scholarly journals Bacteriological spectrum of urinary, wound and respiratory infection with antibiogram of gram negative bacteria in a Bangladeshi tertiary care hospital

Mediscope ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 17-24
Author(s):  
NM Wahidur Rahman ◽  
Bushra Tanzem ◽  
Golam Nabi ◽  
Afsana Mahbub ◽  
Abu Md Mayeenuddin Al Amin
Keyword(s):  
Urinary Tract ◽  
Respiratory Tract ◽  
Antibiotic Susceptibility ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Infection remains the main cause of morbidity and mortality in man, particularly in developing areas where it is associated with poverty and overcrowding. Infectious disease cause nearly 25% of all human deaths. This rate of mortality is increasing day by day due to antibiotic resistance, which is a major concern nowadays. Wound, respiratory tract and urinary tract are commonly associated with bacterial infection in both hospital and community settings. Area-specific monitoring studies aimed to gain knowledge about the type of bacterial pathogens responsible for these kinds of infections and resistance pattern of the causative agents may help clinicians to choose correct treatment regimen. So, the present study was aimed to investigate the pattern of bacteria which are responsible for Urinary tract, respiratory tract and wound infection. In addition, we also determined the antibiotic susceptibility profile of gram negative bacteria isolated from the patients who were attending both in and out patient departments at Sir Salimullah Medical College & Mitford Hospital (SSMC & MH) during January, 2009 to December, 2009. In this cross-sectional study, out of 308 clinical samples, a total of 159 (51.62%) samples were found to be positive for bacterial culture. Among the isolates 139 (87.42%) were Gram negative bacteria (Esch. coli, Klebsiella spp., Proteus spp., Pseudomonas spp., Acinetobacter spp.) and 20 (12.57%) were Gram positive bacteria (Staphylococcus aureus, Coagulase negative Staphylococcus). Antibiotic susceptibility of gram negative bacteria showed members of the Enterobacteriaceae were 100% sensitive to imipenem while they were found variably resistance to other commonly used antibiotics. We conclude that infections in the wound, respiratory and urinary tract are caused by both gram negative and gram positive bacteria. However, the frequency of gram negative bacteria is higher than the gram positive bacteria for these infections. Gram negative bacteria showed sensitive to imipenem and most of them were resistant to commonly used antibiotics. Therefore, clinicians should choose imipenem for patients who would be unresponsive to commonly used antibiotics. Mediscope Vol. 7, No. 1: Jan 2020, Page 17-24

scholarly journals Bacterial etiology and antibiotic resistance pattern of neonatal sepsis: a study in a tertiary care hospital, in Bangladesh

2019 ◽  
Vol 6 (5) ◽  
pp. 1839
Author(s):  
Mahfuza Shirin ◽  
M. Monir Hossain ◽  
Manifa Afrin ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Gram Positive Bacteria

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. The objective of the study was to detect causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns.Methods: This prospective cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal Medicine and NICU of Dhaka Shishu (Children) Hospital (DSH). Neonates diagnosed with probable sepsis were studied. After enrollment, 1 mL blood was taken and sent to Microbiology department of DSH for culture and sensitivity. With baseline characteristics, clinical examination findings and outcome, were also recorded.Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates, gram negative bacteria were 77.4% with Klebsiella pneumonae being the commonest (35, 41.7%), gram positive bacteria were 11.9% with Staphylococcus aureus and Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was Candida. Most of the isolated gram-negative bacteria were resistant to ampicillin, gentamicin, and ceftazidime; but gram-positive bacteria preserved 20-80% sensitivity. Klebsiella was more resistant than Acinetobacter to amikacin, netilmicin, ciprofloxacin and levofloxacin. Around 45-65% of gram-negative bacteria were resistant to imipenem and meropenem but gram-positive bacteria showed lesser resistance. Among the gram-negative bacteria, Klebsiella and Acinetobacter were resistant to piperacillin as same as carbapenem group, but gram-positive bacteria were 100% sensitive to piperacillin. All the gram-negative bacteria showed more resistance to 4th generation cephalosporin, cefepime than carbapenem. Out of culture positive 84 neonates, 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired neonates, 47.6% (10/21) were infected with Klebsiella.Conclusion: This study observed that gram-negative bacteria causing neonatal sepsis predominantly, with emergence of Candida. All the isolated gram-positive and gram-negative organisms were mostly resistant to available antibiotics

scholarly journals Antibiotic Susceptibility Profile of respiratory pathogens obtained at tertiary care hospital from western Nepal

