scholarly journals Prevalence and Antibiotic Resistance of ESKAPE Pathogens Isolated in the Emergency Department of a Tertiary Care Teaching Hospital in Hungary: A 5-Year Retrospective Survey

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 624 ◽  
Author(s):  
Ria Benkő ◽  
Márió Gajdács ◽  
Mária Matuz ◽  
Gabriella Bodó ◽  
Andrea Lázár ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Acquired Resistance ◽  
Multi Drug Resistance ◽  
Bacterial Isolates ◽  
E Coli ◽  
Empiric Antibiotic ◽  
Resistance Patterns ◽  
Set Up ◽  
Eskape Pathogens ◽  
Susceptibility Patterns

Antibiotic treatments initiated on Emergency Departments (ED) are empirical. Therefore, knowledge of local susceptibility patterns is important. Despite this, data on expected pathogens and their resistance profile are scarce from EDs internationally. The study aim was to assess the epidemiology and resistance patterns of bacterial isolates from a tertiary-care ED over 5 years, focusing on ESKAPE bacteria (including the Enterobacterales group). After removal of duplicates, n = 6887 individual bacterial isolates were recovered, out of which n = 4974 (72.22%) were ESKAPE isolates. E. coli was the most frequent isolate (2193, 44.1%), followed by the Klebsiella genus (664; 13.4%). The third most frequent isolate was S. aureus (561, 11.3%). In total, multi-drug resistance (MDR) was present in 23.8% and was most prevalent in A. baumanii (65.5%), P. mirabilis (42.7%), and K. pneumoniae (32.6%). MRSA was isolated in 19.6%, while ESBL-producing Enterobacterales in 17.7%, and these were associated with remarkably higher resistance to other antibacterials as well. Difficult-to-treat resistance (DTR) was detected in 0.5%. The frequent isolation of some ESKAPE bacteria and the detected considerable acquired resistance among ED patients raise concern. The revealed data identified problematic pathogens and will guide us to set up the optimal empiric antibiotic protocol for clinicians.

ANTIMICROBIAL SUSCEPTIBILITY PROFILE OF PATIENTS OF UTI IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 15-16
Author(s):  
Tyagi Ayushi ◽  
Gupta Smita ◽  
Grover Ankit
Keyword(s):  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Antimicrobial Drugs ◽  
In Vitro Susceptibility ◽  
E Coli ◽  
Drug Resistance Pattern ◽  
Resistance Patterns

BACKGROUND: Urinary tract infection (UTI) is one of the commonest infection in humans, mainly following instrumentation. Common causative pathogens include E.coli, Pseudomonas, Klebsiella, Proteus etc. Thus, the aim of this study was to determine causative urinary bacteria and assess their in vitro susceptibility pattern to commonly used antimicrobial drugs. MATERIALAND METHODS: One sample from each subject was considered. Total of 100 positive urine cultures were taken. RESULT: E. coli (55%) was the predominant organism followed by K. pneumoniae (15%) and pseudomonas (11%). Resistance of microbes was high towards cefoperazone/ sulbactam, piperacillin/ tazobactam, meropenem. CONCLUSION: Findings from the study revealed that E.coli is the most predominant etiology of UTIs followed by Klebsiella. The results show that the antimicrobial resistance patterns of the causes of UTI are highly variable. The multi-drug resistance pattern in these bacteria was high. Hence, it becomes essential to treat UTI patients based on microbiological susceptibility results.

scholarly journals Antibiotic Susceptibility Patterns of Bacterial Isolates from Pus Samples in a Tertiary Care Hospital of Punjab, India

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Rugira Trojan ◽  
Lovely Razdan ◽  
Nasib Singh
Keyword(s):  
Tertiary Care Hospital ◽  
Antibiotic Prescription ◽  
Tertiary Care ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
E Coli ◽  
Antibiotic Susceptibilities ◽  
Antibiotic Susceptibility Patterns ◽  
Susceptibility Patterns ◽  
Multiple Antibiotics

