scholarly journals Pattern of Aerobic Bacteria in Adult Patients Isolated from Endotracheal Tubes in Tertiary Care Center

KYAMC Journal ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 153-160
Author(s):  
Tanjida Shilpi ◽  
Md Arifur Rahman ◽  
Sabera Sultana ◽  
Shafinaz Khan ◽  
Sunil Krishna Baul
Keyword(s):  
Antimicrobial Susceptibility ◽  
Nosocomial Infections ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Adult Patients ◽  
Diffusion Method ◽  
Aerobic Bacteria ◽  
Gram Negative ◽  
Endotracheal Tubes ◽  
Endotracheal Aspiration

Introduction: Nosocomial infections have been described as an important issue among intubated patients which leads to significant morbidity and mortality. The pattern of microbiological colonization and antibiotic resistance are much valuable in this regard. Objectives: The aim of present study was to determine the pattern of aerobic bacteria isolated from endotracheal tubes in adult patients and determination of their antimicrobial susceptibility patterns. Materials and Methods: Specimens were collected from tracheal tubes of patients with endotracheal aspiration and microbiological investigations were done. The isolated bacteria were identified by using standard cultural and biochemical tests. Then antibiotic susceptibility testing was performed on the isolates by disc diffusion method according to clinical and laboratory Standards Institute (CLSI) guideline. Results: Among 104 participants 68 (65.4%) were female and 36 (34.6%) were male. Most of the patients were in the age group of 71-80 years (48.0%). From 104 positive growths, both Gram positive and Gram negative organisms were found. Maximum samples showed growth of gram negative organism. Antimicrobial susceptibility testing revealed that the most resistant Gram negative isolate was Klebsiella with highest resistance against Vancomycin (40.4%) and which showed highest sensitive against Cefotetan, Cefoxitin and Norfloxain (39.4%). Conclusions: It may be concluded that this study indicates the emergence of antibiotic resistant infections in the studied hospital. So, there is a need to improve the effectiveness of integrated infection control programs to control and manage nosocomial infections caused by highly resistant organisms. KYAMC Journal. 2021;12(3): 153-160

scholarly journals Prevalence of nonfermentative gram-negative bacilli and their antimicrobial susceptibility profiles in a tertiary care hospital of Eastern India

2018 ◽  
Vol 5 (2) ◽  
pp. 366 ◽  
Author(s):  
Mandira Sarkar ◽  
Jagadananda Jena ◽  
Dipti Pattnaik ◽  
Bandana Mallick
Keyword(s):  
Antimicrobial Susceptibility ◽  
Nosocomial Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Burkholderia Cepacia Complex ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Isolation And Identification ◽  
Gram Negative

Background: Nonfermentative gram-negative bacilli (nonfermenters) have emerged as a major concern for nosocomial infections. They exhibit resistance not only to the beta-lactam and other group of antibiotics but also to carbapenems. This study was undertaken to know the prevalence of nonfermenters from clinical samples along with their antimicrobial susceptibility profile.Methods: A cross-sectional study over a period of 21 months in the microbiology laboratory of a tertiary care hospital was done. Clinical samples were processed by conventional bacteriological methods for isolation and identification. Susceptibility testing was done by Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute.Results: 411 nonfermenters (13.18%) were isolated from 3116 culture positive clinical samples. Out of these nonfermenters, most were Acinetobacter baumannii (51.34%) followed by Pseudomonas aeruginosa (42.09%), Burkholderia cepacia complex (4.38%) and others (2.19%). Others included Burkholderia pseudomellei, Acinetobacter lwoffii and Stenotrophomonas maltophilia. Highest sensitivity to gentamicin and amikacin were shown by A. baumannii and P. aeruginosa respectively while both were mostly resistant to ceftriaxone. Burkholderia and Stenotrophomonas species showed 100% sensitivity to cotrimoxazole. A. baumannii was the most prevalent nonfermenter in intensive care units.Conclusions: Timely identification of nonfermenters and monitoring their susceptibility patterns will help in proper management of infections caused by them. Improved antibiotic stewardship and infection control measures should be implemented to prevent nosocomial infections and spread of drug resistant nonfermenters.

