Resistance Pattern of Extended Spectrum β-Lactamase Producing Gram-Negative Pathogens from Surgical Site Infections

2019 ◽  
Vol 12 (6) ◽  
pp. 4709-4712
Author(s):  
G. S. Sharanathe ◽  
S. A Gadgil
Keyword(s):  
Surgical Site Infections ◽  
Resistance Pattern ◽  
Klebsiella Species ◽  
Gram Negative ◽  
E Coli ◽  
Diffusion Technique ◽  
Pseudomonas Species ◽  
Esbl Producers ◽  
Standard Disk ◽  
Operative Wound

There is an increasing resistance for drugs in first line of treatment for post-operative wound. It has imposed the practitioners the use of newer antibiotics. β-lactamase production is the most important mechanism of resistance to the penicillin and cephalosporins. The present study was undertaken with the objective of isolation of ESBL producing gram-negative pathogens from surgical site infections and to study their resistance pattern. A total number of 28 surgical hospitals were selected for the collection of post operative wound infection samples. The ESBL producing pathogens were detected by phenotypic screening and confirmatory methods as recommended by CLSI guidelines 2012. A standard disk diffusion technique for antimicrobial susceptibility testing was performed as recommended by clinical and laboratory standard institute (CLSI). The total number of ESBL producers was 141 (37.80 %) while the number of non-ESBL producers was 232 (62.20 %). The distribution of ESBL producing E. coli, Klebsiella species, Proteus species and Pseudomonas species was 74 (55.64%), 42 (6.20%), was 16 (22.22 %) and 09 (17.31 %) respectively. The ESBL producing isolates were highly resistant to Cephalosporin, Ampicillin, Ciprofloxacin, Gentamycin and Cotromoxazole while they were highly susceptible to Ceftazidime/Cluvanic acid, Piperacillin / Tazobactam, Imipenem and Meropenum. In conclusion, the present study shows the considerable occurrence of ESBL producers among the Gram-negative isolates from surgical site infections and their increasing multidrug resistance.

scholarly journals Frequency of ESBL in Surgical Site Infection at a Tertiary Care Hospital

2014 ◽  
Vol 1 (2) ◽  
pp. 25-29 ◽  
Author(s):  
M Saiful Islam ◽  
M Abdullah Yusuf ◽  
M Badrul Islam ◽  
Waseka Akhter Jahan
Keyword(s):  
Surgical Site Infection ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Site Infection ◽  
Klebsiella Species ◽  
Gram Negative ◽  
E Coli ◽  
Pseudomonas Species ◽  
Esbl Producers

Background: Infection caused by ESBL in the surgical site infection is very alarming. Objective: The purpose of the present study was to see the status of ESBL bacteria isolated from surgical site infection with their antimicrobial sensitivity pattern.Methodology: This cross sectional study was conducted in the Department of Microbiology at Dhaka Medical College, Dhaka from January, 2005 to December, 2005 for a period of one (1) year. All the patients presented with surgical site infections at any age with both sexes were included a study population. Detection of extended spectrum beta lactamase producing Gram negative bacteria was done by using disc diffusion method and was confirmed by E- test ESBL method. Sensitivity pattern of ESBL producers were observed against quinolone and fluoroquinolones. ESBLs are the enzymes capable of hydrolyzing all penicillin, monobactam and cephalosporins except cephamycin, but inactive against imipenem.Result: A total number of 92 surgical wound samples were collected of which 68(73.9%) samples were culture positive. Interestingly, most of the E. coli was ESBL positive (55.0%). Klebsiella species was 33.1% ESBL positive. ESBL positivity of Proteus and Pseudomonas species were low (11.1%). Among the isolated Pseudomonas species, 1(6.67%) of the 15 strains isolated from wound swab was ESBL producers. ESBL positivity was significantly found in surgically wound samples (p=0.0001). Among the ESBL producers, all the E. coli, Klebsiella species, Proteus species and Pseudomonas species were resistant to amoxicillin, cephradine, ceftriaxone, aztreonam, ceftazidime and cefotaxime. All the Gram negative bacteria were sensitive to imipenam. Conclusion: A considerable numbers of ESBL producing bacteria were detected from surgical wound.DOI: http://dx.doi.org/10.3329/jcamr.v1i2.20514 Journal of Current and Advance Medical Research Vol.1(2) 2014: 25-29

scholarly journals Surgical Site Infections with Predominance of Multidrug Resistant in Benin: A Multicenter Study