We determined the prevalence and antibiotic susceptibilities patterns of bacterial isolates from pus samples collected from patients in a tertiary care hospital of Punjab, India. E. coli was the most prevalent pathogen (51.2%) followed by Staphylococcus aureus (21%), Klebsiella pneumoniae (11.6%), Pseudomonas aeruginosa (5.8%), Citrobacter spp. (3.5%), Acinetobacter baumannii (2.3%), Proteus mirabilis (2.3%), and Streptococcus spp. (2.3%). E. coli, K. pneumoniae, A. baumannii, and Citrobacter isolates were resistant to multiple antibiotics including higher generation cephalosporins. S. aureus and Streptococcus isolates were sensitive to cloxacillin and vancomycin. However, P. aeruginosa, P. mirabilis, and Streptococcus isolates were found to be less resistant to the spectrum of antibiotics tested. Overall, our findings indicate the prevalence of resistance to different classes of antibiotics in bacterial isolates from pus infections and hence highlight the need for effective surveillance, regulator reporting, and antibiogram-guided antibiotic prescription.

scholarly journals A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sulochana Manandhar ◽  
Raphael M. Zellweger ◽  
Nhukesh Maharjan ◽  
Sabina Dongol ◽  
Krishna G. Prajapati ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Global Public Health ◽  
Gram Negative ◽  
E Coli ◽  
Extended Spectrum ◽  
High Prevalence

Abstract Background Multi-drug resistance (MDR) and extensive-drug resistance (XDR) associated with extended-spectrum beta-lactamases (ESBLs) and carbapenemases in Gram-negative bacteria are global public health concerns. Data on circulating antimicrobial resistance (AMR) genes in Gram-negative bacteria and their correlation with MDR and ESBL phenotypes from Nepal is scarce. Methods A retrospective study was performed investigating the distribution of ESBL and carbapenemase genes and their potential association with ESBL and MDR phenotypes in E. coli, Klebsiella spp., Enterobacter spp. and Acinetobacter spp. isolated in a major tertiary hospital in Kathmandu, Nepal, between 2012 and 2018. Results During this period, the hospital isolated 719 E. coli, 532 Klebsiella spp., 520 Enterobacter spp. and 382 Acinetobacter spp.; 1955/2153 (90.1%) of isolates were MDR and half (1080/2153) were ESBL producers. Upon PCR amplification, blaTEM (1281/1771; 72%), blaCTXM-1 (930/1771; 53%) and blaCTXM-8 (419/1771; 24%) were the most prevalent ESBL genes in the enteric bacilli. BlaOXA and blaOXA-51 were the most common blaOXA family genes in the enteric bacilli (918/1771; 25%) and Acinetobacter spp. (218/382; 57%) respectively. Sixteen percent (342/2153) of all isolates and 20% (357/1771) of enteric bacilli harboured blaNDM-1 and blaKPC carbapenemase genes respectively. Of enteric bacilli, Enterobacter spp. was the most frequently positive for blaKPC gene (201/337; 60%). The presence of each blaCTX-M and blaOXA were significantly associated with non-susceptibility to third generation cephalosporins (OR 14.7, p < 0.001 and OR 2.3, p < 0.05, respectively).The presence of each blaTEM, blaCTXM and blaOXA family genes were significantly associated with ESBL positivity (OR 2.96, p < 0.001; OR 14.2, p < 0.001 and OR 1.3, p < 0.05 respectively) and being MDR (OR 1.96, p < 0.001; OR 5.9, p < 0.001 and OR 2.3, p < 0.001 respectively). Conclusions This study documents an alarming level of AMR with high prevalence of MDR ESBL- and carbapenemase-positive ESKAPE microorganisms in our clinical setting. These data suggest a scenario where the clinical management of infected patients is increasingly difficult and requires the use of last-resort antimicrobials, which in turn is likely to intensify the magnitude of global AMR crisis.