2019 ◽  
Vol 7 (1) ◽  
pp. 1-7
Author(s):  
Deepak Subedi ◽  
Surya Prasad Devkota ◽  
Dharm Raj Bhatta ◽  
Binita Koirala Sharma ◽  
Ashmita Paudel ◽  
...  
Keyword(s):  
Antibiotic Susceptibility ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Lower Sensitivity ◽  
Respiratory Pathogens ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Sensitivity Rate

The prevalence and drug resistance of the respiratory pathogens is increasing gradually in Nepal. However, their detail study is rare in the western region of Nepal. Hence, this study was carried out to know the incidence and antibiotic susceptibility profile of the respiratory pathogens obtained at a tertiary care center located at Pokhara. 139 pathogens were isolated from 460 clinical samples included. Significant pathogens were Gram-negative bacteria 94 (67.62%), followed by 28 (20.15%) Candida, and Gram-positive isolates 17 (12.23%). The growth rate was significantly higher for sputum samples in comparison to throat swabs. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter were significant Gram-negative isolates while Staphylococcus aureus, Streptococcus pneumoniae, and Streptococcus pyogenes were Gram-positive pathogens. Sensitivity rate was higher for colistin and imipenem among Gram-negative isolates while lower sensitivity was for cefepime. Vancomycin was effective against all tested Gram-positive isolates while erythromycin and ciprofloxacin were less effective.

scholarly journals Sepsis: Antibiotic Resistances of Gram-Positive and Gram-Negative Bacterial in a Tertiary Care Hospital

2021 ◽  
Vol 12 (1) ◽  
pp. 29
Author(s):  
Siti Nurul Jannah ◽  
Muhammad Vitanata Arfijanto ◽  
Musofa Rusli ◽  
Agung Dwi Wahyu Widodo
Keyword(s):  
Bacterial Resistance ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
Systemic Infection ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
New Research

Introduction: Sepsis is a systemic infection that causes multiorgan failure and death. The death rate that is caused by sepsis is increasing. This high value of death has a correlation with the resistance of antibiotics. However, increased antibiotic resistance is not balanced with new research about antibiotics. As a consequence, it causes difficulties in handling sepsis patients who need antibiotic 1-2 hours after diagnosis is enforced. Methods: This was a descriptive study with case study design to analyze medical records of the patients, evaluating the pattern of bacterial resistance to antibiotic in 221 patients with sepsis with 240 blood isolates to identify. Results: From 221 patients identified as sepsis, there were 97 male patients (43.9%) and 124 female patients (56.1%), mostly between 18-59 years old (63.8%), with the highest level in female (54.8 %) and elderly (66.3%). The bacteria that caused the most sepsis were gram-positive. The most species in gram-positive are Staphylococcus haemolyticus (16.3%) and Staphylococcus aureus (12.5%), and the most species in gram-negative is Escheriichia coli (13.3%). The most sensitive antibiotics in gram-positive bacteria were Piperacillin-Tazobactam (100%), Daptomycin (99.2%), and Clindamycin (99.2%). The sensitive antibiotics in gram-negative bacteria were Amikacin (85.9%), Cefoperazone (84.6%), and Piperacillin-Tazobactam (84.1%). Conclusion: The most sensitive antibiotics in gram-positive bacteria were Piperacillin-Tazobactam, Daptomycin, and Clindamycin. The sensitive antibitics in gram-negative bacteria were Amikacin, Cefoperazone, and Piperacillin-Tazobactam. 

INCIDENCE OF DRUG RESISTANCE AMONG BACTERIAL ISOLATES OBTAINED IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 67-69
Author(s):  
A.P. More ◽  
J.D. Andhale
Keyword(s):  
Drug Resistance ◽  
Antibiotic Susceptibility ◽  
Tertiary Care Hospital ◽  
Bacterial Pathogens ◽  
Tertiary Care ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative

