scholarly journals Bacterial profile and their antibiotic resistance in an ICU of Bangladesh: Comparison of four studies from 2004 to 2011

2016 ◽  
Vol 4 (2) ◽  
pp. 79-85 ◽  
Author(s):  
Kaniz Fatema ◽  
ASM Areef Ahsan ◽  
Lovely Barai ◽  
Fatema Ahmed ◽  
Jalaluddin Ashraful Haq ◽  
...  

Antimicrobial resistance plays a vital role in determining the outcome of the critically ill patients with infections in intensive care unit (ICU).Aim: The objective of this study was to evaluate the frequencies of isolated pathogens and their resistance pattern in an ICU of Bangladesh. The study also aimed to analyze and compare the trends of bacterial population and their resistance pattern in the same ICU between 2004 and 2011 in four different studies.Materials and Method: A cross sectional study was carried out in a 10 bed adult ICU of a tertiary care hospital of Bangladesh over a period of 10-month, from January 2011 to October 2011. Blood, respiratory secretions and urine from patients with clinically suspected infections were included in the study. Findings were compared with previous three studies done in 2004, 20006-07, and 2008-09 in same ICU.Results: In 2011, a total of 1408 samples were analyzed. Six hundred eighty-four micro-organisms were isolated from 597 samples. Maximum growth was obtained from respiratory secretions (71.7%). Organisms isolated were Acinetobacter sp. (46.4%), Pseudomonas sp. (21.4%), Candida sp. (11.5%), Klebsiella sp. (9.9%), Eschericia coli (4.1%) and Staphylococcus aureus (2.9%). Major gram negative organisms were highly resistant to 3rd generation cephalosporins (>70%). All Acinetobacter sp. were extremely resistant (>85%) to all antibiotics except colistin. Resistance of isolated Pseudomonas sp. was >65% to ciprofloxacin, >70% to aminoglycosides, and >85% to imipenem. About 72% of the isolated Staphylococcus aureus was methicillin resistant with variable resistant to other antibiotics. Comparing the findings of this study with previous three studies done in same ICU, it has been found that rate of isolation of Acinetobacter sp., was increased significantly (p<0.05) in this ICU population with decrease in rate of Pseudomonas sp., Eschericia coli, Staphylococcus aureus, Enterococci sp., and Candida sp. Resistances pattern of two commonest gram negative organisms, eg Acinetobacter sp. and Pseudomonas sp., to the available antibiotics showed gradual increase in resistance from 2004 to 2011.Conclusion: It is recommended that strict infection control policies and antibiotic stewardship program must be implemented to solve this emerging drug resistance problem which might cause high morbidity and mortality in ICU patients.Bangladesh Crit Care J September 2016; 4 (2): 79-85

2020 ◽  
Vol 14 (3) ◽  
pp. 1961-1966
Author(s):  
A. Deboral ◽  
Namrata K. Bhosale ◽  
S. Umadevi

The antibiotic resistance pattern was observed significantly in various geographical locations. Routine surveillance is therefore essential for constant monitoring of AMR rates in the clinically important pathogens. It is imperative to track the changing resistance pattern over time, to guide proper therapeutic strategies to combat infections due to drug-resistant pathogens. This study aims to highlights the distribution of aerobic bacterial isolated from pus samples, and their susceptibility to different antibiotics collected during 2017 (July to December) in a tertiary care hospital. Nearly 637 clinical pus samples were received during July to December 2017 to the Department of Microbiology, Tertiary care hospital, Puducherry. Bacterial identification was performed using standard conventional biochemical tests and antibiotic susceptibility was carried out according to CLSI guidelines 2017 on each one of the aerobic bacterial isolates from the pus samples. Among the isolates 76.5% were Gram-negative bacilli (GNB) as well as 23.5% were Gram-positive cocci (GPC). The most common bacteria isolated were Pseudomonas spp 24.88% (108 in 434), followed by Escherichia coli 21.66% (94 in 434), Staphylococcus aureus 19.82% (86 in 434) and Klebsiella pneumoniae 13.13% (57 in 434). Of the 86 (19.82%) Staphylococcus aureus isolates, 16 (18.40%) were MRSA. Pseudomonas aeruginosa was highly susceptible to the carbapenems and least susceptible to ciprofloxacin. Acinetobacter baumannii was the most resistant organism according to this study and showed the least susceptibility to ceftriaxone and maximum susceptibility to aminoglycosides. This study concluded that the Pseudomonas aeruginosa isolate was found to be a predominant in our clinical pus samples. Gram negative bacteria are more commonly associated with the pyogenic lesion that Gram positive. A high level of an antibiotic resistance was observed in most of our bacterial isolates.


