scholarly journals The Antibiotic sensitivity of Stenotrophomonas maltophilia in a 5-year period and investigation of clonal outbreak with PFGE

2019 ◽  
Vol 13 (07) ◽  
pp. 634-639
Author(s):  
Ahmet Çalışkan ◽  
Ayşegül Çopur Çicek ◽  
Nebahat Aydogan Ejder ◽  
Alper Karagöz ◽  
Özlem Kirişci ◽  
...  
Keyword(s):  
Stenotrophomonas Maltophilia ◽  
Antibiotic Sensitivity ◽  
The Other ◽  
High Rate ◽  
Automated System ◽  
Clinical Samples ◽  
Common Source ◽  
Cross Contamination ◽  
Vitek 2 ◽  
Contamination Problem

Introduction: Stenotrophomonas maltophilia, which is able to form a biofilm, has mostly been related to catheters when it is the agent in hospital infections; these infections generally present as bacteremia and pneumonia, which may progress with complications and result in death. Methodology: The study included 153 S. maltophilia strains isolated from clinical samples sent to our hospital laboratory between 1 January 2014 and 30 June 2018. The bacteria were identified and their antibiotic sensitivity was determined using the VITEK-2 automated system. PFGE (Pulsed Field Gel Electrophoresis): The strains isolated from 34 patient clinical samples and from 1 patient bedcover were taken for PFGE examination. Results: The TMP/SXT and levofloxacin sensitivity of 153 S. maltophilia strains was examined. TMP/SXT resistance was determined to be 39% and levofloxacin resistance at 5%. Among 35 S. maltophilia strains, seven genotypes were identified using the PFGE method. While three strains showed a specific genotype profile, the other 32 were determined to consist of four clusters. The cluster rate was therefore 91.4% (32/35). Conclusions: There was a clonal relationship between the vast majority of the 35 S. maltophilia isolates, which suggests that there was a cross-contamination problem in the hospital. One strain (#4) was identified by dendrogram analysis showed a high rate of similarity to the other strains and was determined to be the common source of the cross-contamination.

Association between biofilm formation gene bla exoU and metallo and extend spectrum beta-lactamase production of multidrug resistance Pseudomonas aeruginosa in clinical samples

2021 ◽  
Vol 24 ◽  
Author(s):  
Fattma Abodi Ali
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Biofilm Formation ◽  
Public Hospitals ◽  
High Rate ◽  
Clinical Samples ◽  
Antimicrobial Drugs ◽  
Product Size ◽  
Vitek 2 ◽  
Extend Spectrum Beta Lactamase ◽  
Control Management

Background: The presence of biofilm formation exoU gene is significant challenge to infection control management in hospitals and exposure by Pseudomonas aeruginosa may lead to further spread and development of antimicrobial resistance. Methods: Out of 227 samples 40 clinical isolates of P. aeruginosa were collected from patients attending public hospitals ( Rizgary, Teaching hospital, Laboratory center, Raparin, Nanakaly hospitals)in Erbil city/Iraq over a period during 2018 to march 2019 and fully characterized by standard bacteriological procedures and antimicrobial susceptibility test and ESBL has been carried out by Vitek 2 compact system and. by Vitek 2 compact system. The identification has been verified by all isolates as P. aeruginosa by using 16S rDNA with product size (956pb). Results: A high rate of resistance was seen against Penicillin and lincomycin and Piperacillin and chloramphenicol and rifampicin (100 %), whereas Imipenem (5%) were found to be the most effective antimicrobial drugs. Of all P. aeruginosa isolates, 30 (75% %) were identified as MDR, approximately 9(22.5%) of isolates were resistant to 9 drugs in burn samples. Quantitative biofilm determination using the Congo red method revealed that 28 isolates (70%) produced biofilm, biofilm production was significantly higher among MDR P. aeruginosa isolates while coproduction of Extended Spectrum β-lactamase (ESBL) together with Metallo β-lactamase (MBL) ESBLs MBLs recorded in (52.5%) of the isolates. Altogether 40 isolates were processed for analysis by PCR assays and showed that 26(70%) of P. aeruginosa isolates harboured the exoU encoding gene with product size (204) pb was more commonly seen in isolates obtained from burn isolates. In addition, exo U gene was significantly associated with the higher MDR (80%), 8 isolates (76.9%)had exoU gene with ESBL and( 65%) had MBL and the same for MDR (80.8%) in samples for burning. Conclusion: Our results showed surveillance of P. aeruginosa resistance against antimicrobial and ESBL and MBL is fundamental to monitor trends in susceptibility patterns and appropriately guide clinicians in choosing empirical or directed therapy.

