scholarly journals Metallo-ß-Lactamase Producing Pseudomonas species in a Tertiary Care Hospital of Dhaka City

1970 ◽  
Vol 4 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Tanzinah Nasrin ◽  
Md Shariful Alam Jilani ◽  
Lovely Barai ◽  
J Ashraful Haq
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Dhaka City ◽  
Gram Negative ◽  
Pseudomonas Spp ◽  
Pseudomonas Species ◽  
Agar Dilution

Among the various beta-lactam antibiotics, carbapenems are the most potent and have been reserved for use in treating infections caused by multi-drug resistant (MDR) Gram negative bacilli, especially Pseudomonas. They are effective even against Extended Spectrum beta-lactamase (ESBL) and Amp C b-lactamase producing bacteria. The clinical utility of carbapenems is under threat with the emergence of carbapenem resistant bacteria due to production of carbapenem hydrolyzing metallo-beta-lactamase (MBL) which confers high-level resistance to all b-lactam antibiotics except aztreonam. The prevalence of MBLs have been studied in many countries but not been reported in Bangladesh. The purpose of the study to determine the presence of MBLs producing Pseudomonas in clinical samples from a tertiary care hospital. MBLs producing Pseudomonas in various clinical samples of an urban hospital of Dhaka city was investigated over a 6-month period (January 2009-June 2009). EDTA-IMP agar dilution minimum inhibitory concentration (MIC) reduction method was employed to detect MBL producing Pseudomonas sp. Out of 44 Pseudomonas isolates 08 (18.2%) were sensitive and 23 (52.3%) were resistant to imipenem while 13 (29.5%) were intermediate resistant (MIC = 8 μg/ml) to imipenem. All Pseudomonas showing intermediate resistance to imipenem were found sensitive by disc diffusion method. MBL phenotype was detected in 43%(10 out of 23) imipenem resistant Pseudomonas spp. while the rate was 61%(08 out of 13) is intermediate resistant strains by EDTA-IMP agar dilution MIC method. The results of the study indicated high prevalence of MBL producing Pseudomonas spp. in our hospital environment. Early detection of these MBL producing Pseudomonas is necessary to institute appropriate treatment and effective infection control measures. Key words: Metallo-ß-lactamase, Pseudomonas species, Gram negative bacilli. DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8469 BJMM 2011; 4(1): 43-45

scholarly journals Prevalence of CTX-M ? lactamases among Gram negative bacteria in a tertiary care hospital in Bangladesh

2016 ◽  
Vol 9 (1) ◽  
pp. 26-30
Author(s):  
Taslima Yasmin ◽  
Md Akram Hossain ◽  
Shyamal Kumar Paul ◽  
Golam Mowla ◽  
Safia Sultana
Keyword(s):  
Multiplex Pcr ◽  
Clinical Laboratory ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Pseudomonas Spp ◽  
M 14

Extended spectrum beta lactamases (ESBLs) produced by Gram negative bacteria are mainly mediated by three important genes, namely TEM, SHV and CTX-M. In this study, we used a multiplex PCR to determine the prevalence of CTX-M and its subgroups CTX-M-3, CTX-M-14, among the members of Enterobacteriaceae family and in Pseudomonas spp that were isolated from different clinical samples in a tertiary care hospital in Bangladesh. A total of 300 culture positive clinical isolates were selected for the study. Out of these, 216 from urine, 45 from wound swab, 39 from pus aspirates. The ESBL status was determined by double disc diffusion test (DDDT) as recommended by Clinical Laboratory Standard Institute 2010 (CLSI) and by multiplex PCR for TEM, SHV and CTX-M, CTX-M-3, CTX-M-14 genes. Out of 300 isolates tested, 71.3% were positive for ESBL production by DDDT. The rate of positivity for TEM, SHV and CTX-M genes in 107 randomely selected isolates was 83.2%. Among these, 56.2% (50/89) was positive for CTX-M. Among the CTX-M positive isolates, CTX-M-3 and CTX-M- 14 were 78.0% (39/50) and 80.0% (40/50) respectively. Our study demonstrated that CTX-M variants were common in Enterobacteriaceae and Pseudomonas spp prevalent in the hospital of Bangladesh.Ibrahim Med. Coll. J. 2015; 9(1): 26-30

scholarly journals High level gentamicin resistance and susceptibility to Vancomycin in enterococci in a tertiary care hospital of Dhaka City

