EMERGENCE OF MULTIDRUG RESISTANT NFGNB AS AN IMPORTANT CAUSE OF INFECTIONS

2021 ◽  
pp. 1-2
Author(s):  
Nanoty Vaibhavi V ◽  
Matkari Pushkar P
Keyword(s):  
Clinical Laboratory ◽  
Tertiary Care ◽  
Pseudomonas Stutzeri ◽  
Acinetobacter Calcoaceticus ◽  
Multidrug Resistant ◽  
General Ward ◽  
Hospital Environment ◽  
Care Hospital ◽  
Isolation Rate ◽  
Clinical Specimens

Background: The non fermenter gram negative bacilli (NFGNB) are primarily opportunistic pathogens and have emerged as an important cause of health care associated infections. The Methods: non fermenter organisms were isolated from various clinical specimens in a microbiology laboratory of a tertiary care hospital and were identied by the conventional bacteriological identication methods. Susceptibility testing was performed by methods as recommended by Clinical Laboratory Standard Institute (CLSI). Results: A total of 10,456 clinical specimens were processed, of which 442 (4.23%) non fermenter spp. were isolated. Most common infection caused by non fermenters was abscess. Maximum numbers of isolate (52.94%) were of Pseudomonas aeruginosa, followed by Acinetobacter baumannii (42.76%). Other species isolated were Acinetobacter calcoaceticus (1.81%), Pseudomonas putida (1.13%), Acinetobacter lwofi (0.68%), Pseudomonas stutzeri (0.45%), Stenotrophomonas maltophilia (0.23%). The isolation rate of non fermenters from ICU was much higher compared to general ward. High antibiotic resistance was noted for commonly used antibiotics like cephalosporins, quinolones, aminoglycosides. A total 58.60% of multi drug resistant (MDR) non fermenter isolates were obtained. The isolation rate of MDR isolates of non fermenters was more from ICU compared to general ward. Nosocomial infections res Interpretation and Conclusion: istant to most antimicrobials caused by non fermenter organisms have emerged, especially in ICU. Early identication and continued surveillance will help to prevent their spread in hospital environment.

scholarly journals Recent Antimicrobial Susceptibility Patterns of Salmonella Isolates in A Tertiay Care Hospital Lahore

Esculapio ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 45-48
Author(s):  
Hina Bukhari ◽  
Tayyeba Komal ◽  
Raana Akhtar ◽  
Sami Ullah Mumtaz ◽  
Iqra Waheed
Keyword(s):  
Antimicrobial Susceptibility ◽  
Antibiotic Susceptibility ◽  
Clinical Laboratory ◽  
Tertiary Care ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Susceptibility Patterns

Objective: To determine the recent antimicrobial susceptibility patterns of salmonella isolates (typhi and paratyphi) in a tertiary care hospital of Lahore. Methods: It is cross sectional retrospective study conducted out in King Edward Medical University(Pathology deptt)/Mayo Hospital Lahore.The study period is six months from May 2019 to October 2019(Peak months of Typhoid fever).During this six months study period, total of 4284 samples for blood culture were received that were inoculated on the macConkey and blood agar plates.The growths obtained were then processed through biochemical profiling and analytical profile index(API).The Kirby Bauer technique was used for antibiotic susceptibility testing and reporting was done on the basis of clinical laboratory standard institute(CLSI). Results: During these six months, total 4284 blood samples were inoculated, out of which 433 growths were obtained. There were 84 strains of salmonella typhi isolated. Sensitivity pattern of different antibiotics showed that Azithromycin was sensitive to 70 (83.3%) isolates, imipenem in 72 (85.7%), ciprofloxacin to 56 (66.7%), gentamycin to 48 (57.1%), ceftriaxone to 45 (53.6%), cefepime to 20 (23.8%), chloramphenicol to 12 (14.3%) while ampicillin was least sensitive i.e. 8 (9.5%) isolates. There were 24 MDR(multidrug resistant) and 12 were XDR(extensive drug resistant) strains. We also found out that resistance to azithromycin drug is also emerging as 70 out of 84 strains were sensitive while remaining 14 were resistant. Conclusion: According to recent antibiotic susceptibility against salmonella typhi, the most sensitive drugs are Carbapenems (imipenem or meropenem) these days. Second sensitive antibiotic is azithromycin. Key Words: Antimicrobial susceptibility, Salmonella isolates, Carbapenems, Azithromycin. How to cite: Bukhari H., Komal T., Akhtar R., Mumtaz U.S., Waheed I., Recent Antimicrobial Susceptibility Patterns of Salmonella Isolates in A Tertiay Care Hospital of Lahore. Esculapio 2021;17(01):45-48

