scholarly journals Sensitivity pattern of azithrymycin, ofloxacin and ceftriaxone in ciprofloxacin resistant salmonella causing enteric fever

2013 ◽  
Vol 22 (1) ◽  
pp. 55-60
Author(s):  
Shamima Kawser ◽  
Ruhul Amin Miah ◽  
Khandker Md Nurus Sabah ◽  
Tanzima Begum ◽  
Shahin Sultana

The therapeutic alternatives available for use against ciprofloxacin resistant enteric fever isolates in an endemic area are limited. A cross sectional study was carried out in the Department of Microbiology & Immunology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January to December 2008, to see the sensitivity pattern of azithrymycin, ofloxacin and ceftriaxone in ciprofloxacin resistant salmonella causing enteric fever. In this study, the MICs of various drugs were determined for 100 enteric fever isolates (72 Salmonella enterica serovar Typhi and 28 Salmonella enterica serovar paratyphi A). By agar dilution method, 40% Salmonella strains were ciprofloxacin resistant showing MIC values of (4-8 mg/ml), 36% strains were intermediate sensitive with MIC values of 1 to 4 mg/ml and 24% strains were sensitive to ciprofloxacin showing MIC values of 0.125 to 1 mg/ml. All ciprofloxacin- resistant isolates were sensitive to ofloxacin (inhibitory zone diamater 16-32mm), ceftriaxone (inhibitory zone diameter 21mm), 66.66 % isolates were sensitive to azithromycin. These results indicate that ofloxacin and ceflriaxone may be convenient alternative antimicrobial agents for Salmonella isolates. DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15627 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 55-60

2014 ◽  
Vol 8 (2) ◽  
pp. 49-52
Author(s):  
MMSU Islam ◽  
Shamsun Nahar ◽  
Mst Naznin Sarker ◽  
ASM Salimullah ◽  
Mohammad Asadur Rahman ◽  
...  

This cross sectional study was carried out at Bangabandhu Sheikh Mujib Medical University (BSMMU) and International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from July 2008 to September 2009. Aim of the study was to find out the antimicrobial susceptibility profile of Helicobacter pylori isolates from dyspeptic patients. Total 224 dyspeptic patients from Out Patient Department (OPD) of BSMMU were initially enrolled after informed written consent. After upper GI endoscopy 157 patients were finally included who had erosions, ulcers or atrophic changes in the stomach or duodenum. Two biopsy samples were taken from each of them. Samples were incubated at 37°C in a double gas incubator with 5%O2, 10%CO2 and 85%N2. Total 82 (52.23%) samples were found positive for H. pylori. Isolated organisms were then tested for sensitivity to Amoxicillin, Clarithromycin, Tetracycline, Levofloxacin and Metronidazole by Agar dilution method. Among 82 patients 51(62.2%) were male and 31(37.8) were female with a male:female ratio 1.6:1. Patients were categorized into two groups one having gastric or duodenal ulcer (30.5%) and other having no ulcer (69.5%). Among these isolates 92.7% were sensitive to Amoxicillin, 89% to Clarithromycin, 81.7% to Tetracycline, 80.5% to Levofloxacin and only 26.8% to Metronidazole. Beside these, 81.7% isolates were sensitive to both Amoxicillin and Clarithromycin, 74.4% to Amoxicillin and Tetracycline, 73.2% to Amoxicillin and Levofloxacin, 72% to Clarithromycin and Tetracycline, 59% to Clarithromycin and Levofloxacin and 51% to Tetracycline and Levofloxacin DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20280 Faridpur Med. Coll. J. 2013;8(2): 49-52


Author(s):  
Ravi D. Mala ◽  
D. M. Ravichand ◽  
B. V. Patil ◽  
B. S. Payghan ◽  
Anurag Yadav

Background: Adverse drug reactions (ADRs) are noxious and unintended effects of a drug that occurs at doses normally used in humans. ADRs may also result in diminished quality of life, increased physician visits, hospitalizations, and even death. The objectives of this study are to analyze and assess the causality and severity of reported ADRs.Methods: A cross sectional study of ADRs reported to Pharmacovigilance cell of MNR Medical College and Hospital Sangareddy in a year. The details of the various ADRs were statistically analyzed to find out pattern of ADRs. The WHO-UMC causality category and Hartwig-Seigel Scale were used to assess causality and severity of ADRs respectively.Results: The study shows, out of 60 suspected ADRs, the majority of ADRs were adults (68.3%) and out of whom 56% were females. According to the WHO-UMC Causality categories, 43.3% of the ADRs were categorized under Probable/likely, followed by possible (35%). The Hartwig-Siegel severity assessment scale shows that the majority (90%) of suspected ADRs were of mild category.Conclusions: The pattern of ADRs reported in our study is comparable to other studies. The commonest organ system affected was gastrointestinal tract, nervous and cutaneous system. Antimicrobial agents were causing maximum ADRs and medicine and allied departments have more number of ADRs. This study provides a valuable database for ADRs due to all commonly used drugs at hospitals and also helps in creating awareness regarding safe & judicious use of drugs to prevent ADRs.