2020 ◽  
Vol 41 (S1) ◽  
pp. s526-s526
Author(s):  
Carine Laurence YEHOUENOU ◽  
Hector RODRIGUEZ-VILLALOBOS ◽  
Olivia DALLEUR ◽  
Anne SIMON
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Surgical Site Infections ◽  
Public Hospitals ◽  
Secondary Outcome ◽  
Gram Negative ◽  
E Coli ◽  
Maldi Tof ◽  
Esbl Producers

Background: Surgical site infections remain common and widespread; they contribute to increasing antimicrobial resistance among the etiological agents. Antimicrobial resistance is the ability of a microorganism like bacteria to stop an antimicrobial from working against it. This study was conducted to determine the spectrum of bacterial isolates from surgical site infections and their susceptibility patterns. A secondary outcome was to compare bacterial identification by a local lab and a European one. Methods: This descriptive cross-sectional study was conducted between January and August 2019 in 6 public hospitals in Benin. Pus specimens were processed using standard microbiological procedures, and identification was performed using the analytical profile index (API). Antimicrobial susceptibility testing was performed in Benin following the modified Kirby-Bauer disk-diffusion technique and was confirmed in Belgium by MALDI-TOF mass spectrometry. A second antimicrobial susceptibility test was performed using BD Phoenix automated microbiology system (Becton Dickinson). Clinical data of enrolled patients were obtained from hospital records. Results: The mean age of patients was 32 ± 11 years (range, 18–76). The median time for surgical site infections was 9 postoperative days. Of the 229 patients from whom wound swabs were collected, 195 (85.15%) showed positive aerobic bacterial growth. In total, 164 pathogenic bacteria were isolated, including 41 gram-positive organisms (25%), 78 gram-negative fermentative bacteria (47.5%), and 45 gram-negative nonfermentative bacteria (27.5%). We observed 3 discrepancies between API technique and MALDI-TOF. Two Klebsiella pneumoniae and 1 Pseudomonas spp (API) versus, respectively, Klebsiella varicola and Pseudomonas mendocina (MALDI-TOF). The most prevalent bacterial species were E. coli (31%), followed by S. aureus (25%), Pseudomonas aeruginosa (18%), and Klebsiella pneumoniae (11%). Of the 41 S. aureus, 26 (63,41%) were methicillin-resistant Staphylococcus aureus (MRSA), and 3 of these were carrying both MRSA and induced clindamycin resistance (ICR). Extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae were observed in 60 of 78 isolates tested (77%). All of 2 Morganella morgannii and 89% of K. pneumoniae were ESBL producers. Conclusions: Among S. aureus, 2 of 3 were MRSA, whereas almost K. pneumoniae and E. coli were ESBL producers. Three strains are pan–drug resistant in nonfermentative bacteria, and no isolate was susceptible to all antibiotics. These findings are of high interest for better management of patients and control of antimicrobial resistance in Benin.Funding: This study was supported by Académie de Recherche pour l’Enseignement Supérieur (ARES).Disclosures: None

scholarly journals Bacteriological study of post-operative wound infections with special reference to MRSA and ESBL in a tertiary care hospital

2019 ◽  
Vol 6 (6) ◽  
pp. 1700
Author(s):  
Rashmi Basavantsing Rajput ◽  
Anjana Telkar ◽  
Ansh Chaudhary ◽  
Bhupendra Chaudhary
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Wound Infections ◽  
Bacterial Isolates ◽  
E Coli ◽  
Esbl Producers ◽  
Operative Wound

Background: Surgical site infections are known to be one of the most common causes of nosocomial infections worldwide and raises an important public health concern.Methods: A prospective observational study was conducted across 12 months (July 2018-June 2019) in a tertiary care hospital. The present study includes 50 pus samples from clinically suspected cases of post-operative wound infections from various surgical wards which were inoculated in Department of Microbiology. The phenotypic identification of different bacterial isolates especially MRSA and ESBL producers along with their antimicrobial susceptibility testing was interpreted according to CLSI guidelines.Results: Out of 50 samples, 44 showed positive culture. The infections were more common in emergency situations, age group of 20-30 years and in females. The most common bacterial isolates were Staphylococcus aureus (43.18%) followed by E. coli (22.72%), Klebsiella (15.9%), CONS (13.63%) and Pseudomonas (4.54%). Out of 19 Staphylococcus aureus 9 were MRSA and these gram-positive bacteria were highly sensitive to Linejolid and Clindamycin. In gram negative group 22.72% of E. coli and 15.9% of Klebsiella were ESBL producers who were susceptible mainly to Aztreonam, Linezolid or Cefoxitine.Conclusions: Post-operative wound or surgical site infections is the most important factor responsible for significant morbidity, mortality, prolonged hospitalization and additional cost to treatment in surgical patients. Marked resistance of isolates to commonly used antibiotics indicates the need of judicious use of these drugs to prevent the emergence of multi-drug resistant strains.