2016 ◽  
Vol 17 (2) ◽  
pp. 91-94
Author(s):  
Sarker Mohammad Tauhid Jamil ◽  
Mohammad Omar Faruq ◽  
Shafiqus Saleheen ◽  
Prodip Kumar Biswas ◽  
Mohammed Shahadat Hossain ◽  
...  

Objective: Aim of the study was to know the microorganisms profile and determine the antibiotic resistance pattern of the LRT isolates from mechanically ventilated (MV) patients admitted to the ICU. This prospective observational study was done in Department of Critical Care Medicine (ICU) of BIRDEM General Hospital Dhaka from July, 2011 to December, 2011.Methods: Blind Tracheal Aspirate or Broncho Alveolar Lavage or both from 110 consecutive patients (total 130 samples) admitted to the ICU requiring MV were cultured, identified, and antibiotic sensitivity was performed by standard methods.Results: A total of 130 samples were analyzed. Growth was obtained in 93.8% of the samples yielding 143 organisms. Many (21 samples) yielded more than one organism. The major organism isolated were Acinetobacter sp. (54.5%), Pseudomonas sp.(14.7%), Klebsiella sp. (7.7%).Candida sp. (7.0%), Staphylococcus aureus(7.0%), Escherichia coli (4.9%).Proteus and Flavobacterium accounted for 4.2% of the isolates. All the isolates were highly resistant (>90%) to cephalosporins and >70% to fluoroquinolones. The frequency of third generation cephalosporin resistant E. coli, Klebsiellaand imipenem resistant Pseudomonas and Acinetobacter were>90%. Acinetobacter was remarkably resistant to most antibiotics including imipenem (>90% resistant) and Piperacillin+Tazobactum (>85% resistant), but most of the members of the Enterobacteriacae group and Acinetobacter showed maximum sensitivity to colistin (80%-100%).Conclusion: Nonfermenters Gram Negative Bacilli (GNB)-Acinetobacter sp. & Pseudomonas sp. are the most common etiological agents of LRT infections in ICU. There is an alarmingly high rate of resistance to cephalosporin and ²â-lactamase inhibitor group of drugs. Colistin was found to be the most sensitive drug against all GNB.J MEDICINE July 2016; 17 (2) : 91-94


2021 ◽  
Vol 8 (3) ◽  
pp. 910
Author(s):  
Vijayakumar A. B. ◽  
Yerriswamy Parvatha Reddy ◽  
Suphala B. ◽  
Ananya Gopalakrishnan ◽  
Vinod Kumar C. S.

Background: Osteomyelitis has been continuing as the most important cause of morbidity among patients with bone infections. Constant change in the trend of organisms involved and resistance pattern has made management of osteomyelitis cases difficult. With this background present study aimed to look for the changing trends of microorganisms involved in osteomyelitis and their antimicrobial susceptibility pattern.  Methods: A total of 100 cases studied over a period of two years. Samples collected were processed by standard microbiological techniques and antimicrobial testing was done as per the clinical and laboratory Standards Institute guidelines. Results: Among 100 cases, 62 were males and 38 were females, with the mean age of all the patient was 51.6±12.32 years. 64% of the patient were diabetic patients. Long bones are most involved with trauma (45%) as risk factor. Staphylococcus aureus (24.2%) predominant pathogen isolated followed by Pseudomonas aeruginosa (21.2%) and Acinetobacter baumannii (16.7%). Antibiotic sensitivity testing of gram positive organisms showed hundred percent sensitivity to vancomycin and gram negative bacteria showed highest sensitivity to cefoperazone+sulbactam, piperacillin+tazobactam, meropenem and imipenem.  Conclusions: Osteomyelitis caused by methicillin resistant staphylococcus aureus and carbapenem resistance gram negative bacteria is a serious concern. Since multidrug resistant strains have emerged in osteomyelitis cases, emphasis should be given for hygiene and targeted antibiotherapy.   