scholarly journals Evaluation of Antibiotic Sensitivity Pattern and Plasmid Isolation of Klebsiella Pneumoniae Isolates from Clinical Specimens in Sylhet City, Bangladesh

2017 ◽  
Vol 9 (1) ◽  
pp. 79-86
Author(s):  
P. Bhattacharjee ◽  
M. Z. Alam ◽  
S. M. A. Sayem
Keyword(s):  
Klebsiella Pneumoniae ◽  
Antimicrobial Agents ◽  
Bacterial Pathogen ◽  
Antibiotic Sensitivity ◽  
High Rate ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Antimicrobial Sensitivity ◽  
Microbiological Methods ◽  
Sensitivity Pattern

Klebsiella pneumoniae is recognized as an emerging opportunistic bacterial pathogen of clinical relevance for its association with both community acquired and nosocomial infections. Moreover, increased resistance to common antimicrobial agents complicates and limits available therapeutic options. The aim of this study was to investigate an antibiotic sensitivity pattern of K. pneumoniae isolated from clinical samples against commonly used antibiotics and to focus on the associated therapeutic challenges. Presumptive K. pneumoniae isolates were collected from a variety of sources like urine sample, pus, wound swab etc. and further analyzed through standard microbiological methods. Following the identification of 23 bacterium isolates from the collected specimens, an antimicrobial sensitivity test was carried out. The results of this test indicated that the organisms possess diversity of susceptibility profiles towards the drugs tested. A high rate of resistance to the first line antibiotics like Amoxicillin (100%), Vancomycin (90.90%), Erythromycin (83.33%), and Cotrimoxazole (83.33%), designates a critical therapeutic challenge. However, inspite of a moderate sensitivity to the Gentamicin (43.5%), increased number of intermediate sensitivity to the drugs tested clearly point towards the multi-drug resistance of the K. pneumoniae isolates. Plasmid profiling experiment revealed that the size of the isolated plasmids varied in length, ranging from 800-900bp.

scholarly journals Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259005
Author(s):  
Sayran Hamad Haji ◽  
Safaa Toma Hanna Aka ◽  
Fattma A. Ali
Keyword(s):  
Multidrug Resistant ◽  
Automated System ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Beta Lactam ◽  
Isolation And Identification ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
Vitek 2

