Microorganisms Isolated from Blood Cultures and Their Antimicrobial Susceptibility Patterns At a University Hospital During 1994-2003

Abstract Introduction: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices. Methods: This was a descriptive cross sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively. Results: A total of 142 participants were enrolled; 50 (35.2%) had positive blood cultures with 56.0% gram positive, 42.0% gram negative bacteria and 2.0% yeast isolates. Most common isolates were Coagulase Negative Staphylococcus (CoNS) (22.0%), Escherichia coli (16.0%), Klebsiella pneumoniae (14.0%), Enterococcus faecalis (14.0%) and Staphylococcus aureus (8.0%) in all cancer patients. These isolates were similar in both haematological and solid cancers. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all gram negative isolates while vancomycin and linezolid were effective against 96.2% and 100.0% of all gram positive isolates respectively. Ten (66.7%) isolates of E. coli and K. pneumoniae were extended spectrum β-lactamase (ESBL) positive and the same proportion was observed on methicillin resistance among Staphylococcus species. Conclusions: The major microbial aetiologies of sepsis among patients with cancer in Zimbabwe were CoNS, E. coli, K. pneumoniae, E. faecalis and S. aureus. Most isolates were resistant to commonly used empirical antibiotics and there was high level of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.

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Antimicrobial susceptibility patterns of anaerobic bacteria at an Irish University Hospital over a ten-year period (2010–2020)

Anaerobe ◽

10.1016/j.anaerobe.2021.102497 ◽

2022 ◽

Vol 73 ◽

pp. 102497

Author(s):

Saied Ali ◽

Frank Dennehy ◽

Orla Donoghue ◽

Sinead McNicholas

Keyword(s):

Antimicrobial Susceptibility ◽

Anaerobic Bacteria ◽

University Hospital ◽

Susceptibility Patterns

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Antimicrobial Susceptibility Patterns and Wild-Type MIC Distributions of Anaerobic Bacteria at a German University Hospital: A Five-Year Retrospective Study (2015–2019)

Antibiotics ◽

10.3390/antibiotics9110823 ◽

2020 ◽

Vol 9 (11) ◽

pp. 823

Author(s):

Mohamed Tarek Badr ◽

Benjamin Blümel ◽

Sandra Baumgartner ◽

Johanna M. A. Komp ◽

Georg Häcker

Keyword(s):

Antimicrobial Susceptibility ◽

Susceptibility Testing ◽

Medical Center ◽

Demographic Data ◽

Anaerobic Bacteria ◽

Empirical Therapy ◽

Antimicrobial Susceptibility Testing ◽

University Hospital ◽

Comprehensive Overview ◽

Susceptibility Patterns

Local antimicrobial susceptibility surveys are crucial for optimal empirical therapy guidelines and for aiding in antibiotic stewardship and treatment decisions. For many laboratories, a comprehensive overview of local antimicrobial susceptibility patterns of anaerobic bacteria is still lacking due to the long incubation time and effort involved. The present study investigates the antimicrobial susceptibility patterns and related clinical and demographic data of 2856 clinical isolates of anaerobic bacteria that were submitted for analysis to the Institute for Medical Microbiology and Hygiene of the Freiburg University Medical Center (a tertiary university medical center in Southern Germany) between 2015 and 2019. Antimicrobial susceptibility testing has been carried out according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guideline. Minimum inhibitory concentration (MIC)50 and MIC90 for penicillin, metronidazole, moxifloxacin, and clindamycin were established for Gram-positive anaerobes and for ampicillin-sulbactam, meropenem, metronidazole, moxifloxacin, and clindamycin for Gram-negative anaerobes. The distribution of MIC-values for various antibiotics against anaerobic bacteria was also established, especially for those having no specific breakpoints according to EUCAST guidelines. Most clinically relevant anaerobic bacteria originated from general surgery, neurological, and orthopedic wards. A high proportion of isolates were resistant to moxifloxacin and clindamycin indicating the importance of their susceptibility testing before administration. Based on our study metronidazole and other β-lactam/β-lactamase inhibitor combinations such as ampicillin-sulbactam remain suitable for empirical treatment of infections with anaerobic bacteria.

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Evaluation of FASTinov® ultra-rapid flow cytometry antimicrobial susceptibility testing directly from positive blood cultures

Journal of Clinical Microbiology ◽

10.1128/jcm.00544-21 ◽

2021 ◽

Author(s):

Ana Silva-Dias ◽

Blanca Pérez-Viso ◽

Inês Martins-Oliveira ◽

Rosário Gomes ◽

Acácio G Rodrigues ◽

...

