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

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.

Wound infection is a major problem in hospitals in developing countries. Wound infection causes morbidity and prolonged hospital stay thus this prospective study was conducted for a period of seven months (January 2019 to July 2019). A total of 217 specimens (wound swabs and pus exudates) from wound infected patients in a Tertiary Care Hospital in Bangladesh. A retrospective study of the microbiological evaluation was done by cultural growth as well as Gram staining and biochemical examination to identify the bacterial isolates. Finally, the antimicrobial vulnerability testing was performed by Kirby-Bauer disc diffusion conventional method. A total of 295 samples were tested. Out of which 217 (73.5%) were found culture positive. E. coli was the most predominant gram-negative isolates whereas Staphylococcus aureus and Coagulase-negative Staphylococcus were the most commonly isolated gram-positive organisms. Antimicrobial sensitivity profile of bacterial isolates revealed imipenem, meropenem, amikacin, and nitrofurantoin to be the most effective antimicrobials against gram-negative isolates, whereas imipenem, meropenem, amikacin, nitrofurantoin, amoxiclav, and gentamicin were the most effective drugs against gram-positive isolates. The result of this examination contributes to the identification of basic causative microbes involved in wound infection and findings of antibiotic susceptibility patterns can be helpful for primary care physicians to optimize the treatment modalities, articulate policies for empiric antimicrobial therapy, and to minimize the rate of infection among wound infected patients.


2020 ◽  
Vol 14 (3) ◽  
pp. 1961-1966
Author(s):  
A. Deboral ◽  
Namrata K. Bhosale ◽  
S. Umadevi

The antibiotic resistance pattern was observed significantly in various geographical locations. Routine surveillance is therefore essential for constant monitoring of AMR rates in the clinically important pathogens. It is imperative to track the changing resistance pattern over time, to guide proper therapeutic strategies to combat infections due to drug-resistant pathogens. This study aims to highlights the distribution of aerobic bacterial isolated from pus samples, and their susceptibility to different antibiotics collected during 2017 (July to December) in a tertiary care hospital. Nearly 637 clinical pus samples were received during July to December 2017 to the Department of Microbiology, Tertiary care hospital, Puducherry. Bacterial identification was performed using standard conventional biochemical tests and antibiotic susceptibility was carried out according to CLSI guidelines 2017 on each one of the aerobic bacterial isolates from the pus samples. Among the isolates 76.5% were Gram-negative bacilli (GNB) as well as 23.5% were Gram-positive cocci (GPC). The most common bacteria isolated were Pseudomonas spp 24.88% (108 in 434), followed by Escherichia coli 21.66% (94 in 434), Staphylococcus aureus 19.82% (86 in 434) and Klebsiella pneumoniae 13.13% (57 in 434). Of the 86 (19.82%) Staphylococcus aureus isolates, 16 (18.40%) were MRSA. Pseudomonas aeruginosa was highly susceptible to the carbapenems and least susceptible to ciprofloxacin. Acinetobacter baumannii was the most resistant organism according to this study and showed the least susceptibility to ceftriaxone and maximum susceptibility to aminoglycosides. This study concluded that the Pseudomonas aeruginosa isolate was found to be a predominant in our clinical pus samples. Gram negative bacteria are more commonly associated with the pyogenic lesion that Gram positive. A high level of an antibiotic resistance was observed in most of our bacterial isolates.


Author(s):  
Asifa Nazir ◽  
Ifshana Sana ◽  
Bushra Yousuf Peerzada ◽  
Tabindah Farooq

Background: Bacterial bloodstream infections (BSIs) are important causes of morbidity and mortality world-wide. The choice of antimicrobial therapy for bloodstream infections is often empirical and based on the knowledge of local antimicrobial activity profiles of the most common bacteria causing such infections. The objective of the study was to determine the pattern of bacterial isolates from the blood cultures in a teaching hospital and determine their antibiotic resistance and provide guidelines for choosing an effective antibiotic therapy in cases of septicaemia.Methods: The etiological and antimicrobial susceptibility profile of blood cultures over a period of one year at a tertiary care hospital was studied. Blood culture positive isolates were identified by BacT/Alert3D, an automated blood culture system, while as identification of the isolates from these samples and their antimicrobial sensitivity testing was performed with Vitek2 Compact.Results: There were 2231 blood culture samples, of which 565 (25.3%) were identified to be culture positive. Out of 565 positive cultures, 447 (79.1%) showed bacterial growth; Gram positive were 306 (54.2%) and Gram negative were 141 (24.9%). Candida species were isolated from 118 (20.9%) of positive samples. The most frequently identified Gram-positive bacteria were Coagulase-negative staphylococci 208 (67.9%) and the most common Gram-negative isolates were Acinetobacter species 89 (63.1%). The most sensitive drugs for gram-positive isolates were vancomycin, and linezolid while as gram-negative isolates showed 100% sensitivity to colistin and tigecycline.Conclusions: This study reveals a significant prevalence of bacterial isolates in blood and it highlights the need for periodic surveillance of etiologic agent and antibiotic susceptibility to prevent further emergence and spread of resistant bacterial pathogens.


Mediscope ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. 17-24
Author(s):  
NM Wahidur Rahman ◽  
Bushra Tanzem ◽  
Golam Nabi ◽  
Afsana Mahbub ◽  
Abu Md Mayeenuddin Al Amin

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


2021 ◽  
pp. 1-8
Author(s):  
Naimshree Sonkar ◽  
Malay Banerjee ◽  
Suman Gupta ◽  
Absar Ahmad

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.


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