scholarly journals Nosocomial blood-stream infections from extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumonia from GB Pant Hospital, New Delhi

2010 ◽  
Vol 4 (08) ◽  
pp. 517-520 ◽  
Author(s):  
Juhi Taneja ◽  
Bibhabati Mishra ◽  
Archana Thakur ◽  
Vinita Dogra ◽  
Poonam Loomba
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Test Method ◽  
Diffusion Method ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

Background: Nosocomial septicemia due to extended spectrum beta-(β)-lactamase (ESBL) producing Klebsiella pneumoniae and Escherichia coli are a therapeutic challenge due to resistance. Knowledge of disease burden and resistance patterns is required for proper and timely management. We report the prevalence and antimicrobial susceptibility of ESBL producing E. coli and K .pneumoniae from septicemia at a tertiary care hospital. Methodology: A total of 2,870 blood samples of suspected cases of septicemia were studied between January and December 2009. Antimicrobial susceptibility was determined by Kirby Bauer's disc diffusion method and MICs for imipenem, meropenem, and ertapenem were determined using the E-test. All isolates of E. coli and K. pneumoniae were tested for ESBL production by E-test method. Results: Forty-one (70.7%) K. pneumoniae isolates and ten (41.7%)  E. coli isolates were ESBL producers. Two (5%) of ESBL producing K. pneumoniae isolates, but no E. coli isolates, were resistant to carbapenems. In vitro, all ESBL producers were sensitive to tigecycline. Conclusion: Our data indicated that the prevalence of ESBL-producing E. coli and K. pneumonia strains isolated from blood cultures from hospitalized patients is high. ESBL-producing organisms were found to be more susceptible to meropenem than to imipenem and ertapenem. Tigecycline is active against all the ESBL or multidrug resistant (MDR) E. coli and Klebsiella spp. isolates.

Higher Prevalence of Extended Spectrum β-Lactamase Producing Uropathogenic Escherichia coli Among Patients with Diabetes from a Tertiary Care Hospital of Kathmandu, Nepal

2021 ◽  
Author(s):  
Tulsi Nayaju ◽  
Milan Kumar Upreti ◽  
Alina Ghimire ◽  
Basudha Shrestha ◽  
Basanta Maharjan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Tertiary Care ◽  
Antimicrobial Properties ◽  
Antibiotic Resistance Genes ◽  
Care Hospital ◽  
Cross Sectional ◽  
E Coli ◽  
Extended Spectrum ◽  
Patients With Diabetes ◽  
Esbl Producers

This study aimed to determine the occurrence of antibiotic resistance genes for β-lactamases; blaTEM and blaCTX-M in uropathogenic Escherichia coli isolates from urinary tract infection (UTI) suspected diabetic and nondiabetic patients. A hospital-based cross-sectional study was conducted in Kathmandu Model Hospital, Kathmandu, in association with the Department of Microbiology, GoldenGate International College, Kathmandu, Nepal, from June to December 2018. A total of 1,267 nonduplicate midstream urine specimens were obtained and processed immediately for isolation of uropathogens. The isolates were subjected to antibiotic susceptibility testing and extended spectrum β-lactamase (ESBL) confirmation. In addition, blaTEM and blaCTX-M genes were detected using specific primers. The overall prevalence of UTI was 17.2% (218/1,267), of which patients with diabetes were significantly more infected; 32.3% (31/96) as compared with nonpatients with diabetes, 15.9% (187/1,171). A total of 221 bacterial isolates were obtained from 218 culture-positive specimens in which E. coli was the most predominant; 67.9% (150/221). Forty-four percent (66/150) of the total E. coli was multidrug resistant and 37.3% (56/150) were ESBL producers. Among 56 isolates, 92.3% (12/13) were from patients with diabetes, and 83.0% (44/53) were from nondiabetics. Furthermore, 84.9% of the screened ESBL producers were confirmed to possess either single or both of blaTEM and blaCTX-M genes. The blaTEM and blaCTX-M genes were detected in 53.6% and 87.5% of the phenotypically ESBL confirmed E. coli, respectively. Higher rates of ESBL producing uropathogenic E. coli are associated among patients with diabetes causing an alarming situation for disease management. However, second-line drugs with broad antimicrobial properties are still found to be effective drugs for multidrug resistance strains.

