identified based on standard methods of morphology study and biochemical tests. The identified isolates were then subjected to antibiotic susceptibility testing following Kirby-Bauer disc diffusion method and the result interpreted as per the CLSI guidelines. The resistance of the reported carbapenem resistant isolates was confirmed by minimum inhibitory concentration (MIC) determination using commercial E-strip kit.ResultsAmong the enterobacterial isolatesKlebsiellaspp. accounted the majority, followed byEscherichia coli,Citrobacterspp.,Shigellaspp. and others. Multi-drug resistance (MDR) was noted among 67.6% isolates; however, carbapenem resistance was confirmed in 18.9% of the totalEnterobacteriaceaeisolates.ConclusionHigher prevalence of resistance towards the last resort antimicrobial, carbapenems, among theEnterbacteriaceaeisolates of upper Assam seems to be upcoming threat to the region, limiting the treatment options in future.

scholarly journals Urinary tract infections and antibiotic susceptibility among the patients attending B & D hospital of Lalitpur, Nepal

2016 ◽  
Vol 7 (5) ◽  
pp. 47-51 ◽  
Author(s):  
Yadav Prasad Joshi ◽  
Shreejeet Shrestha ◽  
Russell Kabir ◽  
Anita Thapa ◽  
Parbati Upreti ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Susceptibility ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Tract Infections

Background:Urinary tract infection is the most common bacterial infections in humans and serious health problem in many parts of the world. It has become more complicated in treatment due to different pathogens and increasing resistant to antimicrobial agents. This study aims to investigate the prevalence of urinary tract infection and antibiotic susceptibility patterns of pathogens among the patients attending in B & B hospital Nepal.Materials and Methods:A hospital based cross sectional study was conducted in between April 2010 to March 2011. Urine samples were collected from clinically suspected patients and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for isolated pathogen using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines.Results:Out of 1260 examined specimens 25.24 % were positive and majority 61.64% were females.  The most common pathogens isolated were Escherichia coli (66.67%), Enterococcus (7.55%) and Staphylococcus (6.60 %). The drug resistant among the positive cases were reported. The highest resistant of positive cases was found with Cefexime (87.88%) and Enterococcus with Ampicillin (66.67%) and Staphyllococcus with Cloxacillin (66.67%). The highest susceptibility was for Vancomycin and Ampicillin i.e. 33.33% in each.Conclusion:The findings showed that E. coli isolates were the predominant pathogen and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs. As drug resistance among bacterial pathogens is an evolving process and serious issue. Therefore, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs. Asian Journal of Medical Sciences Vol.7(5) 2016 47-51

scholarly journals Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

2019 ◽  
Author(s):  
Jacob Stanley Iramiot ◽  
Innocent B. Rwego ◽  
Catherine Kansiime ◽  
Benon B Asiimwe
Keyword(s):  
Vibrio Cholerae ◽  
Antibiotic Susceptibility ◽  
Case Fatality ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Suspected Case ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Mueller Hinton Agar ◽  
Global Threat

Abstract Background Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Materials and methods This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.

scholarly journals Antimicrobial Resistance Pattern of Extensively Drug Resistant Carbapenemase Producing Enterobacteriaceae

2019 ◽  
Vol 13 (2) ◽  
pp. 7-10
Author(s):  
Fatima Afroz ◽  
Shaheda Anwar ◽  
Mashrura Quraishi ◽  
GM Mohiuddin ◽  
SM Ali Ahmed ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Extensively Drug Resistant ◽  
Broth Microdilution Method

Carbapenems, often agents of last resort for multidrug resistant bacterial infections are now threatened by widespread dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Production of carbapenemases remain the most clinically important mechanism of carbapenem resistance in Enterobacteriaceae. The objective of this study was to determine the antibiogram pattern of carbapenemase producing Enterobacteriaceae. A cross sectional study was conducted at department of Microbiology and Immunology, BSMMU from September 2018 to August 2019. A total of 145 CRE isolates from different clinical samples were studied.Antimicrobial susceptibility was examinedby disk diffusion method and MIC of colistin by broth microdilution method. Resistant carbapenemase genes NDM and OXA-48 were identified by polymerase chain reaction. Out of 145 CRE isolates, 104 were NDM, 73 were OXA-48and 34 isolates were both NDM and OXA-48 co-producers. All the NDM and OXA-48 carbapenemase producing isolates were 100% resistant to meropenem, imipenem, ertapenem, ceftriaxone, ceftazidime, cefotaxime, cefuroxime, amoxicillin + clavulanic acid and piperacillin + tazobactam. Resistance rates of reserved antimicrobials to treat CRE isolates were also alarming. Thirty seven percent, 9.6% and 5.5 % of OXA-48 carbapenemase producers and 26.0%, 10.6% and 2.9% of NDM carbapenemase producers were resistant to colistin, polymyxin B and tigecycline respectively.Among the carbapenemase producing isolates, 16.6% (24) were multidrug resistant (MDR), 82.1% (119) were extensively drug resistant (XDR) and 1.3% (2) isolates were pan drug resistantwhich highlights the emerging therapeutic challenge for these superbugs. Bangladesh J Med Microbiol 2019; 13 (2): 7-10

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