Epidemiology of bloodstream Candida species in a Spanish tertiary care hospital as a guide for implementation of T2MR (T2CANDIDA®) for rapid diagnosis of candidemia

2020 ◽  
Author(s):  
Iker Falces-Romero ◽  
María Pilar Romero-Gómez ◽  
Francisco Moreno-Ramos ◽  
Jesús Mingorance ◽  
Julio García-Rodríguez ◽  
...  
Keyword(s):  
Candida Species ◽  
Antifungal Susceptibility ◽  
Tertiary Care ◽  
Common Species ◽  
Care Hospital ◽  
Clinical Value ◽  
Negative Results ◽  
Resistance Patterns ◽  
Resistance Rates ◽  
Susceptibility Patterns

Abstract The aim of this work was to study the epidemiology of candidemia in our hospital in order to determine whether the T2MR system might be a useful tool for early diagnosis of candidemia in selected units. We perform a retrospective review of all candidemia episodes registered in the last 12 years in selected units of our hospital in adult and pediatric patients. Candida species and antifungal susceptibility patterns were registered. A total of 686 isolates were registered, of which 625 were infections due to the five most common species of Candida. C. albicans (45.6%) and C. parapsilosis (33.1%) were the predominant species found in our institution. In adults these species were closely followed by C. glabrata (12–21%) in all units. While in pediatric medical and intensive care units (PICU), these species were followed by other uncommon yeasts. Resistance rates to triazoles were low in C. albicans and C. parapsilosis. In C. glabrata and C. tropicalis the resistance rates to fluconazole ranged from 10.86 to 6.67%. Resistance rates for echinocandins were very low and all strains were susceptible to amphotericin B. T2Candida® might be useful to guide antifungal targeted treatment and discontinuation of antifungal empirical treatment in those units where the five most common Candida species represent more than the ninety percent of the isolates. The selection of medical and surgical units should be based on local epidemiology and antifungal susceptibility patterns. Incidence should be taken into account in order to make clinical decisions based on negative results. Lay Abstract T2Candida® might be useful selectively in clinical units according to their local epidemiology, antifungal resistance patterns, and incidence of candidemia. It optimizes the clinical value of positive results supporting decisions about targeted therapies or discontinuations based on negative results.

scholarly journals Prevalence and Antibiogram of Bacterial Uropathogens of Urinary Tract Infections from a Tertiary Care Hospital of Bangladesh

2017 ◽  
Vol 9 (3) ◽  
pp. 317-328 ◽  
Author(s):  
S. A. Sanjee ◽  
M. E. Karim ◽  
T. Akter ◽  
M. A. K. Parvez ◽  
M. Hossain ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Tertiary Care ◽  
Age Groups ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Antibiotic Resistance Patterns

Urinary tract infections (UTIs) are one of the most frequently occurring infections majority of which are caused by multi-drug resistant (MDR) uropathogens. Hence, the present study was designed to find out the prevalence of bacterial pathogens causing UTIs and to determine their antibiotic resistance patterns against different classes of antibiotics. Clean-catch midstream urine samples were collected from 200 UTI patients of different sex and age groups. The uropathogens were isolated using Hi-Chrome UTI agar, Blood agar, MacConkey agar and then subjected to antibiotic susceptibility analysis against nine antibiotics of different classes using Kirby-Bauer’s disc diffusion method. From 55.08% positive samples, it was found that females were more prone to UTIs than males and in both cases; the prevalence rate was higher in the age group 21-40 years (33%). Among the uropathogens, E.coli was the predominant etiological agent (57.38%) followed by Enterococcus sp. (36.06%), Pseudomonas aeruginosa (3.28%) and Staphylococcus aureus (3.28%). The pathogens showed remarkable amount of sensitivity against Gentamicin and Ciprofloxacin. The present experiment can be helpful for the clinicians in finding proper drugs in the developing countries like Bangladesh where multi-drug resistance problem has just complicated the treatment of UTIs.