Background Emerging worldwide in the past decade, there has been a significant increase in multidrug-resistant bacteria from serious nosocomial infections, especially carbapenemase-producing Gram-negative bacilli that have emerged worldwide. The objective of this study is to investigate carbapenem resistance in Gram-negative bacilli bacteria using phenotypic detection, antimicrobial resistance profiles and genotypic characterisation methods. Methods 200 Gram-negative bacilli isolates were collected from different clinical specimens. All clinical samples were exposed to isolation and identification of significant pathogens applying bacteriological examination and an automated Vitek-2 system. The isolates were subjected to susceptibility tests by the Vitek-2 automated system and those isolates that were resistant to beta-lactam drugs, including carbapenems, third-generation cephalosporines or cefoxitin, were selected for phenotyping using Carba plus disc system assay for detection of carbapenemase-producing isolates. These isolates were further confirmed by molecular detection. PCR was used for the detection carbapenem-resistant genes (OXA-48, IMP, NDM, VIM, and KPC). Results 110 (55%) of 200 Gram-negative bacilli were identified as beta-lactam-resistant isolates. The frequency of carbapenem-resistant isolates was calculated to be 30.9% (n = 34/110). A collection totalling 65/110 (59%) isolates were identified as carbapenemase producers by phenotypic method. Moreover, among the 65 carbapenemase-producing Gram-negative isolates with a positive phenotype-based result, 30 (46%), 20 (30%) and 18 (27%) isolates were positive for OXA-48, KPC and MBL enzymes, respectively, as well as the production of 27% of AmpC with porin loss. Tigecycline was the most effective antibiotic that affected 70% of MDR isolates, but high rates of resistance were detected to other tested antimicrobials. Of interest, a high incidence of MDR, XDR and PDR profiles were observed among all carbapenemase-producing isolates. 36% (24/65) of the tested isolates were MDR to 3 to 5 antimicrobial classes. 29% (17/65) of the recovered isolates were XDR to 6 to 7 antimicrobial classes. Alarmingly, 24% (16/65) of isolates displayed PDR to all the tested 8 antimicrobial classes. Genotype assay, including 53 phenotypically confirmed carbapenemase-producing isolates of Gram-negative bacilli, found 51(96%) isolates were harbouring one or more genes. The most common carbapenemase gene was bla NDM 83% (44/53) followed by bla OXA-48 75% (40/53), bla VIM 49% (26/53) and bla IMP 43% (23/53), while the gene bla KPC was least frequent 7% (4/53). 92% (46/51) of isolates were involved in the production of more than one carbapenemase gene. Conclusion This study demonstrated the emergence of carbapenemase-producing Gram-negative pathogens implicated in healthcare-related infections. Accurate identification of carbapenem-resistant bacterial pathogens is essential for patient treatment, as well as the development of appropriate contamination control measures to limit the rapid spread of pathogens. Tigecycline exhibited potent antimicrobial activity against MDR, XDR and PDR-producing strains that establish a threatening alert which indicates the complex therapy of infections caused by these pathogens.

scholarly journals Comparison of Automated System Vitek-2 with Conventional Methods, for Identification and Antibiotic Sensitivity in Gram Positive Organisms.

JMS SKIMS ◽  
2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Nayeem U din Wani ◽  
Nargis Bali ◽  
Lenah Bashir ◽  
Junaid Ahmad ◽  
Suhail Ahmad
Keyword(s):  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Antibiotic Sensitivity ◽  
Blood Stream ◽  
Antimicrobial Susceptibility Testing ◽  
Automated System ◽  
Major Error ◽  
Gram Positive ◽  
Manual Methods ◽  
Vitek 2

Abstract Background: Prompt identification (ID) and antimicrobial susceptibility testing (AST) of organisms causing blood stream infections has a significant impact on the morbidity and mortality associated with these infections. The need to circumvent the slow turnaround time of conventional gold standard methods has paved way for the rapid automated systems. Aim: To Compare the results of Vitek-2 for the ID and AST of Gram positive isolates with conventional manual methods. Methodology: A total of 215 non-duplicate isolates of Gram positive bacteria recovered from blood samples were part of this prospective study carried out in the Department of Microbiology. Organisms were processed on the Vitek-2 system and by manual methods (ID/AST) for comparison. Descriptive statistics was used for the presentation and comparison of data and appropriate statistical charts were used to present the data. Observations: Concordant identification (ID) results of Vitek-2 were seen with all the isolates of S. aureus, S. epidermidis, S. pneumonia, E. faecalis and E. faecium. Discordant results of Vitek-2 were seen for S. hominis (5 isolates of the organism misidentified as S. epidermidis).  No minor, major or very major error with 100% categorical agreement (CA) was seen for penicillin, cefoxitin, oxacillin, linezolid, ciprofloxacin, tetracycline, co-trimoxazole, clindamycin and erythromycin for various organisms tested. Enterococci gave minor error of 4.5% with an overall CA of 95.5% for ampicillin and a major error of 2.8% with an overall CA of 97.2% for vancomycin. Conclusion: The organisms having slow metabolic rates and late lactose fermenters (S. hominis) are prone to errors by the Vitek-2 system; hence need to be reconfirmed with other possible method. Also AST results for critical antibiotics like vancomycin need to be verified manually before reporting.  Key words: Antimicrobial Susceptibility testing, Enterococci, Vitek-2