AEROBIC BACTERIOLOGICAL PROFILE WITH ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF PUS SAMPLES AT A TERTIARY CARE HOSPITAL IN JAIPUR

2021 ◽  
pp. 65-67
Author(s):  
Hemendra K Sharma ◽  
Niketa Gupta ◽  
Mahesh Yadav ◽  
Aruna Vyas ◽  
Rajni Sharma
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Gram Negative ◽  
Inappropriate Use ◽  
Antimicrobial Susceptibility Pattern

Background: Pyogenic infections can be caused by various microorganisms and may co-exist as poly microbial infections which require antibiotic therapy. The inappropriate use of antibiotics has led to major problems of MDRO's contributing to morbidity and mortality. Even though the bacteriological prole of pus samples in many studies remain the same, antimicrobial susceptibility pattern of these isolates has shown a lot of variation. This study was conducted to assess bacteriological prole of pus samples and their antimicrobial susceptibility pattern Materials and Methods:Aretrospective study was carried out from April to June 2021. 540 pus culture aerobic bacterial isolates were included. The samples were cultured on Blood and MacConkey agar. After aerobic incubation at 37oC for 18-24 hrs, organisms were identied by conventional bacteriology methods as per laboratory protocol and antimicrobial susceptibility was tested by Kirby Bauer disc diffusion method as per CLSI 2020 guideline. Results: Out of 540 pus isolates , 452(83.7%)were gram negative bacili and 88(16.3%) were gram positive cocci Pseudomonas spp. 173(31.9%), was most common gram negative isolate while S.. aureus 66(12.19%) was most common Gram positive isolate. Most of gram negative isolates were susceptible to Imipenem and Polymyxin and gram positive isolates to vancomycin and linezolid . Conclusion: To combat resistance irrational use of antibiotics should be avoided. Also regular surveillance helps in implementing better therapeutic strategies to reduce morbidity and mortality

Occurrence of Non-Fermenting Gram-Negative Bacilli and Their In Vitro Susceptibility Pattern by Vitek 2 at a Tertiary Care Teaching Hospital – An Observational Study

2021 ◽  
Vol 8 (8) ◽  
pp. 429-434
Author(s):  
Atit Dineshchandra Shah ◽  
Urvashi Natubhai Limbachia ◽  
Bhavin K. Prajapati ◽  
Lata Patel ◽  
Dharati Tusharbhai Shah ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Multidrug Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Carbapenem Resistance ◽  
Antimicrobial Susceptibility Testing ◽  
Clinical Samples ◽  
Gram Negative ◽  
Vitek 2

BACKGROUND Non fermenting gram-negative bacilli (NFGNB) are a group of heterogenous, aerobic and non-sporing saprophytic bacteria, found as commensals in humans and other animals primarily causing opportunistic healthcare-associated infections. They are innately resistant to many antibiotics and are known to acquire resistance by various mechanisms. They pose a particular difficulty for the healthcare community because multidrug resistance is common and increasing among them and a number of strains have now been identified that exhibit pan drug resistance. This study was conducted to isolate and identify various non-fermenter gram negative bacilli (NFGNB), to study their antibiotic sensitivity pattern and their clinical significance from various clinical samples. METHODS A study was undertaken from March 2019 to February 2020 to isolate NFGNB from various clinical samples received for culture and sensitivity in the department of microbiology in a tertiary care hospital, Ahmedabad. Non lactose fermenting colonies on MacConkey agar plates were further processed by Vitek 2 to identify them and to study their antimicrobial susceptibility testing (AST). RESULTS A total of 2010 NFGNB were isolated from various clinical samples and their AST was evaluated by Vitek 2. Pseudomonas aeruginosa (52.7 %) and Acinetobacter baumannii (36.5 %) were the most common NFGNB isolated. Carbapenem resistance was 93 % for Acinetobacter species and 61 % for Pseudomonas species. CONCLUSIONS Accurate and rapid identification and antimicrobial susceptibility testing of NFGNB help in early initiation of appropriate antimicrobial therapy and proper management of patients thereby help in reducing emergence of MDR strains of NFGNB, mortality and overall hospital stay. KEYWORDS NFGNB – Non-Fermenting Gram-Negative Bacilli, Multidrug Resistance, Pan Drug Resistance, Carbapenem Resistance

scholarly journals Bacteriological Profile of Chronic Osteomyelitis with Special Reference to Antibiotic Resistance Mechanisms/Patterns – A Cross-sectional Prospective Study from Tertiary Care Hospital in Central India

2020 ◽  
pp. 43-52
Author(s):  
Aparna Pandey ◽  
Prachi Shaw ◽  
Aamir Johar
Keyword(s):  
Multidrug Resistance ◽  
Antimicrobial Susceptibility ◽  
Chronic Osteomyelitis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Central India ◽  
Diffusion Method ◽  
Care Hospital ◽  
Age Group ◽  
Gram Negative

