scholarly journals Bacterial Isolates from Endotracheal Aspirates and their Antimicrobial Resistance Pattern in Patients from Intensive Care Unit

2019 ◽  
Vol 70 (9) ◽  
pp. 3299-3304
Author(s):  
Andreea Loredana Golli ◽  
Floarea Mimi Nitu ◽  
Maria Balasoiu ◽  
Roxana Maria Nemes ◽  
Sorin Ioan Tudorache ◽  
...  

The emergence of multidrug-resistant (MDR) pathogens, especially for intensive care unit (ICU) patients is a serious threat to public health. To determine the frequency and antibiotic resistance pattern of bacterial pathogens isolated from tracheal aspirates of the patients admitted in ICU. The retrospective study included endotracheal aspirates from 734 patients admitted to the ICU, from January to December 2017. The analysis of the resistance patterns for the action of the appropriate antibiotics was performed using Vitek 2 Compact system and diffusion method. A total of 985 bacterial isolates were obtained, of which 227 strains of Klebsiella spp. (23.04%), followed by Nonfermenting Gram negative bacilli, other than Pseudomonas and Acinetobacter (NFB) (170- 17.25%), MRSA (134- 13.60%). Isolation rates indicates a higher value for male patients and elderly patients (over 65 years), statistically significant. High rates of MDR were found for Klebsiella spp. (70.04%) and Pseudomonas aeruginosa (66.25%) while almost all of the isolated NFB strains were MDR (98.82%). The study revealed high rates of MDR pathogens in the majority of ICU isolates which may be due to unnecessary use of higher generations of antibiotics, use of mechanical devices, age, comorbidities, and can determine a higher rate of morbidity and mortality among these patients.

2019 ◽  
Vol 69 (12) ◽  
pp. 3433-3438
Author(s):  
Andreea Loredana Golli ◽  
Floarea Mimi Nitu ◽  
Maria Balasoiu ◽  
Marina Alina Lungu ◽  
Madalina Olteanu ◽  
...  

To identify and to determine the resistance pattern of bacterial pathogens involved in infections of the elderly patients (� 65 years) admitted in the intensive care unit (ICU) at County Emergency Clinical Hospital Craiova, Romania. A retrospective study of bacterial pathogens was carried out on 463 elderly patients (� 65 years) admitted to the ICU, from January to December 2017. The analysis of the resistance patterns for the action of the appropriate antibiotics was performed using Vitek 2 Compact system and diffusion method. In this study there were analyzed 617 samples from 463 elderly patients (� 65 years). A total of 776 bacterial isolates were obtained, of which 175 strains of Klebsiella spp. (22.55%), followed by MRSA - Methicillin-Resistant Staphylococcus Aureus (108 -13.91%) and Escherichia coli (99 -12.75%). The most common isolates were from respiratory tract (572 isolates -73.71%). High rates of MDR were found for Pseudomonas (73.07%), MRSA (62.03%) and Klebsiella (44.57%). The study revealed an alarming pattern of antibiotic resistance in the majority of ICU isolates from elderly patients (�65 years), which draws attention to the need for judicious use of antibiotics and for careful monitoring of the drug resistance of patients.


2019 ◽  
Vol 70 (5) ◽  
pp. 1778-1783
Author(s):  
Andreea-Loredana Golli ◽  
Floarea Mimi Nitu ◽  
Maria Balasoiu ◽  
Marina Alina Lungu ◽  
Cristiana Cerasella Dragomirescu ◽  
...  

To determine the resistance pattern of bacterial pathogens involved in infections of the patients aged between 18-64 years, admitted in a ICU from a 1518-bed university-affiliated hospital. A retrospective study of bacterial pathogens was carried out on 351 patients aged between 18-64 years admitted to the ICU, from January to December 2017. In this study there were analysed 469 samples from 351 patients (18-64 years). A total of 566 bacterial isolates were obtained, of which 120 strains of Klebsiella spp. (35.39%%), followed by Nonfermenting Gram negative bacilli, other than Pseudomonas and Acinetobacter (NFB) (75- 22.12%), Acinetobacter spp. (53 - 15.63%), Pseudomonas aeruginosa and Proteus (51 - 15.04%), and Escherichia coli (49 - 14.45%). The most common isolates were from respiratory tract (394 isolates � 69.61%). High rates of MDR were found for Pseudomonas aeruginosa (64.70%), MRSA (62.65%) and Klebsiella spp. (53.33%), while almost all of the isolated NFB strains were MDR (97.33%). There was statistic difference between the drug resistance rate of Klebsiella and E. coli strains to ceftazidime and ceftriaxone (p[0.001), cefuroxime (p[0.01) and to cefepime (p[0.01). The study revealed an alarming pattern of antibiotic resistance in the majority of ICU isolates.


