scholarly journals Frequency of Isolation of Coagulase Negative Staphylococcus from Blood Cultures and its Antibiogram

2021 ◽  
Vol 10 (3) ◽  
pp. 140-144
Author(s):  
Nadia Aslam ◽  
Nazma Kiran ◽  
Naima Mehdi

Background: Coagulase-negative Staphylococci are members of stable skin inhabitants. They are frequent contaminants in blood cultures and can lead to unnecessary exposure of patients to antimicrobial drugs and excess hospital costs. This study aims to estimate the frequency of Coagulase-negative Staphylococci in blood cultures and their antibiograms. Materials and Methods: This cross-sectional study was performed in a tertiary care hospital over one year from April 2018 to March 2019. Blood cultures received in the laboratory were processed to isolate Coagulase-negative Staphylococci. Susceptibility to various antimicrobial drugs was detected by disc diffusion method and E-strips. Results: A total of 13802 blood cultures were processed in one year. 1750 blood cultures yielded bacterial growth and 374 blood cultures were positive for Staphylococci. Out of these 374 blood cultures, 97 were categorized as Staphylococcus aureus and 277 were Coagulase-negative Staphylococci. Out of 13802 total blood cultures performed during study period, 277 blood cultures positive with Coagulase negative Staphylococcus means contamination rate of 2% out of total blood cultures. 277 Coagulase negative Staphylococcus positive cultures out of 1750 positive blood cultures means contamination rate of 15.8% out of positive blood cultures. Among Coagulase-negative Staphylococci, 68.2% isolates were resistant to Cefoxitin, 95.3% to Penicillin, 85.1% to Erythromycin, 37.5% to Ciprofloxacin, 59.6% to Gentamicin, 68.6% to Fusidic acid, 3.6% to Teichoplanin, and 1.4% to Linezolid. All isolates were sensitive to Vancomycin. Conclusion: The rate of blood culture contamination was 2% out of total blood cultures and 15.8% out of positive blood cultures.

2018 ◽  
Vol 72 (2) ◽  
pp. 181-184
Author(s):  
Saugata Choudhury ◽  
Lee Kar Mun ◽  
Esme Ng Chu Xuan ◽  
Lee Shin Jia ◽  
Shawn Vasoo ◽  
...  

We compared the in vitro antimicrobial activities of tedizolid and linezolid on the Sensititre broth microdilution system for Gram-positive cocci isolates (n=146) from skin and skin structure infections and bloodstream infections, bronchoalveolar lavage and sputum. These pathogens included 40 methicillin-resistant Staphylococcus aureus, 38 coagulase-negative staphylococci, 20 Enterococcus faecalis and 48 beta-haemolytic Streptococcus spp. Susceptibility was simultaneously determined for 48 vanA vancomycin-resistant enterococci isolates 2013–2016 from rectal swabs (23 E. faecalis and 25 E. faecium, of which 4 were linezolid-non-susceptible). MIC90s for tedizolid were fourfold to eightfold lower than linezolid on the Sensititre and ranged from 0.12 to 0.5 µg/mL for the different pathogen groups. All isolates were susceptible to tedizolid except two vanA E. faecium strains (MICs of 1 and 2 µg/mL, respectively). Categorical and essential agreement for tedizolid were 99.48% and 92%, respectively, between Liofilchem gradient diffusion and Sensititre methods. Overall, the drug exhibited excellent activity against the surveyed Gram-positive pathogens.


2021 ◽  
Vol 18 (4) ◽  
pp. 734-740
Author(s):  
Dharma Nagarkoti ◽  
Krishna Prajapati ◽  
Ajay Narayan Sharma ◽  
Aarogya Gyawali ◽  
Sarita Manandhar