scholarly journals Patterns of Extended-Spectrum β-Lactamase Producing Uropathogens Detection in Tertiary Care Hospital of Bangladesh

2021 ◽  
pp. 29-34
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Human Life ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Bacterial Strains ◽  
Extended Spectrum ◽  
Resistance Patterns

It is a great concern that extended-spectrum β-lactamase (ESBL) and non-ESBL uropathogenic micro-organisms have been worldwide illustrated to increase multidrug resistance. To study the prevalence and patterns of uropathogens, and antimicrobial susceptibilities profiles of ESBL and non-ESBL producing bacterial infection in a tertiary level health service center of Bangladesh. The prevalence of ESBL producing uropathogens and their antimicrobial resistance patterns were identified in 176 isolates from patients with UTI. ESBL and non-ESBL producing bacterial isolates and their antibiotic sensitivity and resistance patterns were distinguished from the 176 patients of suspected urinary tract infection. The Double-disc diffusion test was done to determine the presence of ESBL-producing bacterial strains. The most widely ESBL positive uropathogen was Escherichia coli (87%), followed by Pseudomonas aeruginosa, (6.8%), Enterococcus spp. (3.4%), Acinetobacter spp. (2.5%) and non-ESBL positive E. coli (41.4), Staphylococcus saprophyticus (25.9%), Pseudomonas aeruginosa (17.2%), Staphylococcus aureus (10.3%), and Klebsiella pneumoniae (5.2%). The current investigation found most frequently Escherichia coli in both ESBL and non-ESBL uropathogenic groups as 87% and 41.4% respectively. Generally, a large number of antibiotic resistance patterns and ESBL producing common bacterial isolates were found in this study which increases the public health problem. Therefore, for safe human life, we ought to be taking appropriate action against the threat.

scholarly journals Biofilm Production and Antimicrobial Resistance among Uropathogens in Pediatric Cases: a Hospital Based Study

2018 ◽  
Vol 16 (2) ◽  
pp. 178-183
Author(s):  
Dhiraj Shrestha ◽  
Pratigya Thapa ◽  
Dinesh Bhandari ◽  
Hiramani Parajuli ◽  
Prakash Chaudhary ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Tract Infection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
E Coli ◽  
Biofilm Production ◽  
Resistance Patterns

Background: The study was designed to provide account of etiological agents of urinary tract infection in pediatric patients and the antimicrobial resistance pattern plus biofilm producing profile of the isolates.Methods: The prospective study was conducted in Alka Hospital, Nepal with 353 clean catch urine samples from children. It was obtained during July 2014 to January 2015 which were first cultured by semi-quantitative method, followed by antimicrobial susceptibility testing and biofilm production assay on Congo red agar. Multidrug- resistance, extensively drug- resistance and pandrug- resistance among isolates were considered as per international consensus.Results: Out of 353 samples, 64 (18.13%) showed positive growth in culture, confirming urinary tract infection. E. coli, 44 (68.8%) was the predominant organism followed by Klebsiella spp. 6 (14.1%). Most E. coli were sensitive to amikacin (93.2%) followed by nitrofurantoin (86.4%), and highly resistant to ampicillin (95.5%). Of 64 isolates, 23 (35.93%) were found to be multidrug- resistant strains. Biofilm was produced by 36 (56.25%) isolates.Conclusions: This study showed higher biofilm production and resistance to in-use antibiotics rendering ineffective for empirical use. Regular surveillance of resistance patterns should be done to regulate multidrug- resistant bugs and to ensure effective management of urinary tract infection in children in a tertiary care setups.Keywords: AMR; antimicrobial resistance; biofilm; urinary tract infection; UTI.

scholarly journals ANTIBACTERIAL SURVEILLANCE: AN APPROACH TO MITIGATING MULTI-DRUG RESISTANCE MENACE AMONG CLINICAL UROPATHOGENS IN EKITI STATE, NIGERIA