Keyword(s):

Flow Cytometry ◽

Data Analysis ◽

Antimicrobial Susceptibility ◽

Susceptibility Testing ◽

Blood Cultures ◽

Antimicrobial Susceptibility Testing ◽

University Hospital ◽

Antimicrobial Susceptibility Test ◽

Rapid Flow ◽

Amoxicillin Clavulanate

The ultra-rapid antimicrobial susceptibility test FASTinov® flow cytometry kit was directly evaluated on positive blood cultures (BC) at two sites: i) FASTinov® in Porto (Portugal) using spiked BC with well-characterized bacteria and ii) Ramon y Cajal University hospital in Madrid (Spain) using patients positive BC. Two kits were evaluated, FAST gramneg ( Enterobacterales , Pseudomonas , Acinetobacter ) and FAST grampos ( Staphylococcus , Enterococcus ). A dedicated software for cytometric data analysis and interpretative reporting, both using CLSI and EUCAST criteria, were used. The FAST gramneg kit also provides information about the presence of resistant mechanisms, including ESBLs and carbapenemases. After 1-h incubation at 37°C bacteria were analysed by CytoFLEX® cytometer (Beckman, CA). Disk diffusion was performed as reference susceptibility method. Overall, 447 positive BC were included, 100 from hospitalized patients. Categorical agreement for FAST gramneg panel was 96.8% for EUCAST and 96.4% for CLSI. For FAST grampos panel it was 98.6% when using both criteria. Using EUCAST criteria the percentage of errors for FAST gramneg panel was 2.1% minor errors (mE), 1.3% major errors (ME) and 0.6% very major errors (VME). Concerning CLSI, 2.9% mE, 0.9% ME and 0.4% VME were found. VMEs were mainly observed with amoxicillin-clavulanate, cefotaxime, ceftazidime and gentamicin. FAST grampos panel showed 0.3% mE, 1.4% ME and 0.4% VME using EUCAST criteria (VME regarded gentamicin and Staphylococcus ) while 0.4% mE, 1.4% ME and no VME when using CLSI criteria. FASTinov® flow cytometry kits represent a rapid alternative for direct antimicrobial susceptibility testing from positive BC, showing time-to-results <2-h, which can be used to personalized antibiotics and stewardship practices.

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Sepsis in cancer patients residing in Zimbabwe: Spectrum of bacterial and fungal aetiologies and their antimicrobial susceptibility patterns.

10.21203/rs.2.10948/v2 ◽

2019 ◽

Author(s):

FRANK CHINOWAITA ◽

Wendy Chaka ◽

Tinashe K Nyazika ◽

Tendai C Maboreke ◽

Emmanuel Tizauone ◽

...

Keyword(s):

Blood Culture ◽

Cancer Patients ◽

Antimicrobial Susceptibility ◽

Antimicrobial Treatment ◽

Blood Cultures ◽

Gram Positive ◽

Gram Negative ◽

E Coli ◽

Patients With Cancer ◽

Susceptibility Patterns

Abstract Introduction: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices. Methods: This was a descriptive cross sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively. Clinical and laboratory standards institute (CLSI) standard breakpoints were used to interpret the antimicrobial susceptibility results. Results: A total of 142 participants were enrolled; 50 (35.2%) had positive blood cultures with 56.0% Gram positive, 42.0% Gram negative bacteria and 2.0% yeast isolates. Most common isolates were coagulase negative Staphylococcus spp. (CoNS) (22.0%), Escherichia coli (16.0%), Klebsiella pneumoniae (14.0%), Enterococcus faecalis (14.0%) and Staphylococcus aureus (8.0%) in all cancer patients. These isolates were similar in both haematological and solid cancers. Gram negative isolates exhibited high resistance to gentamicin (61.9%) and ceftriaxone (71.4%) which are the empiric antimicrobial agents used in our setting. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all Gram negative isolates while vancomycin and linezolid were effective against 96.2% and 100.0% of all Gram positive isolates respectively. Ten (66.7%) isolates of E. coli and K. pneumoniae were extended spectrum β-lactamase (ESBL) positive. Among Staphylococcus species it was also observed that 10/15 (66.7%) of the isolates were methicillin resistan t. Conclusions : The major microbial aetiologies of sepsis among patients with cancer in Zimbabwe were CoNS, E. coli , K. pneumoniae , E. faecalis and S. aureus . Most isolates were resistant to commonly used empirical antibiotics and there was high level of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.

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