Biofilm Formation and Susceptibility to Polymyxin B by a Highly Prevalent Clone of Multidrug-Resistant Acinetobacter baumannii from a Mexican Tertiary Care Hospital

Chemotherapy ◽  
2015 ◽  
Vol 61 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Roberto Rosales-Reyes ◽  
María Dolores Alcántar-Curiel ◽  
Ma. Dolores Jarillo-Quijada ◽  
Catalina Gayosso-Vázquez ◽  
María del Rayo Morfin-Otero ◽  
...  
Keyword(s):  
Biofilm Formation ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Care Hospital ◽  
Resistant Clone ◽  
Disk Diffusion Method

Background:Acinetobacter baumannii has emerged as a major cause of hospital-associated infections with increased morbidity and mortality among those affected. Methods: A total of 85 isolates of a highly prevalent multidrug-resistant clone, identified during the period 2007-2011, were analyzed for biofilm formation on a polystyrene surface. The minimal inhibitory concentration was determined by the Sensititre System, the agar disk diffusion method and then read by means of the BIOMIC system and serial dilutions on Müller-Hinton agar. Results: In this study, covering a period of 5 years (2007-2011), we demonstrate that a particular clone emerged as the most prevalent, with an associated lethality of 28.2%. We demonstrate that 92.9% of strains corresponding to this clone are biofilm producers. Our results also demonstrate that all isolates were 100% susceptible to polymyxin B. Conclusion: Our study suggests that the high prevalence and lethality of this multidrug-resistant clone of A. baumannii and its persistence over close to 5 years in a Mexican tertiary hospital environment can be explained in part by the ability of these clinical isolates of A. baumannii to form biofilms.

scholarly journals Control of an Outbreak ofAcinetobacter baumanniiin Burn Unit in a Tertiary Care Hospital of North India

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Shweta Sharma ◽  
Nirmaljit Kaur ◽  
Shalini Malhotra ◽  
Preeti Madan ◽  
Charoo Hans
Keyword(s):  
Infection Control ◽  
Acinetobacter Baumannii ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Hospital Environment ◽  
North India ◽  
Care Hospital ◽  
Burn Unit

Acinetobacterinfection is increasing in hospitals and now it is considered as a global threat, as it can be easily transmitted and remain viable in the hospital environment for a long time due to its multidrug-resistant status, resistance to desiccation, and tendency to adhere to inanimate surfaces. Outbreaks caused by multidrug-resistantAcinetobacter baumannii(MDRAB) are difficult to control and have substantial morbidity and mortality, especially in vulnerable host. Here we are describing an outbreak of multidrug-resistantAcinetobacter baumanniiin burn unit of a tertiary care hospital in India followed by its investigation and infection control measures taken to curtail the outbreak. Outbreak investigation and environmental sampling are the key factors which help in deciding the infection control strategies for control of outbreak. Implementation of contact precautions, hand hygiene, personnel protective equipment, environmental disinfection, isolation of patients, and training of health care workers are effective measures to control the outbreak of MDRAB in burn unit.

scholarly journals Glycopeptide sensitivity patterns in Staphylococci isolated from clinical specimens in a Tertiary Care Hospital

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Muhammad Tahir Majeed ◽  
Mateen Izhar
Keyword(s):  
Clinical Laboratory ◽  
Tertiary Care ◽  
Diffusion Method ◽  
National Committee ◽  
Care Hospital ◽  
Glycopeptide Antibiotics ◽  
Human Pathogens ◽  
Disk Diffusion Method ◽  
Clinical Specimens ◽  
High Level