2014 ◽  
Vol 7 (2) ◽  
pp. 28-31 ◽  
Author(s):  
Shakila Tamanna ◽  
Lovely Barai ◽  
AA Ahmed ◽  
J Ashraful Haq
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Dhaka City ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
Agar Dilution ◽  
High Level

Vancomycin and high level gentamicin resistant enterococci detection is important for effective treatment and control of nosocomial infection. The present study was undertaken to determine the species distribution of Enterococcus and the rate of vancomycin and high level gentamicin resistant enterococci (HLGRE) in clinical samples in a tertiary care hospital of Dhaka city. Enterococci were identified to species level by standard biochemical and serological methods. Their susceptibilities to antibiotics were determined by disc diffusion method according to CLSI guideline. Minimum inhibitory concentration (MIC) of vancomycin and gentamicin were determined by agar dilution method. The study was conducted from July 2009 to February 2010. Among 80 isolates, 95% and 5% were identified as Enterococcus faecalis and Enterococcus faecium respectively. Out of 80 isolates 72 (90%) were sensitive and 8 (10%) were intermediate resistant to vancomycin (30?g) by disc diffusion method, but all isolates were susceptible by agar dilution MIC method. Out of 80 enterococci, 37 (46.25%) showed high level resistance to gentamicin (MIC: > 500 ?g/ml) by MIC method but, initially six of which showed sensitive result to gentamicin by disc diffusion method using 120 ?g disc. The study indicated high prevalence of HLGRE in our hospital population. MIC method was more accurate in detecting high level gentamycin resistant enterococci compared to disc diffusion method with 120 ?g gentamicin disc. However, none of the enterococcal strains showed resistance to vancomycin. HLGRE should be monitored regularly in clinical samples as it is difficult to treat. DOI: http://dx.doi.org/10.3329/imcj.v7i2.20103 Ibrahim Med. Coll. J. 2013; 7(2): 28-31

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 Antimicrobial Sensitivity Pattern in the Mixed Intensive Care Unit in a Tertiary Care Hospital of Eastern Nepal

2020 ◽  
Vol 2 (2) ◽  
pp. 9-15
Author(s):  
Niraj Kumar Keyal ◽  
Mahendra Shrestha ◽  
Partima Sigdel Ghimire
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Sensitivity Pattern

 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.

scholarly journals Prevalence of MDR and ESBL producing Gram-negative isolates from various clinical samples from patients visiting a tertiary care hospital in Kathmandu, Nepal

2021 ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Confirmatory Test ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Severe Problem ◽  
Gram Negative ◽  
Esbl Producers

Abstract BackgroundThe existence of multi-drug resistance organisms, including extended-spectrum beta-lactamases (ESBLs), is on the rise 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.MethodsA 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 by using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the Kirby Bauer disc 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.ResultsOut of 92 isolates, 84 (91.3%) isolates were multidrug resistant, and 47 (51.1%) isolates 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.ConclusionMultidrug 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 Emerging resistance to carbapenem among Gram-negative bacteria in a tertiary care hospital

2020 ◽  
Vol 11 (SPL2) ◽  
pp. 153-156
Author(s):  
Pooja Nair ◽  
Renu Mathews ◽  
Kalyani M
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Inhibitory Concentration ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Diffusion Technique

The emergence of bacterial antibiotic resistance is a cardinal concern in the health care system. The spread of resistance in Enterobacteriaceae and non-fermenters to the currently available drugs make the treatment of serious nosocomial infections troublesome.  The purpose of the study is to find out the carbapenem resistance among Gram-negative bacilli in a tertiary care hospital. Antibiotic susceptibility pattern of 1913 aerobic Gram-negative bacilli isolated from clinical samples was made for a period of 6 months. All the isolates were tested for susceptibility to antibiotics by the Kirby-Bauer disc diffusion technique according to CLSI guidelines. Carbapenemase production was confirmed by the Modified Hodge Test (MHT). Minimum Inhibitory Concentration (MIC) by Epsilometer (E) test was performed (for Imipenem and Meropenem) for carbapenem-resistant strains. A total of 1731 clinical samples, 1913 Gram-negative bacilli were isolated. 1476 (77.1%) were Enterobacteriaceae and 433 (22.6%) were non-fermenters. 54 were carbapenemase-producing Gram-negative bacilli. Meropenem E test was done for carbapenemase-producing Gram-negative bacilli. The minimum inhibitory concentration for Meropenem ranged from 0.002μg/ml to 32μg/ml. To overcome the problem of emerging resistance, combined interaction and cooperation of microbiologists, clinicians and the infection control team is needed.

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