Background: Staphylococci are posing threat due to increasing trend of antimicrobial resistance particularly methicillin. Macrolide lincosamide streptogramin B (MLSB) family of antibiotics is commonly used to treat such infections. This study was aimed to determine the prevalence of inducible clindamycin resistance and observation of erm and msr genes among Staphylococci isolated from tertiary care hospital of Nepal during July 2017 to March 2018.Methods: Staphylococci from different clinical specimens were identified and antibiotic susceptibility profile was assessed following Kirby Bauer disc diffusion method. The double disc diffusion or D-zone test as outlined in CLSI document M100-S24 was performed to examine inducible clindamycin resistant isolates. Multiplex PCR was performed for detection of erm and msr gene in isolates using specific primers for ermA, ermB, ermC, msrA and msrB genes.Results: Of the 60 Staphylococci isolates, 39 (65%) were S. aureus and 21 (35%) were coagulase negative Staphylococci (CNS) with 25 (64%) and 15 (71%) representing methicillin resistant S. aureus and CNS respectively. Constitutive and inducible MLSB phenotype was observed among 24 (40%) and 14 (23%) isolates respectively by D test. The most prevalent resistant gene was ermC (37%) followed by msrB (12%), ermB (10%) and msrA (10%). None of the isolates were found to possess ermA gene. Conclusions: The presence of constitutive and inducible MLSB as well as resistant genes among Staphylococci necessitates detection of such isolates to minimize treatment failure. The result from this study may help elucidate the predominant resistant characteristics in clinical Staphylococci isolated from tertiary care hospital of Nepal.Keywords: D test; erm gene; MLSB; msr gene; staphylococci.


Author(s):  
Uma Chikkaraddi ◽  
Namratha W Nandihal

Coagulase Negative Staphylococci (CoNS) are common inhabitants of skin and mucous membrane, may act as pathogens causing fatal infections especially in immunocompromised patients. CoNS mainly cause infections involving biofilm on implanted biomaterials. Increase in antimicrobial resistance causes difficulties to treat life threatening infections. Despite their growing importance, their speciation is rarely done. Therefore, the present study is undertaken to identify CoNS to the species level and to know their antibiotic susceptibility pattern along with rate of MRCoNS.250 isolates from various clinical specimens were considered in this study. The isolates were identified by colony morphology, Gram staining, catalase, slide and tube coagulase test. Speciation was done by Novobiocin resistance, urease activity, ornithine decarboxylase, pyrrolidonylarylamidase and aerobic acid production from mannose. The antimicrobial susceptibility was performed by Kirby-Bauer's disc diffusion method as per CLSI guidelines.Among 250 CoNS isolates, commonest species identified was (59.2%) followed by (19.6%) and (12.4%). They were commonly isolated in the age group 21 to 30 years (26.8%) and among males(58%). Total of 33.2% were isolated from pus followed by blood(21.6%). Majority species expressed resistance towards nalidixic acid(97.2%) followed by Penicillin(94%), 74.4% to Amoxicillin-Clavulanic acid and 66.4% to Cotrimoxazole. All the isolates were sensitive to Vancomycin. Methicillin resistance among CoNS was 73.2%. : The increased recognition of pathogenic potential in CoNS and emergence of drug resistance among them demonstrates the need to adopt simple laboratory methods to identify the species and determine the antibiotic resistant patterns to help the clinicians in treating the infections caused by CoNS.


2019 ◽  
Author(s):  
Dharma Nagarkoti ◽  
Krishna Prajapati ◽  
Ajay Narayan Sharma ◽  
Arrogya Gyawali ◽  
Sarita Manandhar

Abstract Background Staphylococci are the most commonly isolated pathogen from clinical specimen. These isolates are posing threat due to increasing trend of antimicrobial resistance particularly methicillin. Macrolide-lincosamide streptogramin B family of antibiotics is commonly used to treat such infections. This study was aimed to detect the prevalence of inducible clindamycin resistance and observation of erm and msr genes among Staphylococci isolated from tertiary care hospital of Nepal.Methods Staphylococci from different clinical specimen were identified and antibiotic susceptibility profile were determined following Kirby Bauer disc diffusion method. The double disc diffusion or D-zone test as outlined in CLSI document M100-S24 was performed to examine inducible clindamycin resistance isolates. Multiplex PCR was performed for detection of erm and msr gene in isolates using specific primers for ermA , ermB, ermC, msrA and msrB genes.Results Of the 60 Staphylococci isolates, 39 (65%) were Staphylococcus aureus ( S. aureus ) and 21 (35%) were coagulase negative Staphylococci (CNS) with 25 (64%) and 15 (71%) representing methicillin resistant S. aureus and CNS respectively. Constitutive and inducible MLS B phenotype was observed among 24 (40%) and 14 (23%) isolates respectively by D test. The most prevalent resistant gene was ermC gene (37%) followed by msr B (12%), erm B (10%) and msr A (10%). None of the isolates were found to possess erm A gene.Conclusions The resistant genes were detected more among CNS than S. aureus. The presence of constitutive and inducible MLS B as well as resistant genes among Staphylococci necessitates detection of such isolates to minimize treatment failure. The presence of resistant characteristic varies with hospital settings, geographical locations, patients’ demography etc. The result from this study may help elucidate the predominant resistant characteristics in clinical Staphylococci isolated from tertiary care hospital of Nepal.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Maaroufi ◽  
H Zahidi ◽  
M Abdulhakeem ◽  
S Arous ◽  
E G Benouna ◽  
...  