scholarly journals PREVALENCE OF CEPHALOSPORIN-RESISTANT GRAM-NEGATIVE BACILLI FROM CLINICAL SAMPLES

2016 ◽  
pp. 176
Author(s):  
Kavi Aniis ◽  
Rajamanikandan Kcp ◽  
Arvind Prasanth D
Keyword(s):  
Clinical Samples ◽  
Beta Lactamase ◽  
Bacterial Isolates ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Lactam Ring ◽  
Esbl Producers

<p>ABSTRACT<br />Objective: Beta-lactams are the group of antibiotics that contain a ring called as “beta-lactam ring,” which is responsible for the antibacterial activity.<br />The presence of resistance among Gram-negative organisms is due to the production of beta-lactamases enzymes that hydrolysis the beta-lactam ring<br />thereby conferring resistance to the organism. This study is undertaken to determine the prevalence of extended-spectrum beta-lactamase (ESBL)<br />producing Gram-negative organism from clinical samples.<br />Methods: A total of 112 clinical samples were taken for this study. The combined disc synergistic test (CDST) was used for the phenotypic detection<br />of ESBL producers from the clinical samples. The genotypic identification of ESBL producers was carried out by alkaline lysis method by isolation of<br />plasmid DNA.<br />Result: A total of 87 bacterial isolates were isolated and identified. Among them, Klebsiella (41%) was the predominant organism followed by<br />Escherichia coli (33%), Proteus (10%), Pseudomonas (10%), and Serratia (6%). Among the various bacterial isolates, Klebsiella showed a higher<br />percentage of resistance. The CDST showed that 8 isolates of Klebsiella, 3 isolates of E. coli, and 1 isolate of Pseudomonas were found to be ESBL<br />producers. The genotypic confirmation showed that the two bacterial isolates, namely, Klebsiella and E. coli were found to possess temoniera (TEM)<br />gene which was the 400-500 bp conferring resistance to the antibiotics.<br />Conclusion: The results of this study suggest that early detection of ESBL producing Gram-negative organism is a very important step in planning the<br />therapy of patient in Hospitals. CDST continues to be a good indicator in the detection of ESBL producers.<br />Keywords: Beta-lactamases, Gram-negative bacilli, Extended-spectrum beta-lactamase, Resistance, Combined disc synergistic test.</p><p> </p>

scholarly journals Antibiotic susceptibility pattern of biofilm forming uropathogenic Escherichia coli isolated from UTI infected patients of Koshi Zonal Hospital in Biratnagar, Nepal

BIBECHANA ◽  
2018 ◽  
Vol 16 ◽  
pp. 47-54
Author(s):  
S Chaudhary ◽  
B Khatiwada ◽  
N K Chaudhary
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Susceptibility ◽  
Uropathogenic Escherichia Coli ◽  
Urine Samples ◽  
Resistance Pattern ◽  
Isolation And Identification ◽  
Antibiotic Susceptibility Pattern ◽  
E Coli ◽  
Diffusion Technique ◽  
Antibiotic Susceptibility Test

Objectives: To investigate the prevalence and antibiotic resistance pattern of biofilm-forming Uropathogenic Escherichia coli (UPEC) from urine samples isolated from UTI infected patients of Koshi zonal hospital, Biratnagar.Methods: A total of 51 urine samples from urinary tract infected patients were collected from Koshi zonal hospital, Biratnagar in the period of July to August 2017. Following the isolation and identification of biofilm-forming uropathogenic Escherichia coli, antibiotic susceptibility test was performed by a modified Kirby-Bauer disc diffusion technique. The biofilm detection was done by Congo red agar method.Results: In the present study, 45% of the urine samples showed a predominant growth of E. coli, among which 70% of isolates exhibited positive biofilm formation. Biofilm forming isolates revealed 100%, 87.5%, 75%, 63% and 12.5% resistant to erythromycin, amoxicillin, cefotaxime, levofloxacin, and nitrofurantoin respectively. Approximately 87.5% of biofilm-forming isolates were found multi-drug resistant.Conclusion: The study revealed the major issue of UTI by E. coli which may be due to poor sanitation, not the proper cleanliness of genitals and unsafe sexual intercourse. Nitrofurantoin and levofloxacin were examined the most effective antibiotics for UPEC. BIBECHANA 16 (2019) 47-54 