Staphylococci are among the most important and common human pathogens worldwide. Their resistance to antibiotics is increasing. The glycopeptide antibiotics (vancomycin and teicoplanin) are the last resort to treat serious infections caused by these bacteria. During the last decade the strains of staphylococci have developed intermediate levels of resistance to teicoplanin and vancomycin. The objective of this study was to establish the prevalence glycopeptide resistance among clinical isolates of staphylococci in Shaikh Zayed Hospital, Lahore, and comparison of antimicrobial sensitivities of vancomycin and teicoplanin among these isolates. 75 (Seventy five) consecutive staphylococci isolated from clinical specimens received in the laboratory were collected and their sensitivity to antibiotics was tested by National Committee for Clinical Laboratory Standards (NCCLS) disk diffusion method. Results show that all staphylococci were sensitive to the glycopeptide antibiotics. This indicates that no high-level resistance to glycopeptide antibiotics in these organisms is present in our hospital. However, the emerging resistance in staphylococci against these drugs worldwide necessitates strict surveillance of these organisms, institution of effective infection control policies and judicious use of antibiotics.

scholarly journals Resistance profiles and biofilm formation of coagulase negative staphylococci isolated from clinical specimens in a tertiary care hospital in Palestine

10.3823/814 ◽  
2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Dr. Nahed Ali Al Laham ◽  
Emad Abou Elkhair ◽  
Abdallah Bashir ◽  
Nahed Abdelateef
Keyword(s):  
Antibiotic Resistance ◽  
Biofilm Formation ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Common Species ◽  
Multidrug Resistant ◽  
Common Source ◽  
Care Hospital ◽  
Coagulase Negative Staphylococci ◽  
Clinical Specimens

Background: Coagulase-negative staphylococci (CoNS) represent one of the major resistant nosocomial pathogens where its biofilm-related infections often fail to respond to antibiotic chemotherapy. Here, we studied the resistance profiles and biofilm formation in CoNS isolates from clinical specimens at Al Shifa hospital in Gaza, Palestine. Methods: This study was carried out from March to July 2016 and included 81 clinical isolates. Identification and antibiotic susceptibility testing were performed using VITEK-2 system. The presence of nuc and mecA genes was performed using multiplex PCR. Qualitative and quantitative biofilm assays were performed using standard methods. Results: Of the 81 clinical CoNS isolates, S. haemolyticus was the most common species (34, 42%), followed by S. epidermidis (26, 32.1%) and S. saprophyticus (13, 16%). The majority of isolates (83.9%) were from surgery, ICUs, pediatrics and medicine wards and the most common source was pus (28, 34.6%). Antibiotic resistance was highest against aminoglycosides, β-lactams, carbapenems, cephalosporins, fluoroquinolones, fosfomycin and macrolides. Though, no resistance was detected against rifampicin, vancomycin, teicoplanin, nitrofurantoin, linezolid and mupirocin. The antibiotic resistance among MR-CoNS was significantly higher than that among MS-CoNS. Nearly 88.9% of isolates were multidrug resistant with higher percentage among MR-CoNS. Most S. epidermidis (76.9%) isolates were biofilm producer, with statistically significant association between methicillin resistance and biofilm production. Conclusions: High rates of antibiotic resistance were found among CoNS to commonly used antibiotics and the majority were methicillin and multidrug resistance. Most S. epidermidis isolates were biofilm producer. These results justified the necessity for national programs and measures to monitor and manage the usage of antibiotics in the Palestinian hospitals and community.

Prevalence of Vancomycin Resistant Enterococci in Various Clinical Specimens in Tertiary Care Hospital in North Delhi

2012 ◽  
Vol 3 (3) ◽  
pp. 141-144
Author(s):  
Swati Chaudhary ◽  
◽  
Swastika Aggarwal ◽  
Pawan Kumar ◽  
SK Aggarwal SK Aggarwal ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Clinical Specimens ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant

scholarly journals 99. Effectiveness of Antibiotic Prophylaxis Among Patients Undergoing Elective Transurethral Resection of the Prostate in the Era of Antibiotic Resistance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S179-S180
Author(s):  
Thana Khawcharoenporn ◽  
Pimjira Kanoktipakorn
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Prophylactic Antibiotics ◽  
Care Hospital ◽  
Extended Spectrum Beta Lactamase ◽  
Observational Cohort