2012 ◽  
Vol 1 (1) ◽  
pp. 9-13 ◽  
Author(s):  
D Adhikari ◽  
D Acharya ◽  
P Shrestha ◽  
R Amatya

INTRODUCTION: Enteric fever caused by Salmonella enterica serovars Typhi and Paratyphi A is the common clinical diagnosis among febrile patients presenting to hospital in Nepal. The aim of this study was to evaluate the ciprofloxacin (CIP) and other antibiotics susceptibility patterns of Salmonella enterica serovars Typhi and Paratyphi A from blood samples of suspected enteric fever patients visiting KIST Medical College, Kathmandu. MATERIALS AND METHODS: Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method as per CLSI guidelines whereas MIC determination of ciprofloxacin was performed by agar dilution method. RESULTS: Altogether 64 presumptive Salmonella spp. were isolated from 840 blood samples of suspected enteric fever patients, of which 41 were S. Typhi and 23 were S. Paratyphi A. All Salmonella spp. isolates were sensitive to ceftriaxone and ofloxacin whereas 4 isolates were resistant to ciprofloxacin. One isolates each of S. Typhi and S. Paratyphi A were multidrug resistant. Fifty five isolates of Salmonella spp. were resistant to nalidixic acid (NA) with higher rate in S. Paratyphi A (91.3%) compared to S. Typhi (82.9%). MIC determination of ciprofloxacin revealed that majority of the isolates were resistant to ciprofloxacin and 2 isolates were resistant with MIC value of 4 µg/ml and 8 µg/ml. Importantly, we found simultaneous presence of NA resistance and decreased susceptibility to CIP suggesting that resistance to NA is a reliable indicator of decreased CIP susceptibility. CONCLUSIONS: Disc diffusion test failed to detect the reduced susceptibility of ciprofloxacin. Hence the MIC determination of ciprofloxacin against Salmonella spp. isolates would be important.  DOI: http://dx.doi.org/10.3126/ijim.v1i1.6938Int J Infect Microbiol 2012;1(1):9-13


2014 ◽  
Vol 15 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Md. Mehedi Hasan ◽  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
...  

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124


2011 ◽  
Vol 31 (3) ◽  
pp. 180-183 ◽  
Author(s):  
BG Joshi ◽  
K Keyal ◽  
R Pandey ◽  
BM Shrestha

Introduction: Enteric fever is a systemic infection caused by the bacteria, Salmonella enterica serovar Typhi (S.typhi) and Salmonella enterica serovara Paratyphi (S. paratyphi A, B and C). Most of the burden of the disease is limited to the developing world and the disease still has the issues like wide spectrum of clinical presentation and multidrug resistance. Objectives: This study was done to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive enteric fever. Methods: A prospective cross-sectional study was conducted in Civil Service Hospital from February 2010 to January 2011 in the paediatric population in the age group of 2 to 14 years. Children with Salmonella species isolated in blood culture were included in the study. Results: Out of the 40 children with culture positive enteric fever, male to female ratio was 1.3:1 with common age group between 11-14 years. S typhi was isolated in 25 cases while S. paratyphi in 15 cases. Clinical features of S. typhi and S. paratyphi were indistinguishable. Both S.typhi and S. paratyphi were found to be 100% sensitive to drugs like Ceftriaxone, Cefotaxime, Cefixime and Chloramphenicol. Sensitivity to Ofloxacin was 100% in S. paratyphi and 92% in S.typhi. Similarly sensitivity of Azithromycin was 92% and 93% for S.typhi and S. paratyphi respectively. Conclusion: Salmonella serotype is still 100 % sensitive to third generation cephalosporin. Some percentage of resistance is seen with Ofloxacin in S. typhi and with Azithromycin in both S.typhi and S. paratyphi. Key words: Enteric fever; S.typhi; S.paratyphi; Sensitivity DOI: http://dx.doi.org/10.3126/jnps.v31i3.4382 J Nep Paedtr Soc 2011;31(3): 180-183


2015 ◽  
Vol 9 (02) ◽  
pp. 149-156 ◽  
Author(s):  
Sintayehu Fekadu ◽  
Yared Merid ◽  
Hunachew Beyene ◽  
Wondu Teshome ◽  
Solomon Gebre-Selassie