Prevalence and Antibiogram of Extended-Spectrum Beta-Lactamase Producing Gram-negative Bacteria Isolated from Septicemic Neonates in a Tertiary Care Hospital

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 171-175
Author(s):  
Tania Rahman ◽  
Momtaz Begum ◽  
Sharmeen Sultana ◽  
SM Shamsuzzaman
Keyword(s):  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Blood Samples ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

Background: In recent years, Extended-spectrum beta-lactamase (ESBL) producing microorganisms have complicated treatment of infections due to resistance of ESBL producing strains to a wide range of antimicrobials. Objective: Target of this study was to determine the prevalence of ESBL producing gramnegative bacteria in neonatal sepsis cases and to reveal the antimicrobial susceptibility pattern of those isolated ESBL producers. Materials and Methods: This cross sectional study was carried out in Dhaka Medical College Hospital (DMCH) over a period of 12 months from January to December in 2016. Following isolation and identification of gram-negative bacteria from blood samples of suspected septicemic neonates, antimicrobial susceptibility test was performed by Kirby Bauer disk-diffusion method and ESBL producers were detected by Double Disk Synergy (DDS) test. Results: Among 52 Gram-negative bacteria isolated from 106 blood samples, 34.61% ESBL producers were detected and Enterobacter spp. (45%) was predominant followed by Klebsiella pneumoniae (33.33%). None of the ESBL producers was resistant to colistin and tigecycline. All ESBL producing Acinetobacter baumannii, 77.78% and 66.67% of ESBL producing Enterobacter spp and Klebsiella spp. respectively showed resistance to meropenem. All ESBL producers were resistant to piperacillintazobactam. Conclusion: Appropriate measures should be taken to prevent the spread of ESBL producing strains by combining strategies for infection prevention, control and rational use of antibiotics. KYAMC Journal Vol. 11, No.-4, January 2021, Page 171-175

scholarly journals Comparison of Biofilm Producing and Non-Producing Escherichia coli Isolated from Urine Samples of Patients Visiting a Tertiary Care Hospital of Morang, Nepal

2019 ◽  
Vol 6 ◽  
pp. 76-81
Author(s):  
Manita Tumbahangphe ◽  
Bijay Kumar Shrestha ◽  
Jenish Shakya ◽  
Hemanta Khanal
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Urine Samples ◽  
Diffusion Method ◽  
Care Hospital ◽  
Microtitre Plate ◽  
Plate Method ◽  
E Coli

Objectives: The main objective of this study was to determine the prevalence of Escherichia coli among urinary tract infection (UTI) suspected patients visiting tertiary care hospital and to assess the biofilm producing ability of E. coli isolates. Methods: A prospective cross-sectional study was carried out in Biratnagar Metropolitan city, Eastern Nepal from December 2018 to May 2019. During the study 400 urine samples were collected from UTI suspected patients visiting a tertiary care hospital of Biratnagar. Urine samples were cultured by using semi-quantitative culture technique and identified. Antibiotic susceptibility testing was done by Kirby-Bauer Disk Diffusion method according to CLSI (2011) guidelines. Biofilm assays were performed by microtitre plate method. Results: This study reported 15% prevalence of E. coli out of 400 urine samples. 100% of E. coli isolates showed resistance to both Ampicillin and Amoxicillin while 100% were sensitive to Chloramphenicol. 70% (42/60) isolates were Multi Drug Resistance (MDR)E. coli. The maximum isolates (86.66%) were found to be biofilm producers by microtitre plate method. Resistance to other antibiotics such as Nalidixic acid (71.11% vs 46.66%), Norfloxacin (53.33% vs 46.66%), Cotrimoxazole (42.22% vs 26.66%) was comparatively higher among biofilm producers than non-biofilm producers. There was a significance of association between biofilm and MDR (p<0.05). Conclusion: There is relation between the ability of biofilm formation and drug resistance in the bacterium resulting to the failure of antibacterial drugs.