Objective: Chronic osteomyelitis is the infection and inflammation of the bone. Inappropriate use of antibiotics and multidrug resistance has raised the morbidity and mortality rate in chronic osteomyelitis. This study aims to determine the bacterial profile and antimicrobial susceptibility patterns of chronic osteomyelitis with special mention to various resistant mechanisms. Methods: The study is a prospective design. Hundred (100) clinically diagnosed cases of chronic osteomyelitis of all age group and both sex admitted in a tertiary care hospital at central India, in one year were included. Samples like pus, sinus discharge or exudates were collected aseptically and sent for microbiological investigation. Antimicrobial susceptibility of bacterial isolates to the commonly used antibiotics was done by using modified Kirby Bauer disc diffusion method. Results: The aerobic bacteriological study of chronic osteomyelitis showed Staphylococcus aureus is being continued to be major etiological agent followed by Pseudomonas aeruginosa and Staphylococcus epidermidis. Gram-positive isolates were sensitive to linezolid, teicoplanin while gram-negative isolates were sensitive to colistin, ciprofloxacin in the majority. The disease occurs mostly due to traumatic injuries commonly affecting the middle age group. In present study prevalence of methicillin-resistant Staphylococci aureus and β Lactamase producing (ESBL, Amp-C and MBL) gram-negative bacilli is found to be on the higher side. Conclusion: It has been the major cause of morbidity for a long time. The emerging multidrug-resistant strain is a major concern for the treatment. Identification of causative isolates and using a judicious selection of antibiotics will help the clinician in starting the empirical treatment accordingly would limit the multidrug resistance strains in the hospital as well as the community.

scholarly journals ANTIMICROBIAL SUSCEPTIBILITY;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Javeria Gul ◽  
Iffat Javed ◽  
Sohaila Mushtaq ◽  
Muhammad Saeed Anwar
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Diffusion Method ◽  
Medical Institute ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Pathology Department

Background: The emergence and spread of antibiotic resistant bacteria causing infection is a great health issue for clinicians. The problem of multidrug resistant (i.e. resistant to at least three groups of antimicrobial) is becoming more and more threatening. The rate of resistance among Gram negative bacteria especially non fermenters are increasing to all available antibiotic groups. Objectives: The aim of study was to detect the pattern of antimicrobial susceptibility in non-fermenter Gram negative bacilli (NFGNB) in a tertiary care hospital (Postgraduate Medical Institute, Lahore). Study Design: Descriptive study. Settings: The study was conducted in Pathology Department, Postgraduate medical institute (PGMI), Lahore. Study Period: Six months from August 2014 to December 2014. Material and Methods: Non-fermenter Gram negative bacteria were collected from various clinical specimen including blood, pus, urine, fluid aspirates and respiratory tract in a period of six months in pathology department, PGMI. All non-fermenter Gram negative isolates were identified up to species level by standard laboratory procedures using API (Analytical profile index) 20 NE (non-enterobacteriaceae). Antimicrobial susceptibility testing of non-fermenter Gram negative isolates were performed by modified Kirby Bauer disk diffusion method as recommended in CLSI. Results: Out of the total 51 samples the most commonly isolated NFGNB were Acinetobacterbaumanni and Burkholderiacepacia (16 each) followed by Pseudomonas aeruginosa (7), Pseudomonas luteola (5), Stenotrophomonasmaltophilia (4), Pseudomonas fluorescens (2) and Pseudomonas stutzeri(1). Conclusion: The study showed that rate of multidrug resistance increased in non-fermenter Gram negative organisms.

scholarly journals Incidence of Diphtheria among Clinically Probable Cases in a Tertiary Care Centre- A Prospective Study

2020 ◽  
Author(s):  
Gunturu Sowjanya ◽  
Pennagaram Sarguna
Keyword(s):  
Antimicrobial Susceptibility ◽  
Microscopic Examination ◽  
Susceptibility Testing ◽  
Throat Swab ◽  
Tertiary Care ◽  
Antimicrobial Susceptibility Testing ◽  
Diffusion Method ◽  
Upper Respiratory Tract ◽  
Tertiary Care Centre ◽  
Presumptive Diagnosis