Introduction: Large quantities of antimicrobials are used in hospitals for patient care and disinfection. Antibiotics are partially metabolized and residual quantities reach hospital wastewater, exposing bacteria to a wide range of biocides that could act as selective pressure for the development of resistance. Methodology: A cross-sectional study was conducted between December 2010 and February 2011 on hospital wastewater. A total of 24 composite samples were collected on a weekly basis for bacteriological analysis and susceptibility testing. Indicator organisms and pathogenic and potentially pathogenic bacteria were found and isolated on selective bacteriologic media. Disinfectant activity was evaluated by use-dilution, and minimum inhibitory concentration (MIC) was determined by the agar dilution method. Similarly, antibiotic susceptibility tests were performed using the Kirby-Bauer disk diffusion method. Results: Pathogenic (Salmonella, Shigella, and S. aureus) and potentially pathogenic (E. coli) bacteria were detected from effluents of both hospitals. Dilution demonstrated tincture iodine to be the most effective agent, followed by sodium hypochlorite; the least active was 70% ethanol. MIC for ethanol against S. aureus and Gram-negative rods from Yirgalem Hospital (YAH) showed 4 and 3.5 log reduction, respectively. Salmonella isolates from YAH effluent were resistant to ceftriaxone, tetracycline, and doxycycline. Isolates from Hawassa University Referral Hospital (HURH) effluent were resistant to the above three antibiotics as well as gentamycin. Conclusions: Hospital effluents tested contained antibiotic-resistant bacteria, which are released into receiving water bodies, resulting in a threat to public health.


Background: The bacterium Salmonella enterica serovar typhi causes typhoid fever which is a life-threatening systemic infection that mainly occurs in developing countries of the world and remains a major public health issue. Paratyphoid fever is caused by Salmonella enterica serovars Paratyphi A and B and (infrequently C). Appropriate and immediate antimicrobial therapy is required for the prevention of complications and mortality due to enteric fever. Therefore, this study is designed to investigate the current sensitivity pattern of Salmonella typhi so that appropriate antibiotics can be initiated on time. Objective: To determine the sensitivity pattern of Salmonella typhi in enteric fever among the pediatric population visiting a tertiary care hospital. Methods: This cross-sectional study was carried at the Department of Pediatrics in National Institute of Child Health Karachi from 13-12-2019 to 13-06-2020 after acquiring ethical approval from the hospital committee. There were 149 children aged 3-12 years of either gender diagnosed with enteric fever selected for this study. Patients' information was collected on pre-designed proforma. Blood of five milliliters quantity was drawn and sent to the pathology department within 12 hours of the admission. Salmonella typhi was identified by biochemical testing of the suspicious non-lactose fermenting colonies. Mueller Hinton Agar medium was used for testing antibiotic sensitivity. The sensitivity of the drug was interpreted as Sensitive, Intermediate and Resistant based on inhibition zone size. Results: The average age of the children was 5.56±2.39 years. Sensitivity for meropenem, azithromycin was 100% and 93.3% respectively while the sensitivity of ciprofloxacin was 53.7%. Ampicillin, Co-trimoxazole, Chloramphenicol and Ceftriaxone were more than 80% resistant. Conclusion: Our study confirms the sensitivity for meropenem, azithromycin, ciprofloxacin. Ampicillin, Co-trimoxazole, Chloramphenicol and Ceftriaxone showed higher resistance. This study emphasizes the need for continuous evaluation and judicious use of antimicrobials, considering the ever-changing antibiogram.


2021 ◽  
Vol 8 (09) ◽  
pp. 5584-5590
Author(s):  
Bivash Boran Biswas ◽  
Mousumi Malakar ◽  
Sazzad Bin Shahid ◽  
Sayem Hossain ◽  
Khan Nazrul Islam ◽  
...  