scholarly journals Frequency and Antimicrobial Susceptibility of Diarrheagenic Escherichia coli Obtained from Patients with Acute Diarrhea in a Tertiary Care Hospital, Bangladesh

2013 ◽  
Vol 2 (2) ◽  
pp. 46-51
Author(s):  
MR Kabir ◽  
MA Hossain ◽  
MM Alam ◽  
SK Paul ◽  
Z Begum ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Nalidixic Acid ◽  
Antimicrobial Susceptibility ◽  
Acute Diarrhea ◽  
Tertiary Care ◽  
Etiologic Agent ◽  
Care Hospital ◽  
E Coli ◽  
Diffusion Technique ◽  
Stool Specimens

Escherichia coli (E. coli) is an important group of pathogens associated with diarrhea among children. Despite the fact that diarrhaegenic Escherichia coli (DEC) has been identified as a major etiologic agent of childhood diarrhea, only a few studies have been performed in Bangladesh to identify these organisms. The objective of this study was to determine the frequency and antimicrobial susceptibility of DEC obtained from patients with acute diarrhea. To detect DEC in patients with acute diarrhea, a total of 300 stool specimens were tested by multiplex polymerase chain reaction (PCR). The antimicrobial susceptibility of DEC were tested by Kirby-Bauer disc diffusion technique as per recommendation of CLSI (Clinical and Laboratory Standards Institute), 2010. Out of 300 stool specimens collected from patients with acute diarrhea, the DEC was detected in 18% (54/300) cases. The dominating strain was Enterotoxigenic E. coli ( ETEC) (13%, 39/300), followed by Enteroaggregative E. coli (EAEC) (5%, 15/300) and no Enterohemorrhagic E. coli (EHEC), Enteroinvasive E. coli ( EIEC) and Enteropathogenic E. coli ( EPEC) could be detected. Detected ETEC were 100% sensitive to Ceftriaxone, Nitrofurantioin, Amikacin, 94% sensitive to Nalidixic acid, 89% sensitive to Gentamycin, 83% sensitive to Ciprofloxacin, 79% sensitive to Cephalexin, 39% sensitive to Amoxycillin, 46% sensitive to Tetracyclin and 31% sensitive to Cotrimoxazole. Detected EAEC were 100% sensitive to Ceftriaxone, Nitrofurantioin, Amikacin, Nalidixic acid, 90% sensitive to Gentamycin and Ciprofloxacin, 85% sensitive to Cephalexin, 41% sensitive to Amoxycillin, 49% sensitive to Tetracycline and 31% sensitive to Cotrimoxazole. Both ETEC and EAEC isolates exhibited decreased susceptibility for Amoxycillin, Tetracycline and Cotrimoxazole. Our results revealed that ETEC and EAEC, had significant association with acute diarrhea and should be considered as potential pathogens. Guidelines for appropriate use of antibiotics in tertiary care hospitals need updating. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16698 Community Based Medical Journal 2013 July: Vol.02 No 02: 46-51