Abstract Introduction Infective endocarditis (IE) is a rare serious disease for which diagnosis and treatment and prophylaxis continue to develop. Purpose The aim of our work were to analyze evolution in its epidemiologic, clinical, and microbiologic characteristics, as well as the outcomes. Methods This study compare data from a retrospective study conducted by Bennis and Al based on 157 cases of infectious endocarditis admitted in tertiary care Hospital between January 1983 and December 1994, theses cases are referred as Group A; and 103 cases of infective endocarditis according to Duke criteria admitted to the same center three decades afterwards from december 2013 to January 2020, which are referred as Group B. Results The mean age of the patients has became older over decades, with a mean of 27.5 years (11–65 years) in the group A versus 39.2 years [13–84] in the group B, with preservation of the male predominance (62.8% in group A vs 62.1% in group B). Infectious endocarditis secondary to rheumatic valvular heart disease has significantly decreased from 63.% of patients in group A to 27.5% in group B. Mitral or mitro-aortic valve involvement stayed predominant in both groups with a increase of mechanical prosthetic valve involvement with 9.7% in group B. A portal of entry of the infection was identified in 63% of patients in group A versus 41% in group B, we noted a significant decrease of dental-related cases from 64% in group A to 29% in group B, and a predominance of invasive procedure/devices cases in group B with 36% of identified cases. In group A Blood cultures were positive in 42% of cases with a predominance of Staphylocci (30%) and coagulase-negative Staphylococci (25.7% of cases) whilst in group B blood cultures were positive in 30% of cases with a predominance of Staphylococci (36.6%) and Streptococci (20% of cases). Echocardiography as a useful diagnostic tool demonstrated specific lesions of infectious endocarditis (abcess or vegetations) in 73.2% of cases in group A and 82% in group B. The clinical course in group A was complicated by congetive heart failure CHF (47.8%) or neurological lesions (11.5%) while in group B CHF was noted in 35% of cases and 8% of neurological lesions and The global mortality went from 28.7% in group A to 15% in group B related mostly to cardiogenic shock. Conclusion Our work demonstrated changes in the epidemiologic characteristics of IE that parallel changes in demographic and risk factors. The progress of diagnosis and treatement options in developing countries explains the better prognosis for this condition today. FUNDunding Acknowledgement Type of funding sources: None.


2019 ◽  
Vol 19 (3) ◽  
pp. 327-333 ◽  
Author(s):  
Reza Khashei ◽  
Hadi Sedigh Ebrahim-Saraie ◽  
Mahtab Hadadi ◽  
Maysa Ghayem ◽  
Hadi Raeisi Shahraki