scholarly journals A 5-year surveillance on antimicrobial resistance of Acinetobacter isolates at a level-I trauma centre of India

2019 ◽  
Vol 11 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Minu Kumari ◽  
Priyam Batra ◽  
Rajesh Malhotra ◽  
Purva Mathur
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Control Measures ◽  
High Rate ◽  
Automated System ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Hospital Infection Control ◽  
Acinetobacter Spp ◽  
Vitek 2

Abstract INTRODUCTION: Acinetobacter spp. has emerged as a major cause of nosocomial outbreaks. Multiple antibiotic resistance is an important problem in Acinetobacter isolates in recent years. The aim of this study was to evaluate the rate of antimicrobial resistance and changes in resistance pattern over a period of 5 years (2012–2016) in Acinetobacter spp. isolated from trauma patients. MATERIALS AND METHODS: Acinetobacter spp. was identified by VITEK 2 and antibiotic susceptibility of isolates was investigated by disc-diffusion method and VITEK 2 automated system. Interpretation of susceptibility results was based on the Clinical and Laboratory Standards Institute guidelines. RESULTS: Out of the total 16,210 isolates obtained throughout the period of 5 years, Acinetobacter spp. accounted for 3744 (28.9%). Out of which, the species which was maximally isolated was Acinetobacter baumannii (98.5%), followed by Acinetobacter lwoffii (1.4%) and Acinetobacter hemolyticus (0.1%). The highest number of clinical isolates of Acinetobacter were recovered from neurosurgical ward (n = 1210), followed by the neurosurgical intensive care unit (ICU) (n = 1000) and surgical ICU (n = 948) and the most common sample of Acinetobacter isolation was from tracheal aspirate (37.1%), followed by wound swab (18.8%). The highest level of resistance was observed against ciprofloxacin (96%), followed by cefepime (95%), ceftazidime (95%), piperacillin (95%), and amikacin (92%). The trend of antibiotic resistance was found to be statistically significant (P < 0.001) for most of the antibiotics being tested such as amikacin and carbapenems. CONCLUSION: The high rate of antibiotic resistance of the Acinetobacter strains indicated that there is an urgent need for controlled antibiotic usage and appliance of hospital infection control measures.

scholarly journals Evaluation of the Vitek 2, Phoenix and Microscan for Antimicrobial Susceptibility Testing of Stenotrophomonas maltophilia

2021 ◽  
Author(s):  
Ayesha Khan ◽  
Cesar A. Arias ◽  
April Abbott ◽  
Jennifer Dien Bard ◽  
Micah M. Bhatti ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Stenotrophomonas Maltophilia ◽  
Susceptibility Testing ◽  
High Rate ◽  
Broth Microdilution ◽  
Antimicrobial Susceptibility Tests ◽  
Microscan Walkaway ◽  
Vitek 2 ◽  
Susceptibility Tests ◽  
Immunocompromised Hosts