scholarly journals Detection and genetic characterization of extended-spectrum beta-lactamases producers in a tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 253-258 ◽  
Author(s):  
Suryarashmi Sahoo ◽  
Sarita Otta ◽  
Bichitrananda Swain ◽  
Subrat Kumar Kar
Keyword(s):  
Klebsiella Oxytoca ◽  
Tertiary Care ◽  
Conventional Polymerase Chain Reaction ◽  
Diffusion Method ◽  
Care Hospital ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing organisms inactivate extended beta-lactam antibiotics and monobactams and also exhibit coresistance to many other classes of antibiotics. The present study was carried out to assess the prevalence of the ESBLs and to determine the most prevalent genotype in our hospital. MATERIALS AND METHODS: All clinically significant Gram-negative isolates were identified, and their antimicrobial susceptibility testing was done by Kirby–Bauers' disc diffusion method. ESBL detection was confirmed by minimal inhibitory concentration method using agar dilution technique for those who screened positive by ceftazidime (30 μg) disc. Further, the established ESBL-positive isolates were subjected to genotyping for bla TEM, bla CTX-M, and bla SHV genes by using conventional polymerase chain reaction. RESULTS: Escherichia coli was the most common (28.84%) Gram-negative bacillus followed by Klebsiella pneumoniae (18.07%), while Pseudomonas spp. (9.61%) was the most commonly identified nonfermenter. ESBL production was detected in 160 (30.8%) isolates. Klebsiella oxytoca (46.7%) followed by E. coli (44%) were the common ESBL producers. Most predominant ESBL gene was bla TEM, found in 122 (76.25%) isolates. Combinations of two genes were seen in 109 (68.1%) isolates, the most common (43.12%) combination being blaTEM and blaCTX-M. In this study, 16 (10%) strains had all the three types of genes. Most of the isolated Gram-negative bacilli (GNB) were sensitive to amikacin, imipenem, and colistin. CONCLUSION: In our study, the 30.8% of GNB were ESBL producers. This is the only study that shows that TEM is the most prevalent ESBL genotypes in our area. Of concern is a good number of isolates showing all three patterns of genes (TEM, SHV, and CTX-M). Amikacin, imipenem, and colistin were the most useful antibiotics in our setup.

scholarly journals Comparative Antimicrobial Susceptibility Profiles of Uropathogenic Extended-Spectrum ß-Lactamase Producing Strains of Klebsiella pneumonia and Escherichia coli by the CLSI and EUCAST Methodologies

2020 ◽  
Author(s):  
Doğan Akdoğan ◽  
Mustafa Güzel ◽  
Orhan Akpınar ◽  
Altan Aksoy ◽  
Yasemin Genç Bahçe
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Test ◽  
Klebsiella Pneumonia ◽  
Test Results ◽  
Poor Agreement ◽  
Antimicrobial Susceptibility Test ◽  
E Coli ◽  
Extended Spectrum ◽  
Kappa Agreement

Aims: The lack of information about the inter variability of the test results obtained by CLSI and EUCAST requires further clarifications to interpret antimicrobial susceptibility patterns better. This study aimed to compare the CLSI and EUCAST interpretations of the antimicrobial susceptibility test results of the ESBL&ndash;producing uropathogenic Escherichia coli and Klebsiella pneumonia strains. Methods: After obtaining 157 ESBL-producing E. coli and 95, ESBL-producing K. pneumonia isolates from the urine specimens of the patients, Kirby-Bauer&rsquo;s disc diffusion method was used for conducting antimicrobial susceptibility test. The test procedures and the interpretation of the results were carried out according to the year 2017 versions of both of the two guidelines. For the statistical comparison of concordance between the two guidelines, the Kappa coefficients and the concordance rates were calculated. Results: The results were graded in the range from perfect to poor agreement. For E. coli, interpretations of the AST results revealed a moderate to perfect agreement between both methods. Weighted Kappa agreement scores in the range from 0.42 to 1. The agreement for AMC, TPZ30/6, ceftazidime 10, meropenem, and aztreonam was poor without any inconsistencies. For Klebsiella, the kappa agreement score was in the range from 0.25 to 1. It was incompatible with AMC, TPZ 30/6, ceftazidime 10, aztreonam; there was poor agreement for cefepime, amikacin and ertapenem. Conclusions: Our results showed agreement between the two guidelines for uropathogenic extended-spectrum &szlig;-lactamase producing Escherichia coli and Klebsiella pneumoniae but also showed inconsistencies between two guidelines. Therefore, the results of our study contribute to the comparison of these guidelines for interpreting antibiotic susceptibilities.