Urosepsis usually develops from a community or nosocomial acquired urinary tract infection (UTI) or during the procedure of various urinary disease such ureterorenoscopy (URS) and percutaneous nephrolithotomy (PCNL). Urosepsis is associated with bacteriuria, Urosepsis due to manipulation during or after percuteneous nephrolithotomy (PCNL) or ureterorenoscopy (URS) or push bang stenting can be catastrophic despite prophylactie antibiotic coverage. This cross sectional study was carried out in Dhaka Medical College Hospital, Dhaka, Bangladesh during the period of July 2011 to June 2013. Sampling technique was purposive and sample size was 70. Among them 23 patients for PCNL and 47 patients for URS were selected by selection criteria. Data were collected by interview of the patients, clinical examinations and laboratory investigations using the research instrument. Data were processed and analyzed using software SPSS (Statistical Package for Social Sciences) version 11.5. Incidence of bacteriuria and urosepsis were measured according to urine and blood culture report. Sensitivity pattern was also observed. According to this study, the incidence of bacteriuria and urosepsis were 17.1% and 5.7% respectively, Of the 70 patients, 12(17.1%) exhibited bacterial growth on urine culture, These 12 patients were then subjected to blood culture and 4(33.3%) of them were found positive. Most (83.4%) of the urine and blood infections (75%) were caused by E. coli. Some widely used antibiotics like moxicillin, Cephalexin and Ciprofloxacin were found 100% resistant in urine culture. Few sensitive antibiotics were Tobramycin (100 %), Amikacin and Ceftazidime (75%). Almost same sensitivity pattern was found in blood culture. In urosepsis, as in other types of sepsis. Urosepsis after PCNL and URS is an important and potentially catastrophic complication. Percuteneous nephrolithotomy (PCNL), Ureterorenoscopy (URS) occurs frequently in this institution. Although the incidence of urosepsis and bacteriuria with resistant organism is low, but it is a burning issue in management in urology practice. The apparent increase in ciprofloxacin resistant organisms appears to be associated with the increased rate of ciprofloxacin resistant organisms are observed in the general population.


2014 ◽  
Vol 86 (1) ◽  
pp. 451-457 ◽  
Author(s):  
LISHA J. JOHN ◽  
MEENU CHERIAN ◽  
JAYADEVAN SREEDHARAN ◽  
TAMBI CHERIAN

Background: Diseases of the ear, nose and throat (ENT) are associated with significant impairment of the daily life and a major cause for absenteeism from work. Aim: The study determined antimicrobial prescription pattern in patients with acute tonsillitis. Materials and Methods: A cross-sectional study was carried out among all the patients attending the ENT department with acute tonsillitis. Data were retrieved from the medical records using a proforma. Statistical analysis was carried out using SPSS.19. Results: Total of 238 patients included (Males 138; females 100). About 96% of total drugs were prescribed by generic name. Median number of drugs prescribed was four (range 1-7). Eighty eight percent of prescriptions contained antimicrobials, (78.5%) analgesics and (57.9%) antipyretics. Amoxicillin / Clavulanic acid (24.8%) and Ceftriaxone (12.2%) were the most commonly prescribed antimicrobials. Parenteral route was preferred in 41.6%. About 23.7% of the patients on Amoxicillin / Clavulanic acid had received the drug as intravenous injection. Culture and sensitivity tests were carried out in 106 (44.5%) of the cases. Antimicrobials were changed / added after the culture and sensitivity test in 25 patients. Conclusion: Study findings highlighted rational practices in drug prescribing. Therapeutic guidelines based on current sensitivity pattern optimize the use of antimicrobial agents.


2020 ◽  
Vol 16 (2) ◽  
pp. 74-77
Author(s):  
Atanu Pan ◽  
Debarshi Jana

Background: About 26.9 million typhoid cases and more than 2 lakh deaths occur each year, with      majority of the cases reported in Asia. The incidence of typhoid varies substantially within Asia. The aim of the study is to asses study the clinical and laboratory profile, culture positive & sensitivity pattern of Salmonella Typhiand its response to antimicrobial therapy in the paediatric department of College Of Medical Sciences, Bharatpur, Nepal. Methods: A descriptive cross sectional study was conducted among 104 Children in the age group of 5 to 12 years admitted with history of fever ≥5 days duration chosen as study population Paediatric Department College Of Medical Sciences, Bharatpur, Nepal from  February 2015 to October 2019. Results: Our study found that 40(38.5) patients had pallor, 28(26.9) patients had Hepatomegaly, 19(18.3) patients had splenomegaly and 21(20.2) patients had coated tongue. It was found that 37(90.2) patients had sensitive ciprofloxacin, 37(90.2) patients had sensitive ofloxacin, 39(95.1) patients had sensitive levofloxacin and 37(90.2) patients had sensitive azithromycin. 38(92.7) patients had sensitive Cefixime, 38(92.7) patients had sensitive ceftriaxone, 39(95.1) patients had sensitive imipenam and 33(80.5) patients had sensitive cotrimoxazole ,32(78.0) patients had sensitive amoxicillin, 37(90.2) patients had sensitive cefotaxime. Conclusions: Enteric fever is an important cause of febrile illness in children. Fever with anorexia, cough, diarrhea, headache, hepatosplenomegaly were the common clinical manifestations of enteric fever. An adequate trial of first line antibiotics like oral cefexime,ofloxacin,co-trimoxazole, ampicillin can be tried before starting injectable antibiotics due to increased emergence of sensitivity to these drugs. Keywords: enteric fever; antibiotic sensitivity pattern  


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