Introduction: Infections caused by Gram negative bacteria is major health threat to patients in intensive care units and to patients with some comorbidity. Constant surveillance of drug-resistance among the different bacterial pathogens is important in prevention and management of infections caused by these pathogens. Such type of study also help clinicians to prescribe correct drug regimen to the patients suffering from these infections which may be primary, secondary or nosocomial, reducing the morbidity, mortality and hospitalization period. The present study is undertaken to study the drug susceptibility pattern and its incidence among the different bacterial pathogens isolated from different clinical samples obtained at Tertiary Care Hospital. Materials and Methods: The samples received from different clinical units were subjected to bacteriological investigations using standard microbiological procedures. The isolated pure cultures of bacterial pathogens were subjected to antibiotic susceptibility testing as per the CLSI guidelines of 2016. The data of antibiotic susceptibility of each isolated pathogens were tabulated and prevalence of each drug resistance and multidrug resistance were determined to study the trends of drug resistance among these pathogens. Results: The incidence of infections caused by Gram negative bacteria was found to be 74.67% among all the isolates and that of Gram positive bacterial infections was found to be 25.33% respectively. Esch.coli (37.32%) was the most frequently isolated Gram negative bacterium followed by Ps. aeruginosa, Klebsiella spp., Acinetobacter spp. and Proteus spp.in the descending order among all the isolates of Gram positive and Gram negative isolates. Conclusion: The incidence of infections caused by Gram negative bacteria was higher than those caused by Gram positive bacteria. Esch.coli was the most common pathogen among the Gram negative bacterial isolates whereas Staph.aureus was the most common pathogen among all the Gram positive bacterial isolates. All the bacterial isolates showed 100% multi-drug resistance and the incidence of drug resistance to second generation penicillin and cephalosporins were found to be remarkably higher among all the bacterial isolates.

scholarly journals Microbial Patterns and Antibiotic Susceptibility in Blood Culture Isolates of Septicemia Suspected Children in the Pediatrics Ward of a Tertiary Care Hospital

2021 ◽  
Author(s):  
Muhammad Sarfraz Khan ◽  
Arslan Kareem ◽  
Kiran Fatima ◽  
Saima Rauf ◽  
Areeb Khalid ◽  
...  
Keyword(s):  
Antibiotic Susceptibility ◽  
Lower Sensitivity ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Two Samples ◽  
Acinetobacter Spp ◽  
Multiple Drugs

Abstract Objectives This study aims to determine microbial patterns and antibiotic susceptibility to alert clinicians to the emerging pathogens that may pose a threat to the community, especially children. Materials and Methods This retrospective cross-sectional study was conducted in the Department of Pathology, Holy Family Hospital, Rawalpindi, Pakistan, from July 2019 to December 2019. Two samples were taken from two different sites of each patient at the time of fever (> 100° F) to avoid chances of contamination. A blood sample of 5 to 10 mL was drawn from each site. In a 50 mL brain heart infusion broth (BHIB), 5 to 10% blood was injected in two different bottles and incubated for 48 hours at 37°C. After 48 hours, subculture was done by streaking the drops of blood samples taken from BHIB on blood and MacConkey agar. Cultures were incubated in aerobic conditions at 37°C for 24 to 48 hours. For testing antibiotic susceptibility, criteria defined by the Clinical and Laboratory Standards Institute (CLSI) were followed. Microbes were identified under a microscope by observing their morphological characteristics after gram staining and applying biochemical tests. Antibiotic sensitivity test was performed using standard aseptic methods. Statistical Analysis Bacterial isolates and their susceptibility patterns were represented using frequencies and percentage charts. Results Out of 423 blood cultures, growth was recorded in 92 (21.75%) of the cultures with female to male ratio 2.1:1. The gram-positive bacteria accounted for 43.48% (n = 40), whereas gram-negative bacteria covered the majority 54.36% (n = 50). Among isolates, Staphylococcus aureus (42.39%) was the most common, followed by Acinetobacter spp. (17.39%) and Pseudomonas aeruginosa (14.13%). Acinetobacter spp. showed 0% susceptibility to amikacin and cefotaxime. All the isolates were 100% resistant to amoxicillin-clavulanic acid. S. aureus showed lower sensitivity for ceftazidime (0%), clindamycin (66.67%), ciprofloxacin (0%), clarithromycin (11.76%), and ceftriaxone (0%). Tigecycline showed 100% sensitivity for all isolates tested. Conclusion Gram-negative bacteria form the majority of isolates in our setup, with Acinetobacter as the most common species among them. The resistance against cephalosporins, penicillin, and fluoroquinolones shown by Acinetobacter, Pseudomonas, Salmonella, and Klebsiella is of grave concern. Among gram-positive bacteria, S. aureus has established resistance against multiple drugs. Limited and objective use of antibiotic therapy is a much-needed strategy under new guidelines.