Background:Cell phones have become one of the necessary means of life and they are commonly used almost everywhere by every population. Colonized microorganisms on cell phones can be easily cross-transmitted. Given the widespread prevalence of nosocomial infections, this study aimed to determine the frequency of bacterial contamination and antibiotic resistance in cell phones of healthcare workers (HCWs) in a tertiary care hospital, from southwest of Iran.:In this cross-sectional study conducted between April and June 2016, sampling were performed from cell phones of 25 nurses and 75 medical students.Methods:Samples were collected from each cell phone by a moistened cotton swap dipped in normal saline prior and after decontamination with available alcohol-based handrubs. Identification of bacterial isolates was performed by conventional microbiologic methods. Antibiotic susceptibility pattern of the isolates was determined using the disk diffusion method.:The contamination rates of cell phones prior and after disinfection were 88% and 52%, respectively. Ninety-nine (71.2%) out of 139 isolated distinct bacterial colonies prior to cleaning were potentially nosocomial pathogens. Of them, staphylococci (88.9%) were the most prevalent bacteria, in which 40.9% were methicillin-resistant isolates. The majority of Gram-positive and - negative isolates were susceptible to the tested antimicrobials. Totally, contamination rate of cell phones was significantly reduced after decontamination. Regular disinfection of the hands and cell phones was significantly associated with reduction of colonization of the methicillin-resistant isolates.Result & Conclusion:These findings emphasize the restricted use of cell phones and encourage the higher compliance with hygienic practices in hospitals to reduce the risk of nosocomial infections.


Author(s):  
Mahesh N. Belhekar ◽  
Sweta B. Tondare ◽  
Prasad R. Pandit ◽  
Kiran A. Bhave ◽  
Tejal C. Patel

Background: The present study was undertaken to evaluate the incidence and pattern of adverse drug reaction (ADRs), causality, severity and preventability of ADRs.Methods: Data was collected and analyzed with the information such as patients’ demographic details, associated co-morbid conditions and detailed drug related information gathered from ADR reporting forms. World Health Organization (WHO) scale was used for assessing causality, modified Hartwig scale was used for assessing severity and modified Schumock and Thorntons scale were used for assessing preventability of ADRs. Data was analyzed using descriptive statistics.Results: Total 154 ADRs were reported in a period of one year (August 2016- July 2017). Out of 154 ADRs analyzed, 120 (77.9%) were in adults, 33 (21.4%) pediatric and 01 (0.7%) in geriatric patients. The most common ADR recorded was cutaneous reactions (43.5%) and the most common causative class of drugs for the same was found to be antimicrobials (46.7%) followed by non-steroidal anti-inflammatory drugs (15.6%). Causality assessment scale indicated 68.8% ADRs possible and 24% ADRs as probable. Severity assessment revealed that 45.5 % were mild, 50.6% moderate and 3.9% ADRs severe. Preventability assessment showed 84.4% of the cases were probably non-preventable.Conclusions: In this study it was found that, most of the ADRs were of possible category with mild to moderate severity and majority being non-preventable. Antimicrobial drugs being the most common offending drug class causing ADRs. Strategies targeting appropriate and cautious use of this class of drugs may benefit in reducing the number of ADRs and therefore the cost involved in the treatment.


Author(s):  
Mateen Izhar

Introduction: Staphylococcus aureus harboring Panton Valentine Leucocidin gene are emerging and spreading worldwide. PVL gene was first identified by Noel Panton and Francis Valentine in 1932 who IC Pakistan only limited data is available regarding the effect of PVL gene on sensitivity pattern of Staphylococcus aureus. Therefore, this study was conducted to understand the antimicrobial sensitivity pattern of both PVL positive and negative Staphylococcus aureus isolates. Aims & Objectives: This study was conducted to understand the antimicrobial sensitivity pattern of both PVL positive and PVL negative Staphylococcus aureus isolated from pus samples received from various indoor and outdoor departments of a tertiary care hospital of Lahore. Place and duration of study: Microbiology and Molecular Biology Laboratory Shaikh Zayed Hospital Lahore. Duration of study is one year after the approval of research topic. Material & Methods: A total of 384 Staphylococcus aureus isolates from skin and soft tissue infections were identified and selected. Their antimicrobial sensitivity testing was done by Kirby disc diffusion method using Muller Hinton agar. Results: Frequencies of PVL gene in MRSA and MSSA were 51% and 44% respectively. Frequency of PVL gene was also found to be high in Ciprofloxacin sensitive, Gentamicin sensitive, Erythromycin resistant and fusidic acid resistant isolates. Conclusion: Almost half of Staphylococcus aureus isolates were found PVL positive. They were mostly multidrug resistant. The PVL positive Staphylococcus aureus isolates showed high resistance against antibiotics than PVL negative isolates