2016 ◽  
Vol 4 (2) ◽  
pp. 69-73
Author(s):  
ASM Areef Ahsan ◽  
Lovely Barai ◽  
Mohammad Omar Faruq ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
...  

Background : Ventilator-associated pneumonia (VAP) is the most common type of nosocomial infection in critical care practice with high morbidity and mortality. Microorganisms responsible for VAP vary from place to place. So, identification of causative organism and knowledge of their resistance pattern is very important for empirical choice of antibiotic in managing VAP. The aim of this survey was to evaluate the quantitative cultures of endotracheal aspirates to determine the microorganisms responsible for VAP and to study their antibiotic resistance pattern.Materials and Methods: This cross sectional study was performed over a period of six month starting from November, 2015 to April, 2016 in the Intensive Care Unit (ICU) of BIRDEM General Hospital. Patients with a clinical and radiological diagnosis of VAP were included in this study.Result: A total of 51 patients with a clinical diagnosis of VAP were included in this study. Growth was obtained in100% of the samples yielding 88 organisms. Gram-negative organisms were the mostly isolated organism (76.13%), followed by fungi (17.04%) and gram-positive cocci (6.81%). The most common pathogen was Acinetobacter sp. followed by Klebsiella sp., Candida sp. and Pseudomonas sp. respectively. Among the gram negative organisms, Acinetobacter sp., Klebsiella sp. and Pseudomonas sp. were highly resistant (>80%) to third generation cephalosporins and fluoroquinolones. Resistance to aminoglycosides (>68%) and imipenem (>60%) was also high. Resistance of Pseudomonas sp. to piperacillin-tazobactum was lower (18.2%) in comparison to Acinetobacter sp. and Klebsiella sp. All the Gram-negative organisms were 100% sensitive to colistin except proteus. Regarding gram-positive cocci,Staphylococcus aureus is 100% sensitive to netilmycin and vancomycin with variable resistance pattern to other antibiotics.Conclusion: Emergence of drug resistance against the microorganism causing VAP is a serious concern in most of the ICUs. A knowledge of antibiotic susceptibility pattern will avoid its irrational use in order to control the spread of infection and for proper management of VAP.Bangladesh Crit Care J September 2016; 4 (2): 69-73


Author(s):  
Dr. Nadeem Amin ◽  
Dr. N. Kamath ◽  
Dr. Rita Swaminathan ◽  
Dr. Jyoti Sonawane ◽  
Nitin Bharos ◽  
...  