Pharmacokinetics of Oral Ciprofloxacin in Continuous Cycling Peritoneal Dialysis

2004 ◽  
Vol 24 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Sharon M. Yeung ◽  
Scott E. Walker ◽  
Sandra A.N. Tailor ◽  
Linda Awdishu ◽  
Sheldon Tobe ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Concentration ◽  
Empirical Treatment ◽  
Klebsiella Species ◽  
Maximum Serum ◽  
Gram Negative ◽  
E Coli ◽  
Continuous Cycling ◽  
Maximum Serum Concentration ◽  
Oral Ciprofloxacin

Background In order to avoid aminoglycosides, the International Society for Peritoneal Dialysis recommends cefazolin and ceftazidime for empirical treatment of peritonitis. Ciprofloxacin covers relevant gram-negative pathogens without the resistance associated with ceftazidime. However, ciprofloxacin pharmacokinetic data in patients on continuous cycling peritoneal dialysis (CCPD) are lacking. Objectives ( 1 ) To determine the pharmacokinetics of oral ciprofloxacin in CCPD patients, ( 2 ) to compare serum and dialysate ciprofloxacin concentrations with minimum inhibitory concentrations (MIC) of the gram-negative bacteria associated with peritonitis, and ( 3 ) to establish oral ciprofloxacin dosing guidelines for the empirical treatment of peritonitis in patients receiving CCPD. Methods Eligible CCPD patients received 2 doses of ciprofloxacin: 750 mg orally every 12 hours. Serial blood and end-of-dwell dialysate samples were collected during the first 12-hour interval; an end-of-dwell dialysate sample from the overnight dwell and a final blood sample were collected at the end of the second 12-hour interval. Ciprofloxacin concentrations were determined using a liquid chromatographic (HPLC)-fluorescence method. Pharmacokinetic calculations were completed assuming a one-compartment model. Results Eight patients completed the study. The pharmacokinetic parameters determined for ciprofloxacin were (mean ± SEM) serum half-life 10.1 ± 1.2 hours, maximum serum concentration 2.7 ± 0.5 mg/L, time to maximum serum concentration 1.6 ± 0.1 hours after the first dose, and peritoneal clearance 1.2% ± 0.1% of the mean calculated total body clearance. While all patients achieved serum area under the concentration-time curve: MIC > 125 for Escherichia coli and Klebsiella species after the first dose, only 2 patients achieved this goal for Pseudomonas aeruginosa. End-of-dwell dialysate concentrations were above the MIC for E. coli, Klebsiella spp, and P. aeruginosa after the second dose. Conclusion Ciprofloxacin 750 mg orally every 12 hours in CCPD patients may be useful for empirical gram-negative coverage of CCPD peritonitis and for treatment of documented peritonitis caused by sensitive E. coli or Klebsiella species. While ceftazidime may be required for documented pseudomonal peritonitis, the oral ciprofloxacin regimen achieved adequate serum concentrations to treat systemic gram-negative infections caused by sensitive E. coli or Klebsiella species.

scholarly journals Antibacterial Activityof Aqueous And Ethanolic Leaf Extracts Of Vernonia Amygdalina On Selected Species Of Gram Positive And Gram Negative Bacteria

2013 ◽  
Vol 2 (1) ◽  
pp. 147-152 ◽  
Author(s):  
AM Bukar ◽  
MA Isa ◽  
HS Bello ◽  
AS Abdullahi
Keyword(s):  
Antibacterial Activity ◽  
Antibacterial Drug ◽  
Gram Negative Bacteria ◽  
Phytochemical Screening ◽  
Vernonia Amygdalina ◽  
Leaf Extracts ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Pseudomonas Species

The phytochemical screening and antibacterial activity of ethanolic and Methanolic leaves extract of Vernonia amygdalina against five clinical isolates (Staphylococcus aureus, E. coli, Pseudomonas species, Salmonella species and Proteus species) was determined using standard method of analysis. The results of the antibacterial activity of ethanol, methanol and aqueous extract of leaves of V. amygdalina have diameters ranging between 0.4 to 10mm. The plant extracts from the plants had profound activities against gram-positive than gram negative bacteria. From the above studies, it has clearly indicated that V. amygdalina extract may represent new sources of antibacterial drug, if the phytoactive components are purified and proper dosage are determined for administration. International Journal of Environment, Volume-2, Issue-1, Sep-Nov 2013, Pages 147-152 DOI: http://dx.doi.org/10.3126/ije.v2i1.9217

scholarly journals Microbial Profile of Various Catheter Tips among Hospitalized Patients