Introduction: Diphtheria is a vaccine preventable communicable acute infectious disease of upper respiratory tract caused by Corynebacterium diphtheriae (C. diphtheria) which is endemic in India. Delayed diagnosis of the disease leads to spread of infection in the community and causes increased morbidity and mortality in the affected individuals. To reduce the delay, an early attempt for microbiological diagnosis of diphtheria should be done as it is crucial and complimentary to clinical diagnosis. Aim: To know the prevalent toxin producing biotypes of Corynebacterium among the clinically probable cases of diphtheria. Materials and Methods: Throat swab samples from 300 clinical cases of diphtheria were processed by direct microscopy and culture. Microscopic examination was done by direct throat swab and samples were inoculated in Loeffler’s Serum Slope (LSS). Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method. Results were analysed using MS Excel. Results: Out of 300 samples, presumptive diagnosis of diphtheria by microscopic examination of direct throat swab was 3% and swab inoculated in LSS was 10%. Confirmed cases of diphtheria by culture were 48 (16%). A 100% sensitivity was seen for all antibiotics tested for all 48 isolates in antimicrobial susceptibility testing. Conclusion: A shift in the age wise incidence of the disease from pre-school to school age has been observed with more cases reported. C. diphtheriae gravis was the highly prevalent strain isolated. Culture should be considered as confirmatory method for diagnosis.

scholarly journals Antimicrobial susceptibility pattern of carbapenemase-producing Gram-negative nosocomial bacteria at Al Zahra hospital, Isfahan, Iran

2021 ◽  
Author(s):  
Sima Bahrami ◽  
Fatemeh Shafiee ◽  
Atousa Hakamifard ◽  
Hossein Fazeli ◽  
Rasool Soltani
Keyword(s):  
Antimicrobial Susceptibility ◽  
Nosocomial Infections ◽  
Susceptibility Test ◽  
High Rate ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Susceptibility Pattern ◽  
Gram Negative ◽  
Antimicrobial Susceptibility Pattern ◽  
Vitro Effect

Background and Objectives: Bacterial antibiotic resistance is one of the most important threats for public health around the world. Carbapenemase-producing Gram-negative bacteria have resistance to most antibiotics including carbapenems complicating the treatment of infections. The aim of this study was to determine the antimicrobial susceptibility pattern of carbapenemase-producing nosocomial Gram-negative pathogens at a referral teaching hospital to reveal the best options for treatment of related infections. Materials and Methods: Gram-negative bacteria, isolated from hospitalized patients with nosocomial infections, underwent meropenem susceptibility test by disk diffusion method. Meropenem-resistant strains were evaluated for the presence of carbapenemase using Modified Hodge test (MHT). Finally, the antibiotic susceptibility test was performed to determine the sensitivity of each carbapenemase-positive strain against various antimicrobial agents according to the guidelines of Clinical and Laboratory Standards Institute (CLSI). Results: Over the study period, 155 carbapenemase-positive isolates were detected. Pneumonia was the most frequent related nosocomial infection (67.1%) followed by UTI (23.2%). Acinetobacter baumannii (53.5%) and Klebsiella pneumoniae (40%) were the most frequently isolated pathogens. The pathogens had high rate of resistance to all antibiotics. Colistin had the most in vitro effect against all pathogens. Also, K. pneumoniae had a co-trimoxazole sensitivity rate equal to colistin (30.6%). Conclusion: Carbapenemase-positive Gram-negative bacteria causing nosocomial infections are common in our hospital and have high rate of resistance to most antibiotics. Improvement in the pattern of antibiotic use and infection control measures are necessary to overcome this resistance.

scholarly journals Epidemiology and antibiotic resistance trends of Pantoea species in a tertiary-care teaching hospital: A 12-year retrospective study

2019 ◽  
Vol 2 (3) ◽  
pp. 72-75 ◽  
Author(s):  
M Gajdács
Keyword(s):  
Retrospective Study ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Antimicrobial Susceptibility Testing ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Empiric Antibiotic

Purpose Pantoea species are pigmented, Gram-negative rods belonging to the Enterobacterales order. They are considered rare, opportunistic pathogens and are mostly implicated in nosocomial outbreaks affecting neonates and immunocompromised patients. The aim of this study was to describe the prevalence and antibiotic susceptibility of Pantoea species during a 12-year period. Materials and methods This retrospective study was carried out using microbiological data collected between January 1, 2006 and December 31, 2017. Patients’ data such as age, sex, inpatient/outpatient status, and empiric antibiotic therapy were also collected. Antimicrobial susceptibility testing was performed using E-tests; the interpretation was based on European Committee on Antimicrobial Susceptibility Testing breakpoints for Enterobacterales. Results Seventy individual Pantoea spp. isolates were identified; the most frequently isolated species was Pantoea agglomerans. Most isolates were susceptible to relevant antibiotics. In 61 out of 68 patients, ampicillin was the empirically administered antibiotic. The highest levels of resistance were to amoxicillin–clavulanic acid and ampicillin. No extended spectrum beta-lactamase-positive isolate was detected. Conclusions There is a scarcity of data available on the susceptibility patterns of Pantoea species, but our results correspond to what we could find in the literature. The development of multidrug-resistant (MDR) Gram-negative bacteria is a grave concern, and the development of MDR Pantoea spp. may be expected in the future.