Urinary tract infection is one of the most common human infections. Furthermore there is rise in the Resistance of causative pathogens against the commonly prescribed antibiotics. Present study was aimed at finding the prevalence of such uropathogens and their antibiogram. Among 1059 suspected urinary samples were processed in the Department of Microbiology, D Y Patil Hospital, Nerul.,Navi-Mumbai. 580 (54.78%) were found to be culture positive. The predominant pathogen was E.coli (37.79%), while Enterococcus (30.30%), Klebsiella spp. (13.55%), Pseudomonas spp. (7.13%), Enterobacter spp. (2.67%), Acinetobacter spp. (2.67%), Citrobacter spp. (1.96%), Proteus spp. (2.14%), Staphylococcus aureus (0.71%), Streptococcus spp. (0.89%), Providentia rettgeri (0.18%) were other uropathogens isolated in this study. Of the isolated pathogens, 98.58% Gram negative organisms were sensitive only to Colistin and 95.28% to Imipenem except Pseudomonas species, Enterobacter species and Acinetobacter species. More than 95.28% Gram negative organisms showed resistance to Amoxycillin-clavulanic acid. The resistant pattern for other antibiotics was as follows, Ciprofloxacin (83.96% except for Klebsiella, Enterobacter, Citrobacter, Proteus and Pseudomonas aeruginosa), Cephalosporins (73.3% except for Klebsiella, Pseudomonas aeruginosa and Proteus vulgaris). Amongst Gram positive isolates (Enterococcus faecalis & Staphylococcus aureus), 100% of the isolates showed sensitivity to Linezolid and Vancomycin. Staphylococcus aureus also showed 100% sensitivity to Imipenem. 100% of the Staphylococcus aureus showed resistance to Penicillin by 94.71%. Enterococcus faecalis showed resistance to Penicillin 98.82% and to Co-trimoxazole. Enterococcus showed more multidrug resistant pattern amongst Gram positive isolates.


2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Bidya Shrestha ◽  
B M Pokhrel ◽  
T M Mohapatra

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), the most common cause ofnosocomial infection has been a major cause of morbidity and mortality around the world. They arenormally resistant to most of the antibiotics used in clinical practice. This study has been carried outto fi nd out the resistance pattern among S. aureus.Methods: During November 2007 to June 2008, clinical samples from patients with nosocomialinfection were processed for culture and sensitivity following standard methodology in microbiologylaboratory, Tribhuvan University teaching hospital, Kathmandu, Nepal.Results: Among 149 Staphylococcus aureus isolates, highest resistance was observed against Penicillin(91.94%) followed by Fluoroquinolone (61.74%), Erythromycin (52.94%), Gentamicin (46.98%),Cotrimoxazole (42.95%), Tetracycline (40.94%) and others, whereas susceptibility was observedmaximum against Chloramphenicol (94.85%) followed by Rifampicin (92.61%), Tetracycline(59.06%), Cotrimoxazole (57.04%), and others. None of the isolates were resistant to Vancomycinand Teicoplanin. Of these isolates 44.96 % of the isolates were Methicillin resistant S. aureus (MRSA).Resistance to Penicillin, Fluoroquinolone, Erythromycin, Gentamicin, Co-trimoxazole and Tetracyclinewere associated signifi cantly with MRSA isolates (X2= 8.779, p<0.05, X2= 74.233, p<0.05, X2= 84.2842,p<0.05, X2= 108.2032, p<0.05, X2= 88.1512, p<0.05 and X2= 79.1876, p<0.05 respectively). Althoughmost of the Methicillin sensitive S. aureus (MSSA) isolates were susceptible to both Rifampicinand Chloramphenicol, only Rifampicin susceptibility was signifi cantly associated with them (X2=10.1299, p<0.05). Among three Biochemical tests for the detection of β lactamase detection namelychromogenic, iodometric and acidimetric test, chromogenic test method had highest sensitivity andspecifi city.Conclusions: Since MRSA comprised a greater part of S. aureus isolates and were multi-resistant,patients infected by such strains should be identifi ed and kept in isolation for hospital infectioncontrol and treated with second line of drug like vancomycin.Key Words: β lactamase, methicillin resistant Staphylococcus aureus,methicillin sensitive Staphylococcus aureus, resistance pattern


Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 954
Author(s):  
Vikas Saini ◽  
Charu Jain ◽  
Narendra Pal Singh ◽  
Ahmad Alsulimani ◽  
Chhavi Gupta ◽  
...  