2018 ◽  
Vol 5 ◽  
pp. 32-38
Author(s):  
Pushpa Man Shrestha ◽  
Nisha Thapa ◽  
Navraj Dahal ◽  
Nabaraj Adhikari ◽  
Upendra Thapa Shrestha
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Descriptive Analysis ◽  
Multidrug Resistant ◽  
Antimicrobial Susceptibility Testing ◽  
Resistance Pattern ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli ◽  
Klebsiella Spp

Objectives: This study aimed to identify the microbiological profile of various catheter tips, and multidrug resistance pattern of extended spectrum β-lactamase (ESBL) producing E. coli and Klebsiella spp. isolates. Methods: A descriptive analysis of 263 catheter tip specimens processed for culture and antimicrobial susceptibility testing was carried out in B&B Hospital, Lalitpur. Five different types of catheter tips were analyzed for microbiological growth and antimicrobial susceptibility testing. Results: Among catheter tips, the highest percentage of microbial growth was observed in tracheostomy tip. Monomicrobial growth was recorded in 82.9% catheter tips and polymicrobial growth was observed in 17.1% tip samples. Of 180 isolates, gram negative rods (76.6%) followed by yeast (19.4%) and gram-positive cocci (3.9%) were isolated. Gram negative Acinetobacter spp. (25%) and Pseudomonas spp. (23.3%) and gram-positive Enterococcus spp. (2.2%) were the most frequently isolated bacteria. However, carbapenam was the most effective antibiotic for both groups. Conclusion: Of the total isolates tested, 61.4% were found to be multidrug resistant (MDR). Among gram negative rods, 22.2% E. coli and 27.3% Klebsiella spp. were confirmed as ESBL producer. It is recommended to apply standard protocol during insertion and removal of catheter which may help in managing nosocomial infection associated with catheters.

scholarly journals Antimicrobial Susceptibility Profile of Urinary Tract Pathogenic Infections in Diabetic Patients Attending a Health Facility in Kumasi, Ghana

2020 ◽  
pp. 37-45
Author(s):  
Maxwell Adu-Poku ◽  
Matthew Glover Addo
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Health Facility ◽  
Antimicrobial Susceptibility ◽  
Diabetic Patients ◽  
Klebsiella Species ◽  
E Coli ◽  
Antimicrobial Susceptibility Profile ◽  
Pseudomonas Species ◽  
Proteus Species

Aims: This study seeks to investigate the antimicrobial susceptibility profile of urinary tract pathogenic infections in diabetic patients attending a health facility in Kumasi, Ghana. Study Design: A total of 285 patients were recruited using Cochran’s formula at a prevalence of 26.4% for this study from patients attending the University Hospital from April 2018 to October 2018. Data were collected using a structured questionnaire. Methodology: Clean-catch midstream urine samples were screened for the presence of pathogenic bacteria and their antimicrobial susceptibility pattern using recommended culture methods. Results: Out of the 285 patients, 125 (43.9%) were diabetic with 90 (72%) being female and 35 (28%) male. There was no association between UTI’s and gender (P=0.5799) with diabetic patients recording higher bacteriuria compared to non-diabetics (P< 0.001). Isolates from 113 (39.4%) of the samples were identified and these included, Escherichia coli, Pseudomonas species, Klebsiella species, Proteus species and Staphylococcus aureus. The most predominant was E. coli 62 (54.9%) followed by S. aureus 24 (21.2%), Klebsiella species 14(12.4%), Pseudomonas species 12(10.6%) and Proteus species 1(0.9%). E. coli showed a high antimicrobial sensitivity rates against most of the tested antibiotics, gentamycin (90.3%), amikacin (98.4%), nalidixic (34%), cefotaxime (80.6%) and nitrofurantoin (93%). Proteus spp. on the other hand, showed a 100% sensitivity to all the antibiotics except tetracycline, amikacin and cefotaxime. It was observed that Escherichia coli was mostly resistant to tetracycline (96.8%), norfloxacin (69.4%) and cefotaxime (61.4%). Conclusion: S. aureus showed a higher level of resistance to tetracycline (100%). The prevalence of this study indicated that UTI among diabetic patients was relatively comparable with other studies. Amikacin and nitrofurantoin should be recommended as antimicrobials for the treatment of UTIs whilst the use of tetracycline, norfloxacin and cefotaxime should be discouraged.

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