2020 ◽  
Vol 3 (2) ◽  
pp. 10
Author(s):  
Seye Julius Oladeji ◽  
Gbenga Victor Kayejo
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Care Hospital ◽  
Gram Negative ◽  
Microbiological Methods ◽  
Resistance Patterns ◽  
Etiological Agents ◽  
Tract Infections ◽  
Urine Specimens

Urinary tract infections (UTIs) are among the most common human infections with the distribution of etiological agents and antibiotic resistance patterns varying from region to region and from time to time. The aims of this study were to ascertain the prevalence and antibiotic resistance profiles of common Gram-negative uropathogens among patients attending a Tertiary Care Hospital in Ekiti State, Nigeria. One hundred and fifty clean-catch midstream urine specimens were obtained and cultured within 2 hours of collection for the detection of Gram-negative uropathogens. The isolated organisms were identified by standard microbiological methods. Of the total 150 urine specimens analyzed, 82 (54.67%) specimens were positive for Gram-negative uropathogen with significant bacteriuria of which 34 (41.46%) were males and 48 (58.54%) were females. Klebsiella spp. 38 (46.34%) and Escherichia coli 32 (39.02%) were the most frequently isolated Gram-negative uropathogens, followed by Proteus mirabilis 10 (12.20%) while the least occurring uropathogen was observed to be Pseudomonas aeruginosa 2 (2.44%). All the isolated uropathogens were observed to be highly resistant to the commonly prescribed antibiotics. Emerging resistance to carbapenems was also observed. Nevertheless, carbapenems showed highest susceptibility compared to other tested antibiotics. Conclusively, high levels of resistance of uropathogens to antibiotics exist in our setting. This therefore calls for continuous antibiotic surveillance and improved antibiotic stewardship.  

Antimicrobial resistance patterns of WHO priority pathogens isolated in children from a tertiary care hospital in Southern India: A descriptive and time trend analysis

2020 ◽  
Author(s):  
Vijayalaxmi V Mogasale ◽  
Prakash Saldanha ◽  
Vidya Pai ◽  
Rekha PD ◽  
Vittal Mogasale
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Trend Analysis ◽  
Time Trend ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
E Coli ◽  
Resistance Patterns

Abstract Background There is global consensus that Antimicrobial Resistance (AMR) poses an unprecedented challenge to modern medicine as we know it today; and the lack of new antibiotics in the pipeline is compounding the threat to contain emerging drug-resistant infections. In 2017, the World Health Organization (WHO) has articulated a priority pathogens list (PPL) to provide strategic direction to research and development of new anti-microbials. Anti-microbial resistance patterns of selected ‘drug-bug’ combinations based on the WHO-PPL in one tertiary health care facility in India are explored in this paper. Methods Culture reports of laboratory specimens, collected between 1st January 2014 and 31st October 2019 from paediatric patients in a tertiary care hospital in India, were retrospectively extracted. The antimicrobial susceptibility patterns for selected antimicrobials based on the WHO-PPL are analysed and reported. Results Of 12,256 culture specimens screened, 2,335 (19%) showed culture positivity; of which 1,556 were organisms from the WHO-PPL. E. coli was the most common organism isolated (37%) followed by Staphylococcus aureus (16%). Total 72% of E. coli were extended-spectrum beta-lactamases producers, 55% of Enterobacteriaceae were resistant to 3rd generation cephalosporins, and 53% of Staphylococcus aureus were Methicillin resistant. Time-trend analysis of the data showed continued high resistance to carbapenem in E coli, Klebsiella pneumoniae and Enterobacter cloacae. Conclusions The AMR trends and prevalence patterns are likely to be different, across various local settings, than as defined at the national level or the WHO-PPL. This difference needs to be recognised in decision and policy making. It is critical, that the evidence used at national and global levels, have reasonable geographical and population representation through standardised and more granular AMR surveillance, in order to improve the effectiveness of the overall national AMR response.

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