2020 ◽  
Vol 70 (12) ◽  
pp. 4287-4294

Cancer is the second leading cause of death in Romania and worldwide. Cancer patients are at increasing risk of acquiring bacterial infection with multi-resistant germs, including multidrug-resistant (MDR) strains of Gram-negative bacteria involved in nosocomial infection. Romania is one of the South-Eastern European countries with one of the highest prevalence rates of MDR pathogens. To determine the resistance pattern of bacterial profile and antibiotic resistance pattern in cancer patients admitted at the County Emergency Clinical Hospital Craiova, Romania. A retrospective study of bacterial pathogens was carried out on 90 adult cancer patients admitted from January to December 2018. The analysis of the resistance patterns for the action of the appropriate antibiotics was performed using Vitek 2 Compact system and diffusion method. In this study there were analysed 92 samples from 90 oncological patients (37-86 years). A total of 157 bacterial isolates were obtained, of which 37 strains of Staphylococcus aureus (23.56%), followed by Streptococcus pneumoniae (23- 14.64%), Klebsiella spp. and Escherichia coli (22 - 14,01%). The most common isolates were from respiratory tract (86 isolates - 54.77%). High rates of MDR were found for E. coli (63.63%), MRSA (61,11%) and Klebsiella spp. (54,54%), while one third of the isolated strains of Pseudomonas aeruginosa, Acinetobacter spp. and Proteus spp. were MDR. The findings of this study may be the basis for further more extensive studies highlighting the germs involved in the infectious pathology of cancer patients, in order to determine the antimicrobial resistance and to improve the methods of prophylaxis and treatment. Keywords: multidrug resistance (MDR), cancer patients, bacterial pathogen


2002 ◽  
Vol 23 (8) ◽  
pp. 441-446 ◽  
Author(s):  
Geir Bukholm ◽  
Tone Tannæs ◽  
Anne Britt Bye Kjelsberg ◽  
Nils Smith-Erichsen

Objective:To investigate an outbreak of multidrug-resistantPseudomonas aeruginosain an intensive care unit (ICU).Design:Epidemiologic investigation, environmental assessment, and ambidirectional cohort study.Setting:A secondary-care university hospital with a 10-bed ICU.Patients:All patients admitted to the ICU receiving ventilator treatment from December 1,1999, to September 1, 2000.Results:An outbreak in an ICU with multidrug-resistant isolates ofP. aeruginosabelonging to one amplified fragment-length polymorphism (AFLP)–defined genetic cluster was identified, characterized, and cleared. Molecular typing of bacterial isolates with AFLP made it possible to identify the outbreak and make rational decisions during the outbreak period. The outbreak included 19 patients during the study period. Infection with bacterial isolates belonging to the AFLP cluster was associated with reduced survival (odds ratio, 5.26; 95% confidence interval, 1.14 to 24.26). Enhanced barrier and hygiene precautions, cohorting of patients, and altered antibiotic policy were not sufficient to eliminate the outbreak. At the end of the study period (in July), there was a change in the outbreak pattern from long (December to June) to short Quly) incubation times before colonization and from primarily tracheal colonization (December to June) to primarily gastric or enteral Quly) colonization. In this period, the bacterium was also isolated from water taps.Conclusion:Complete elimination of the outbreak was achieved after weekly pasteurization of the water taps of the ICU and use of sterile water as a solvent in the gastric tubes.


2016 ◽  
Vol 34 ◽  
pp. 116-120 ◽  
Author(s):  
Garba Iliyasu ◽  
Farouq Muhammad Daiyab ◽  
Abdulwasiu Bolaji Tiamiyu ◽  
Salisu Abubakar ◽  
Zaiyad Garba Habib ◽  
...  