Predictive Factors for the Development of Central Line–Associated Bloodstream Infection Due to Gram-Negative Bacteria in Intensive Care Unit Patients After Surgery

2008 ◽  
Vol 29 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Pranavi V. Sreeramoju ◽  
Jocelyn Tolentino ◽  
Sylvia Garcia-Houchins ◽  
Stephen G. Weber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Predictive Factors ◽  
Tertiary Care ◽  
Central Line ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Objectives.To examine the relative proportions of central line-associated bloodstream infection (BSI) due to gram-negative bacteria and due to gram-positive bacteria among patients who had undergone surgery and patients who had not. The study also evaluated clinical predictive factors and unadjusted outcomes associated with central line-associated BSI caused by gram-negative bacteria in the postoperative period.Design.Observational, case-control study based on a retrospective review of medical records.Setting.University of Chicago Medical Center, a 500-bed tertiary care center located on Chicago's south side.Patients.Adult intensive care unit (ICU) patients who developed central line-associated BSI.Results.There were a total of 142 adult patients who met the Centers for Disease Control and Prevention National Nosocomial Infection Surveillance System definition for central line-associated BSI. Of those, 66 patients (46.5%) had infections due to gram-positive bacteria, 49 patients (34.5%) had infections due to gram-negative bacteria, 23 patients (16.2%) had infections due to yeast, and 4 patients (2.8%) had mixed infections. Patients who underwent surgery were more likely to develop central line-associated BSI due to gram-negative bacteria within 28 days of the surgery, compared with patients who had not had surgery recently (57.6% vs 27.3%; P = .002). On multivariable logistic regression analysis, diabetes mellitus (adjusted odds ratio [OR], 4.6 [95% CI, 1.2-18.1]; P = .03) and the presence of hypotension at the time of the first blood culture positive for a pathogen (adjusted OR, 9.8 [95% CI, 2.5-39.1]; P = .001 ) were found to be independently predictive of central line-associated BSI caused by gram-negative bacteria. Unadjusted outcomes were not different in the group with BSI due to gram-negative pathogens, compared to the group with BSI due to gram-positive pathogens.Conclusions.Clinicians caring for critically ill patients after surgery should be especially concerned about the possibility of central line-associated BSI caused by gram-negative pathogens. The presence of diabetes and hypotension appear to be significant associated factors.

scholarly journals Frequency and predictors of colonization of the respiratory tract by VIM-2-producing Pseudomonas aeruginosa in patients of a newly established intensive care unit

2006 ◽  
Vol 55 (10) ◽  
pp. 1435-1439 ◽  
Author(s):  
Maria Horianopoulou ◽  
Nicholas J. Legakis ◽  
Maria Kanellopoulou ◽  
Sotiris Lambropoulos ◽  
Athanassios Tsakris ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Tertiary Care ◽  
Nucleotide Sequencing ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Icu Stay

The aim of this study was to examine the frequency and predictors of colonization of the respiratory tract by metallo-β-lactamase (MBL)-producing Gram-negative bacteria in patients admitted to a newly established intensive care unit (ICU) of a tertiary care hospital. Specimens of tracheobronchial aspirates for microbiological studies were obtained every day for the first 3 days of the ICU stay and subsequently every third day for the rest of the ICU stay. PCR analysis and nucleotide sequencing were performed to identify bacteria that had MBL genes. Thirty-five patients (20 male, 15 female) were hospitalized during the initial 3 month period of functioning of the ICU. Colonization of the lower respiratory tract by Gram-negative bacteria was found in 29 of 35 patients (83 %) during the first 6–20 days (median 13 days) following admission to the ICU (13 patients with Acinetobacter baumannii, ten with Pseudomonas aeruginosa, three with Enterobacter aerogenes, two with Klebsiella pneumoniae and one with Stenotrophomonas maltophilia). Six of 29 patients (21 %) colonized with Gram-negative bacteria had bla VIM-2-positive P. aeruginosa isolates; one of these patients developed clinical infection due to this micro-organism. Previous use of carbapenems (P=0.01) or other β-lactams (P=0.03), as well as a stay in the ICU of >20 days (P<0.001), were associated with colonization with bla VIM-2-producing P. aeruginosa. In conclusion, colonization by Gram-negative bacteria of the respiratory tract of patients in this newly established ICU was common (83 %). Use of β-lactams, including carbapenems, was associated with subsequent colonization of the respiratory tract with MBL-positive P. aeruginosa.

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