Author(s):  
Dr. Rajesh Kumar Meena ◽  
Dr. Prasanna Gupta

Background: Coagulase-negative staphylococci (CoNS) have been recognized as an important agent of human infection since the past five decades.  Currently, there are 38 species of CoNS isolated from various human infections. Methods: A observational descriptive study conduct on 71 samples collected from the hospitalized patients and nonhospitalized patients. Various samples like Urine, body fluids, pus, blood, swabs (wound, high vaginal, nose, throat) and other clinical samples were collected from patients attending outpatient departments (OPD) and admitted in wards and ICUs in NIMS hospital and processed for isolation and identification of Coagulase negative Staphylococcus (CONS) by the phenotypic methods. Results: Staphylococcus epidermidis(35.21%) isolated more in our study. Second most common species was Staphylococcus saprophyticus(33.80%). Other species that isolated were as Staphylococcus haemolyticus(15.49%), Staphylococcus lugdanensis(7.04%), Staphylococcus schleiferi(4.22%) and Staphylococcus xylosis(7.40%) Concussion- In this study, the most common species identified was S. epidermidis. Keywords: Staphylococcus, Infection, Urine, Blood, Pus.


2020 ◽  
Vol 41 (S1) ◽  
pp. s468-s468
Author(s):  
Ahmed Babiker ◽  
Aditi Ramakrishnan ◽  
Jessica Howard-Anderson ◽  
Jill Holdsworh ◽  
Mini Jacob ◽  
...  

Background: Blood culture contamination rates are frequently higher than the ≤3% standard in the emergency department (ED). Objective: We sought to determine whether the implementation of a blood diversion device that mechanically sequesters the initial aliquot of the blood culture sample decreased blood culture contamination rates. Methods: We performed a quasi-experimental study in two 500-bed hospitals. The blood-diversion device was implemented in the ED in hospital A, but not in hospital B, starting in January 2018. Preintervention data were collected over a 29-month baseline period, and postintervention data were collected for 20 months. Both hospitals provided ongoing feedback on contamination rates. Blood culture contamination was defined as presence of common skin microbiota (eg, coagulase-negative staphylococci) in only 1 of ≥2 blood culture sets collected within 24 hours. Preintervention and postintervention blood culture contamination rates were calculated based on total blood cultures collected and were compared within and between hospitals using the Wilcoxon rank-sum test. Changes in preintervention and postintervention total and ED contamination rates within hospitals were calculated as rate ratios (RRs) using interrupted time series (ITS) analysis with segmented Poisson regression. Results: Among 212,789 total blood cultures (hospital A, 70,005; hospital B, 142,784), 4,025 (1.8%) were contaminated. In hospital A, the intervention resulted in a decrease in overall median blood culture contamination rates (2.4% vs 1.4%; P < .001) and ED median blood culture contamination rates (4.7% vs 2.6%; P < .001), whereas in hospital B there was no significant change during the same period in overall (2.3% vs 2.0%) or ED (5.0% vs 5.0%) median blood culture contamination rates. In the ITS analysis, the intervention was associated with an immediate decrease in hospital A’s contamination rate by 21.3% (level change RR, 0.79; 95% CI, 0.63–0.98; P = .04) overall and 21.0% (level change RR, 0.79; 95% CI, 0.62–1.0; P =.06) in the ED. After the intervention, there was a continued decrease in hospital A’s overall (trend change RR, 0.95; 95% CI, 0.93–0.97; P < .001) and ED (trend RR, 0.94; 95% CI, 0.92–0.96; P < .001) blood culture contamination rates, but not in hospital B’s overall (trend change RR, 1.02; 95% CI, 1.00–1.02; P = .01) or ED (RR, 1.00; 95% CI, 0.99–1.02; P = .30) blood culture contamination rates during the same period. Conclusions: Implementation of the blood diversion device in the ED resulted in a >20% relative reduction from a baseline of 5% of ED blood culture contamination rates. Continued improvement after implementation suggests ongoing efforts to address the workflow and the culture of safety are needed to optimize the use of this device.Funding: NoneDisclosures: None


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