2020 ◽  
Vol 20 (5) ◽  
pp. 758-762
Author(s):  
Omid Zarei ◽  
Hassan Mahmoudi ◽  
Ali Mohammadi Bardbari ◽  
Pezhman Karami ◽  
Mohammad Yousef Alikhani

Background: Pseudomonas aeruginosa is a gram-negative non-glucose fermenting aerobic bacteria and an opportunistic pathogen in humans and animals. The present study was carried out to investigate the distribution of virulence factors and antibiotic resistance properties of P. aeruginosa isolated from patients and intensive care unit (ICU) environment. Material and Methods: A total of 116 P. aeruginosa isolated from patients and ICU environment were collected from Besat hospital in Hamadan, the West of Iran. P. aeruginosa isolates were analyzed based on the presence of the virulence factors encoding genes included exoA, exoS, exoU, and algD using polymerase chain reaction (PCR). Antimicrobial susceptibility test was performed using a disk diffusion method. Results: The results showed the prevalence of exoA 33 (56.9%), exoS 21 (36.20%), exoU 37 (63.8%), and algD 35 (60.34%) genes in ICU environment P. aeruginosa strains and exo A 23 (39.25%), exoS 25 (43.1%), exoU 40(68.98%), and algD 25 (43.1%) genes in clinical isolates of P. aeruginosa. High resistance levels of the clinical and ICU environment isolate to ampicillinsulbactam (100%), were also observed. Conclusions: Our findings should raise awareness about antibiotic resistance in hospitalized patients in Iran. Clinicians should exercise caution in prescribing antibiotics, especially in cases of human infections.


2020 ◽  
Vol 18 ◽  
Author(s):  
Elhassan Benyagoub ◽  
Miaad K. Alkhudhairy ◽  
S. Mohamed Benchaib ◽  
Abdelmadjid Zaalan ◽  
Youcef Mekhfi ◽  
...  

Background: Emergence of multidrug-resistant uropathogenic strains mainly the global spread of extended-spectrum betalactamase (ESBL) genes accompanied both by uncontrolled use of antibacterial agents and a considerable decrease in their activities makes the monitoring of the resistance pattern one of necessary means that could help the medical practitioners to choose the best treatment. For this purpose and during four months from March 1 to June 30 (2019), an experimental study has been carried out on urine specimens of 123 inpatients (IP) and outpatients (OP) at infectious disease service Boudjemaa TOURABI Public Hospital of Bechar (Algeria), aiming the detection of ESBL-producing Enterobacteriaceae uropathogenic strains. Methods: Firstly, the antibiotic susceptibility testing has been carried out by using the disk diffusion method to determine not only the multidrug resistance patterns, but also the multiple antibiotic resistance indexes of uropathogenic strains isolated from clinical IP and OP samples. Secondly, the ESBL detection was done by using the following methods: synergy tests based on the synergy between a thirdgeneration cephalosporin and clavulanate, double-disc synergy test (DDST) and phenotypic tests on a cloxacillin-containing agar. Results: As a result, 56 patients had a urinary tract infection (UTI) in overall 123 patients; a frequency of 45,52%. Through a UTI’s frequency of 64,7%, the female gender was the most affected. All age groups were affected by UTI, with a mean age of 38,47±19,97 years old. Knowing that UTIs’ patients having ages ranged from 16 to 49 years old were most affected compared to other ages’ groups, with a frequency of 66,6 and 50% for female and male gender, respectively. The microbial strains represented by the bacteria group were predominant, ie (98,22%) followed by yeasts (1,78%), where Gram-negative bacilli showed (96,36%) of the uropathogenic agents, so (3,64%) were Gram-positive bacteria. The antibiotic resistance profile of isolated Enterobacteriaceae showed very high resistance rates for the species of Escherichia coli, Klebsiella spp, and Proteus spp to aminopenicillins, cephalosporins, and less against carbapenems and other drug groups. E. coli had presented the highest multidrug resistance followed by Klebsiella spp with a MAR index ranged from 0,53 to 0,82. Within this range, a total of 28 isolate (25 E. coli, 2 Klebsiella spp, and 1 Proteus mirabilis) had shown resistance against 9 to 14 out of the 17 tested antibiotics. The rate of ESBL-producing Enterobacteriaceae strains was 23,07 and 55,26% for inpatients and outpatients respectively, where E.coli was the most important ESBL producers out of all isolated strains. Conclusion: An alarming ESBLs rate for outpatients which is usually higher among inpatients with UTI, who receive several classes of antibiotics. Such condition should be considered as a major public health concern, and measures must be taken to establish the sources and drivers of this issue. Thus, the findings of this research pushes health sector stakeholders as well as scientific communities to act on reducing the transmission of the multidrug-resistant strains that threatens several classes of life-saving antibiotics.


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