scholarly journals Nitrofurantoin Susceptibility Pattern in Gram-Negative Urinary Isolates: In Need of Increased Vigilance

2021 ◽  
Author(s):  
Garima Gautam ◽  
Sanjib Gogoi ◽  
Sonal Saxena ◽  
Ravinder Kaur ◽  
Megh Singh Dhakad
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Analysis Data ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
Tract Infections ◽  
Urinary Isolates

AbstractNitrofurantoin is the first-line drug in the treatment of uncomplicated urinary tract infections (UTIs) and its use has increased exponentially in recent years. Objectives This study aims to determine the susceptibility pattern of nitrofurantoin in gram-negative urinary isolates and to evaluate their bacteriological and epidemiological profile along with co-existing resistance to other important urinary antimicrobials. Material and Methods This was a retrospective study conducted in a tertiary care hospital in New Delhi in which 500 gram-negative bacterial urinary isolates were evaluated. Records of antimicrobial susceptibility were reviewed from July to September 2019. Antimicrobial susceptibility was performed using the Kirby–Bauer disk diffusion method on Mueller Hinton agar and interpreted using CLSI 2019. Test for extended spectrum β-lactamase (ESBL) producers was done using double disk approximation test. Statistical Analysis Data analysis was performed using the SPSS windows version 25.0 software. Results Out of total 500 isolates, 20.17% (94) isolates were resistant (R) to nitrofurantoin and 9.01% (42) were found to be intermediate (I). Highest resistance was seen in Klebsiella sp. (44.61%) and Escherichia coli (8.12%). About 28.82% of the I/R isolates were of the pediatrics age group and most of the isolates belonged to females (64.69%). High resistance was also seen against ampicillin (92.30%), cefazolin (88.46%), ceftazidime (73.0%), and fluoroquinolones (65.38%). Carbapenemase co-resistance was seen in 57.15% isolates whereas ESBL production was seen in 30.76% of E. coli and 12.06% of Klebsiella sp. Conclusion Increase in multidrug resistance uropathogens along with a near absence of novel oral antibiotics has led to increased consumption of nitrofurantoin since its resistance has increased.

scholarly journals Direct susceptibility testing by disk diffusion on positive BacT/ALERT blood cultures: A rapid and definite tool for antibiotic stewardship

2021 ◽  
Vol 7 (3) ◽  
pp. 179-185
Author(s):  
Sandhya Bhat K ◽  
V Lokeshwari
Keyword(s):  
Antimicrobial Susceptibility ◽  
Antibiotic Stewardship ◽  
Susceptibility Testing ◽  
Tertiary Care ◽  
Blood Stream ◽  
Careful Consideration ◽  
Tertiary Care Centre ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Gram Staining

Blood stream infections continue to be the major cause of mortality and morbidity and hence early availability of direct susceptibility reports can be lifesaving. This study aims to ascertain if direct susceptibility testing (DST) can be used as a diagnostic tool in bacteremic patients and to correlate the results of both DST and standard antimicrobial susceptibility reports (AST), thereby serving to benefit both the patients and also to reduce the irrational use of antibiotics. An experimental study was carried out after obtaining waiver of consent, in a tertiary care centre. A total of 37 patients were included in the study after careful consideration of the inclusion and exclusion criteria. Gram staining report, bacteriological profile, direct susceptibility report, antimicrobial susceptibility report of all the isolates were documented. Statistical analysis was done by using IBM SPSS software. Overall prevalence of sepsis was 40.5%. Gram negative bacteria were more commonly isolated (83.8) and Escherichia coli was the commonest isolate (51.4%). The antimicrobial resistance was observed maximum for amoxicillin/clavulanic acid (66.7%), ceftriaxone (60.6%), Cefotaxime (57.6%) and least for meropenem (9.1%), imipenem (6.1%). On comparison of DST with AST among 28 gram-negative Enterobacteriaceae isolates 15 minor errors (4.8%) and three major errors (0.97%) were recorded, with maximum errors being documented for piperacillin/tazobactam with five minor errors (17.9%) and one major error (3.6%). DST is an important tool for early institution of targeted therapy and should be considered as one of the step towards antibiotic stewardship intervention.

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