Antimicrobial resistance (AMR) is an emerging public health problem in modern times and the current COVID-19 pandemic has further exaggerated this problem. Due to bacterial co-infection in COVID-19 cases, an irrational consumption of antibiotics has occurred during the pandemic. This study aimed to observe the COVID-19 patients hospitalized from 1 March 2019 to 31 December 2020 and to evaluate the AMR pattern of bacterial agents isolated. This was a single-center study comprising 494 bacterial isolates (blood and urine) that were obtained from patients with SARS-CoV-2 admitted to the ICU and investigated in the Department of Microbiology of a tertiary care hospital in Delhi, India. Out of the total bacterial isolates, 55.46% were gram negative and 44.53% were gram positive pathogens. Of the blood samples processed, the most common isolates were CoNS (Coagulase Negative Staphylococcus) and Staphylococcus aureus. Amongst the urinary isolates, most common pathogens were Escherichia coli and Staphylococcus aureus. A total of 60% MRSA was observed in urine and blood isolates. Up to 40% increase in AMR was observed amongst these isolates obtained during COVID-19 period compared to pre-COVID-19 times. The overuse of antibiotics gave abundant opportunity for the bacterial pathogens to gradually develop mechanisms and to acquire resistance. Since the dynamics of SARS-COV-2 are unpredictable, a compromise on hospital antibiotic policy may ultimately escalate the burden of drug resistant pathogens in hospitals. A shortage of trained staff during COVID-19 pandemic renders it impossible to maintain these records in places where the entire hospital staff is struggling to save lives. This study highlights the extensive rise in the use of antibiotics for respiratory illness due to COVID-19 compared to antibiotic use prior to COVID-19 in ICUs. The regular prescription audit followed by a constant surveillance of hospital infection control practices by the dedicated teams and training of clinicians can improve the quality of medications in the long run and help to fight the menace of AMR.


2020 ◽  
Vol 2 (2) ◽  
pp. 9-15
Author(s):  
Niraj Kumar Keyal ◽  
Mahendra Shrestha ◽  
Partima Sigdel Ghimire

 Background: Empirical antibiotics are used in the intensive care unit based on developing countries’ guidelines due to a lack of a bacteriological profile of individual ICU and institution policy. Therefore, this study was conducted to know the antibiogram of the intensive care unit and to make institution policy for antibiotic use in ICU. Materials and methods: It was a prospective descriptive cross-sectional study conducted in the mixed surgical and medical intensive care unit of a tertiary care hospital for one year in 625 patients. Various clinical samples were collected aseptically and organisms were identified by the cultural characteristics, morphology, gram stain, and different biochemical test. Antimicrobial susceptibility was done with a disc diffusion test. Data collection was done in a preformed sheet that included all tested antibiotic and demographic variables. Statistical analysis was done by using statistical package for the social sciences. The result was presented as frequency and percentage. Results: Out of 625 samples, 135(22%) showed growth in culture. Among them, 96(71%) and 39(29%) were gram-negative bacilli and gram-positive cocci respectively. The tracheal aspirate was the most common type of specimen which comprised 49(36.29%) isolates. The most common organism was Staphylococcus aureus which accounts for 27(20%) isolates, followed by Acinetobacter baumanni 25(18.51%), Klebsiella pneumoniae 22(16.29%) and Pseudomonas aeurignosa 21(15.55%). The incidence of multidrug-resistant and extended drug resistance was 44(32.5%) and 45(33%) respectively. Meanwhile, the incidence of methicillin-resistant staphylococcus aureus was 70%. However, in the case of Acinetobacter baumannii and Enterobacteriaceae, all were sensitive to polymyxin B and meropenem. Conclusion:Antibiotics should be prescribed based on the antibiogram of individual intensive care units that can decrease antibiotic resistance. Polymyxin B and meropenem can be prescribed for gram-negative bacilli and vancomycin for Staphylococcus aureus.


Author(s):  
Abigail R. Sopia ◽  
Pushpa Innocent D. Joseph ◽  
M. Kalyani ◽  
B. Ananthi ◽  
Suresh Dhanaraj ◽  
...  

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.


Author(s):  
Abdul Hameed Tunio ◽  
Delijan Mugheri ◽  
Muhammad Khan ◽  
Wasim Sarwar Bhatti ◽  
Abdul Majeed Soomro ◽  
...  

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.


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