Abstract Background Data existing on effectiveness of antibiotic prophylaxis (AP) for transurethral resection of the prostate (TURP) are limited in the era of antibiotic resistance. Methods A 4-year prospective observational cohort study was conducted among patients undergoing TURP in an academic tertiary-care hospital during 2016–2019. Patients were excluded if pre-operative (pre-op) urine cultures were not sent or grew mixed (>2) organisms, or they had pre-op urinary tract infection (UTI) or lost follow-up after TURP. Appropriateness of AP was defined as 1) correct dosing and duration and narrowest spectrum according to the hospital AP guidelines and local epidemiology and 2) being active against uropathogens isolated from the pre-op culture. Primary outcome was the rate of UTI within 30 days post TURP compared between appropriate antibiotic prophylaxis (AAP) and inappropriate antibiotic prophylaxis (IAP) groups. Results 342 patients were screened and 61 were excluded. Of the 281 patients included, 139 (49%) received AAP and 142 (51%) received IAP. The reasons for IAP were prescribing too broad-spectrum antibiotics (57%), inactive antibiotics (41%) and incorrect dosing (2%). Pre-op urine cultures were no growth in 148 patients (53%). Among the 133 positive urine cultures with 144 isolates, Escherichia coli (52%) was the most commonly isolated. Thirty-one percent of these 144 isolates produced extended-spectrum beta-lactamase (ESBL) and 23 (16%) isolates were multidrug-resistant. The resistant rates of Enterobacteriaceae were 73% for ciprofloxacin, 65% for TMP-SMX and 46% for ceftriaxone. The two most commonly prescribed prophylactic antibiotics were ceftriaxone (51%) and ciprofloxacin (34%). The rate of UTI within 30 days post-TURP was significantly higher in IAP group compared to AAP group (47% vs 27%; P< 0.001). Prescribing inactive prophylactic antibiotics was the independent factor associated with 30-day post-TURP UTI (adjusted odds ratio 2.88; P=0.001). Conclusion Appropriate antibiotic prophylaxis significantly reduced UTI within 30 days of elective TURP. Obtaining pre-op urine culture and prescribing an active prophylactic agent are critical for preventing post-TURP UTI in the era of antibiotic resistance. Disclosures All Authors: No reported disclosures

scholarly journals Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Aryatara Shilpakar ◽  
Mehraj Ansari ◽  
Kul Raj Rai ◽  
Ganesh Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Confirmatory Test ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract Background The existence of multidrug-resistant organisms, including extended-spectrum beta-lactamases (ESBLs), is on rise across the globe and is becoming a severe problem. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to study the prevalence of Gram-negative isolates exhibiting ESBL at a tertiary care hospital and study their antibiogram profile. Methods A cross-sectional study was conducted at Shahid Gangalal National Heart Centre, Kathmandu, Nepal, from June 2018 to November 2018. A total of 770 clinical samples were collected and identified using the conventional biochemical tests following the Clinical and Laboratory Standard Institute (CLSI) guidelines. Antimicrobial susceptibility testing (AST) was performed using the standardized Kirby-Bauer disk diffusion method. The screening test for ESBL producers was performed as recommended by the CLSI and the confirmatory test was performed phenotypically using the E-test. Results Out of the 92 isolates, 84 (91.3%) were multidrug-resistant, and 47 (51.1%) were found to be potential ESBL producers. Of these, 16 isolates were confirmed ESBL producers by the E-test. Escherichia coli and Klebsiella pneumoniae were the predominant isolates and were also the major ESBL producers. Besides polymyxin B (100% sensitive), meropenem and imipenem showed high efficacy against the ESBL producers. Conclusion Multidrug resistance was very high; however, ESBL production was low. Polymyxin B and carbapenems are the choice of drugs against ESBL producers but should be used only as the last line drugs.

scholarly journals Effective Utilization of Limited Isolation Rooms to Provide Safe Patient Care and Staff Safety in a Low- and Middle-Income Country