scholarly journals Occurrence of Escherichia coli producing extended spectrum β-lactamases in food-producing animals

2021 ◽  
Author(s):  
Bence Balázs ◽  
József Bálint Nagy ◽  
Zoltán Tóth ◽  
Fruzsina Nagy ◽  
Sándor Károlyi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Gene Families ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Chain Reactions ◽  
E Coli ◽  
Esbl Gene ◽  
Source Of Infection ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract Multidrug resistance due to the production of extended-spectrum beta-lactamases (ESBLs) is a major problem in human as well as in veterinary medicine. These strains appear in animal and human microbiomes and can be the source of infection both in animal and in human healthcare, in accordance with the One Health theorem. In this study we examined the prevalence of ESBL-producing bacteria in food-producing animals. We collected 100 porcine and 114 poultry samples to examine the prevalence of ESBL producers. Isolates were identified using the MALDI-TOF system and their antibiotic susceptibility was tested using the disk diffusion method. ESBL gene families and phylogroups were detected by polymerase chain reactions. The prevalence of ESBL producers was relatively high in both sample groups: 72 (72.0%) porcine and 39 (34.2%) poultry isolates were ESBL producers. Escherichia coli isolates were chosen for further investigations. The most common ESBL gene was CTX-M-1 (79.3%). Most of the isolates belong to the commensal E. coli phylogroups. The porcine isolates could be divided into three phylogroups, while the distribution of the poultry isolates was more varied. In summary, ESBL-producing bacteria are prevalent in the faecal samples of the examined food-producing animals, with a dominance of the CTX-M-1 group enzymes and commensal E. coli phylogroups.

scholarly journals Antibiotic Susceptibility Pattern of Clinical Isolates of Escherichia coli at a Tertiary Care Hospital

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 681-686
Author(s):  
Md Shakhaowat Hossain ◽  
Rehana Khatun ◽  
Mohammed Solayman ◽  
Babul Aktar ◽  
Abdullah Akhtar Ahmed
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Penicillin G ◽  
Diffusion Method ◽  
Care Hospital ◽  
Isolation And Identification ◽  
Disk Diffusion Method ◽  
Tract Infections

Infections due to multidrug resistant E.coli range from uncomplicated urinary tract infections to life-threatening sepsis. A retrospective study was conducted to determine the patterns of antimicrobial susceptibility in 173 (12.84%) Escherichia coli strains isolated from 1347 clinical specimens of different types. Isolation and identification of E.coli were done as per routine laboratory protocol directed by Cheesbrough1. The isolation rate of E.coli was 48.57% in stool followed by 17.68% in urine, 25% in wound swabs, and 15.38% in tracheal aspirate etc. Among the 173 isolates 102 (59%) were from males and 71 (41%) were from females. Patients were classified into five age groups: 0-15, 16-30, 31-45, 46-60 and >60 years. E.coli was found highest number in females (13.9%) of age range 31-45 years and in males (22%) belonged to age group of over 60 years. Antimicrobial susceptibility testing by the disk diffusion method was conducted for 22 different antibiotics. The majority of isolated E.coli were highly sensitive to Imipenem (98.18%), Meropenem (97.37%), Amikacin (91.67%), Amoxiclav (80%), Ceftazidime (73.33%), and Gentamycin (71.76%). The antibiotics Tobramycin and Azithromycin were found as moderately sensitive against E.coli with the susceptibility rate of 52.5% and 50% respectively. The isolates show low degree of susceptibility to Penicillin G (9.52%), Carbenicillin (10%), Erythromycin (19.48%), Amoxycillin (19.59%), and Ampicillin (25%). These findings have clinical and epidemiological significance and provide a benchmark for future studies on the pattern of susceptibility of clinical isolates of E.coli in this region as well as may help the clinician to prescribe the right empirical treatment.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 681-686

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