Stenotrophomonas maltophilia causes high mortality infections in immunocompromised hosts with limited therapeutic options. Many U.S. laboratories rely on commercial automated antimicrobial susceptibility tests (cASTs) and use CLSI breakpoints (BPs) for S. maltophilia. However, contemporary data on these systems is lacking. We assessed performances of Vitek2, MicroScan Walkaway and Phoenix relative to reference broth microdilution for trimethoprim-sulfamethoxazole (SXT), levofloxacin (LEV), minocycline (MIN) and ceftazidime (CAZ), with 109 S. maltophilia bloodstream isolates. Using CLSI breakpoints, categorical agreement (CA) was below 90% on all systems and drugs, with the exception of SXT by MicroScan (98.1%) and Phoenix (98.1%) and MIN by MicroScan (100%) and Phoenix (99.1%). For SXT, Vitek2 yielded a 77.1% CA. LEV and CAZ CA ranged from 67% - 85%. Very major errors (VME) were >3% for SXT (MicroScan, Phoenix), LEV (MicroScan) and CAZ (all systems). Major errors (ME) were >3% for SXT (Vitek 2), LEV (Phoenix) and CAZ (MicroScan, Phoenix). Minor errors were >10% for CAZ and LEV on all systems. Data were analyzed with EUCAST pharmacokinetic/pharmacodynamic CAZ, LEV, ciprofloxacin (CIP) and tigecycline (TGC) breakpoints when possible. CA was <90% for all. VME were >3% for CAZ (all systems), LEV (MicroScan), and TGC (Vitek2) and ME were >3% for LEV (MicroScan), CAZ (all systems), ciprofloxacin (Vitek2 and MicroScan) and TGC (Vitek 2, Phoenix). Minor errors (MI) were >10% for all agents and systems, by EUCAST breakpoints with an intermediate category (LEV, CAZ, CIP). Laboratories should use caution with cASTs for S. maltophilia as a high rate of errors may be observed.

scholarly journals Antibiotic Resistance Profile of Stenotrophomonas maltophilia Infections with Limited Antibiotic Options

2021 ◽  
Author(s):  
Gökçe Kader Aslan ◽  
Fatma Esenkaya Taşbent ◽  
Metin Doğan
Keyword(s):  
Risk Factors ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Stenotrophomonas Maltophilia ◽  
Opportunistic Pathogen ◽  
Automated System ◽  
Clinical Samples ◽  
Multiple Antibiotic Resistance ◽  
Antibiotic Resistance Profile ◽  
Resistance Rates

Objective: Stenotrophomonas maltophilia is an opportunistic pathogen that frequently causes nosocomial infections in recent years. It is generally isolated from respiratory tract samples, blood, urine and drainage materials. Due to multiple antibiotic resistance, a limited number of antibiotics are used in the treatment of these infections. The aim of this study is to investigate the antibiotic resistance status and risk factors in isolated S. maltophilia strains. Method: Diversity and antibiotic susceptibility levels of S. maltophilia strains isolated from various clinical samples between January 2018 and June 2020 were examined using conventional methods and VITEK2 automated system. Demographic and diagnostic data of the patients were retrieved from the hospital’s data base to identify the risk factors of infection. Results: Of the 300 strains examined, 46% were isolated from intensive care units, 35.3% from patients hospitalized in other clinics, and 18.7% from outpatient clinic patients. It was observed that 64 (21.3%) of 300 patients were immunosuppressed. Trimethoprim-sulfamethoxazole resistance was 1.3% and levofloxacin resistance was 0.7%. Conclusion: Resistance rates were found to be lower than the literature data in the study. It was concluded that hospitalization in the intensive care unit and immunosuppression are important risk factors for S. maltophilia infections.

scholarly journals Evaluation of blaGES-5 and bla veb-1 genes with multidrug-resistant extend, pandrug resistance patterns (MDR, XDR, PDR), and biofilm formation in Pseudomonas aeruginosa isolates

2021 ◽  
Vol 67 (3) ◽  
pp. 52-60
Author(s):  
Fattma A. Ali ◽  
Sevan Hassan Bakir ◽  
Sayran Hamed Haji ◽  
Bashdar M. Hussen
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Biofilm Formation ◽  
Phylogenetic Trees ◽  
Antibiotic Sensitivity ◽  
Multidrug Resistant ◽  
Clinical Samples ◽  
Sensitivity Testing ◽  
Automated Method ◽  
Resistance Patterns ◽  
Vitek 2