2020 ◽  
Vol 41 (S1) ◽  
pp. s203-s204
Author(s):  
Rozina Roshanali
Keyword(s):  
Emergency Department ◽  
Tertiary Care ◽  
Limited Resource ◽  
Multidrug Resistant ◽  
Communicable Diseases ◽  
Care Hospital ◽  
Middle Income ◽  
Safe Patient Care ◽  
Bed Management ◽  
Resource Setting

Background: My tertiary-care hospital is a 750-bed hospital with only 17 airborne infection isolation room (AIIR) and negative-pressure rooms to isolate patients who have been diagnosed or are suspected with prevalent diseases like tuberculosis, measles, and chickenpox. On the other hand, only 14 single-patient isolation rooms are available to isolate patients with multidrug-resistant organisms (MDROs) such as CRE (carbapenum-resistant Enterobacter) or colistin-resistant MDROs. Due to the limited number of isolation rooms, the average number of hours to isolate infected patients was ~20 hours, which ultimately directly placed healthcare workers (HCWs) at risk of exposure to infected patients. Methods: Plan-Do-Study-Act (PDSA) quality improvement methodology was utilized to decrease the average number of hours to isolate infected patients and to reduce the exposure of HCWs to communicable diseases. A detailed analysis were performed to identify root causes and their effects at multiple levels. A multidisciplinary team implemented several strategies: coordination with information and technology team to place isolation alerts in the charting system; screening flyers and questions at emergency department triage; close coordination with admission and bed management office; daily morning and evening rounds by infection preventionists in the emergency department; daily morning meeting with microbiology and bed management office to intervene immediately to isolate patients in a timely way; infection preventionist on-call system (24 hours per day, 7 days per week) to provide recommendations for patient placement and cohorting of infected patients wherever possible. Results: In 1 year, a significant reduction was achieved in the number of hours to isolate infected patients, from 20 hours to 4 hours. As a result, HCW exposures to communicable diseases also decreased from 6.7 to 1.5; HCW exposures to TB decreased from 6.0 to 1.9; exposures measles decreased from 4.75 to 1.5; and exposures chickenpox decreased from 7.3 to 1.0. Significant reductions in cost incurred by the organization for the employees who were exposed to these diseases for postexposure prophylaxis also decreased, from ~Rs. 290,000 (~US$3,000) to ~Rs. 59,520 (~US$600). Conclusions: This multidisciplinary approach achieved infection prevention improvements and enhanced patient and HCW safety in a limited-resource setting.Funding: NoneDisclosures: None

ANTIBIOTIC SUSCEPTIBILITY PATTERN OF STAPHYLOCOCCOUS AUREUS ISOLATED FROM VARIOUS CLINICAL SPECIMENS OF TERTIARY CARE HOSPITAL IN TIRUPATI.

2021 ◽  
pp. 14-15
Author(s):  
Indira Ananthapadmanab asamy ◽  
V. Pavani Sai Mounika ◽  
K. Vijayakumar ◽  
C.H. Srinivasa Rao
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Clinical Specimens ◽  
Antimicrobial Susceptibility Pattern ◽  
Wide Range ◽  
Life Threatening ◽  
Mrsa Infection ◽  
Systemic Infections

INTRODUCTION: Staphylococcus aureus causes a wide range of infections including skin and soft tissue infections to life-threatening systemic infections like sepsis, endocarditis. This study ais to evaluate the antimicrobial susceptibility pattern of S.aurues among various clinical specimens. METHODS: The study included 326 S.aurues, isolated from various clinical specimens which were subjected to antimicrobial susceptibility testing as per CLSI guidelines. RESULTS: Among the 326 isolates, the highest were from pus specimens (47.85%), and was from Orthopaedics department (28.53%). Among the isolates, 219 (67.17%) were Methicilin resistant. All isolates were sensitive to Vancomycin, and all urine isolates were sensitive to Nitrofurantoin. The highest resistance was towards Penicillin (87.42%), Erythromycin (85.28), and Ciprooxacin (83.13%). CONCLUSION: The most effective way to prevent MRSA infection in every hospital is by performing continuous surveillance of antibiotic resistance and by following an effetive antibiotic policy.

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