Pseudomonas aeruginosa is a ubiquitous microorganism that is difficult to treat due to the increasing prevalence of multidrug resistance patterns. A total of 227 samples were taken from different clinical samples during the study period from January 2018 to December 2018. The isolates were identified with antibiotic sensitivity testing with ESBL by the Vitek-2 automated method. MDR, XDR, and PDR were determined. 40 (17.6%) isolates were positive for P. aeruginosa, maximum of ESBL and MBL. Positive isolates were detected in the burn, coexisting ESBL + MBL enzymes in 21 (52.5%) of our isolates. Imipenem followed by Meropenem were found to be effective against ESBL and MBL producers. Resistance was reached between 72-100% to 5 antibiotics. The frequency of PDR, MDR, and XDR were 5%, 50%, and 45%, respectively. The frequency of co-production between MDR, XDR, and PDR with MBL, ESBL, and Biofilm was 35%, 12.5% and 5%, respectively. Among the ESBLs, the frequency of distribution of bla VEB-1gene and blaGES-5 gene was 50% and 40 %, respectively. Bacterial isolates simultaneously carrying blaVEB-1 gene with multiple ?-lactamases of different classes of biofilm, MDR, PDR, and XDR as same as a coexisting blaGES-5 gene. One isolate was detected as new isolates registered in global gene bank as locally P. aeruginosa isolates in Erbil city (LOCUS MN900953). The phylogenetic trees of the blaVEB gene isolates were demonstrated a genotype closely related to others, deposited in GenBank similar to the P. aeruginosa gene; gene sequencing revealed a 99% similarity with other isolates deposited in GenBank.

Prevalence and identification of Candida sp. in pregnant women using VITEK-2

2017 ◽  
Vol 6 (12) ◽  
pp. 5359
Author(s):  
Sujata P. Mishra ◽  
Chita R. Sahoo ◽  
Siba N. Rath ◽  
Rabindra N. Padhy
Keyword(s):  
Pregnant Women ◽  
Culture Technique ◽  
Automated System ◽  
Clinical Samples ◽  
Correct Identification ◽  
Candida Sp ◽  
Slide Culture ◽  
Sugar Fermentation ◽  
Vaginal Swabs ◽  
Vitek 2

Background: Candida sp. is seen in several areas of body such as, mouth, groin area including vagina and digestive tract as thrush or gastroenteritis. The slide-culture technique and the VITEK-2 automated system were used for species-identification of the fungus; nonetheless, a gold standard or any first identification method would have inherent errors in arriving at a correct identification of a microorganism at species level.Methods: Morphological fungal criteria were ascertained with germ tubes, glucose agar, sugar fermentation and sugar assimilation tests Candida from vaginal swabs and other clinical samples of 85 infected pregnant women with diabetes, by growing swab lots on Sabouraud’s Dextrose Agar (SDA) plates, the slide culture technique and the VITEK-2 automated system.Results: Of 85 patients, 122 isolates in SDA culture were determined as 7 Candida sp.  with number of isolates of each species, as follows: 47 C. albicans, 9 C. famata, 11 C. glabrata, 13 C. guilliermondii, 8 C. krusei, 3 C. parapsilosis and 37 C. tropicalis from vaginal swabs. From 60 vaginal swabs, 46 urine samples and 12 throat swabs it was seen that C. albicans was most prevalent. However, withVITEK-2, 201 fungal strains were identified; Candida sp. was isolated in all samples: 59 C. albicans, 19 C. famata, 21 C. glabrata, 23 C. guilliermondii,18 C. krusei, 13 C. parapsilosis and 48 C. tropicalis.Conclusions: The most prevalent species among the isolated fungi was C. albicans, causing VC in diabetic pregnant women.

Sign in / Sign up

Export Citation Format

Share Document