In vitro assessment of antimicrobial susceptibility patterns in positive blood cultures of 22 neonates with neonatal sepsis in a children's hospital in Baghdad

IntroductionThe clinical syndrome of neonatal sepsis, comprising signs of infection, septic shock and organ dysfunction in infants ≤4 weeks of age, is a frequent sequel to bloodstream infection and mandates urgent antimicrobial therapy. Bacterial characterisation and antimicrobial susceptibility testing is vital for ensuring appropriate therapy, as high rates of antimicrobial resistance (AMR), especially in low-income and middle-income countries, may adversely affect outcome. Ho Chi Minh City (HCMC) in Vietnam is a rapidly expanding city in Southeast Asia with a current population of almost 8 million. There are limited contemporary data on the causes of neonatal sepsis in Vietnam, and we hypothesise that the emergence of multidrug resistant bacteria is an increasing problem for the appropriate management of sepsis cases. In this study, we aim to investigate the major causes of neonatal sepsis and assess disease outcomes by clinical features, antimicrobial susceptibility profiles and genome composition.Method and analysisWe will conduct a prospective observational study to characterise the clinical and microbiological features of neonatal sepsis in a major children’s hospital in HCMC. All bacteria isolated from blood subjected to whole genome sequencing. We will compare clinical variables and outcomes between different bacterial species, genome composition and AMR gene content. AMR gene content will be assessed and stratified by species, years and contributing hospital departments. Genome sequences will be analysed to investigate phylogenetic relationships.Ethics and disseminationThe study will be conducted in accordance with the principles of the Declaration of Helsinki and the International Council on Harmonization Guidelines for Good Clinical Practice. Ethics approval has been provided by the Oxford Tropical Research Ethics Committee 35-16 and Vietnam Children’s Hospital 1 Ethics Committee 73/GCN/BVND1. The findings will be disseminated at international conferences and peer-reviewed journals.Trial registration numberISRCTN69124914; Pre-results.

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976Antiseptic tolerance and antimicrobial susceptibility of nosocomial Staphylococcus aureus at Texas Children's Hospital: 2007-2013

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu052.684 ◽

2014 ◽

Vol 1 (suppl_1) ◽

pp. S284-S284

Author(s):

Jonathon Mcneil ◽

Eric Kok ◽

Kristina Hulten ◽

Edward O. Mason ◽

Sheldon L. Kaplan

Keyword(s):

Staphylococcus Aureus ◽

Antimicrobial Susceptibility ◽

Children's Hospital ◽

Children’S Hospital

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Sepsis in cancer patients residing in Zimbabwe: Spectrum of bacterial and fungal aetiologies and their antimicrobial susceptibility patterns.

10.21203/rs.2.10948/v1 ◽

2019 ◽

Author(s):

FRANK CHINOWAITA ◽

Wendy Chaka ◽

Tinashe K Nyazika ◽

Tendai C Maboreke ◽

Inam Chitsike ◽

...

Keyword(s):

Blood Culture ◽

Cancer Patients ◽

Antimicrobial Susceptibility ◽

Methicillin Resistance ◽

Antimicrobial Treatment ◽

Blood Cultures ◽

Gram Negative ◽

E Coli ◽

Patients With Cancer ◽

Susceptibility Patterns

Abstract Introduction: Cancer and sepsis comorbidity is a major public health problem in most parts of the world including Zimbabwe. The microbial aetiologies of sepsis and their antibiograms vary with time and locations. Knowledge on local microbial aetiologies of sepsis and their susceptibility patterns is critical in guiding empirical antimicrobial treatment choices. Methods: This was a descriptive cross sectional study which determined the microbial aetiologies of sepsis from blood cultures of paediatric and adult cancer patients obtained between July 2016 and June 2017. The TDR-X120 blood culture system and TDR 300B auto identification machine were used for incubation of blood culture bottles and identification plus antimicrobial susceptibility testing, respectively. Results: A total of 142 participants were enrolled; 50 (35.2%) had positive blood cultures with 56.0% gram positive, 42.0% gram negative bacteria and 2.0% yeast isolates. Most common isolates were Coagulase Negative Staphylococcus (CoNS) (22.0%), Escherichia coli (16.0%), Klebsiella pneumoniae (14.0%), Enterococcus faecalis (14.0%) and Staphylococcus aureus (8.0%) in all cancer patients. These isolates were similar in both haematological and solid cancers. Amikacin and meropenem showed 85.7% and 95.2% activity respectively against all gram negative isolates while vancomycin and linezolid were effective against 96.2% and 100.0% of all gram positive isolates respectively. Ten (66.7%) isolates of E. coli and K. pneumoniae were extended spectrum β-lactamase (ESBL) positive and the same proportion was observed on methicillin resistance among Staphylococcus species. Conclusions: The major microbial aetiologies of sepsis among patients with cancer in Zimbabwe were CoNS, E. coli, K. pneumoniae, E. faecalis and S. aureus. Most isolates were resistant to commonly used empirical antibiotics and there was high level of ESBL and methicillin resistance carriage. A nationwide survey on microbial aetiologies of sepsis and their susceptibility patterns would assist in the guidance of effective sepsis empiric antimicrobial treatment among patients with cancer.

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Macrolide resistance mechanisms and in vitro susceptibility patterns of viridans group streptococci isolated from blood cultures

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dki404 ◽

2005 ◽

Vol 57 (1) ◽

pp. 139-141 ◽

Cited By ~ 15

Author(s):

Alper Ergin ◽

Serpil Ercis ◽

Gülşen Hasçelik

Keyword(s):

Resistance Mechanisms ◽

Blood Cultures ◽

Macrolide Resistance ◽

In Vitro Susceptibility ◽

Viridans Group Streptococci ◽

Susceptibility Patterns

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382Antimicrobial Optimization after Implementation of a Rapid Multiplex PCR Based Diagnostic Test for Positive Blood Cultures at a Children's Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofu052.248 ◽

2014 ◽

Vol 1 (suppl_1) ◽

pp. S149-S149

Author(s):

Emily Thorell ◽

Jared Olson ◽

Michael Lahart ◽

Elizabeth Doby ◽

Anne J. Blaschke

Keyword(s):

Multiplex Pcr ◽

Diagnostic Test ◽

Blood Cultures ◽

Children's Hospital ◽

Children’S Hospital

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In Vitro Antimicrobial Susceptibility Testing of Bacterial Enteropathogens Causing Traveler's Diarrhea in Four Geographic Regions

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.45.1.212-216.2001 ◽

2001 ◽

Vol 45 (1) ◽

pp. 212-216 ◽

Cited By ~ 102

Author(s):

Harumi Gomi ◽

Zhi-Dong Jiang ◽

Javier A. Adachi ◽

David Ashley ◽

Brett Lowe ◽

...

Keyword(s):

Antimicrobial Susceptibility ◽

Antimicrobial Agents ◽

Dilution Method ◽

Agar Dilution Method ◽

Moderate Activity ◽

Traveler’S Diarrhea ◽

The World ◽

Traveler's Diarrhea ◽

Susceptibility Patterns

ABSTRACT The emergence of resistant enteropathogens has been reported worldwide. Few data are available on the contemporary in vitro activities of commonly used antimicrobial agents against enteropathogens causing traveler's diarrhea (TD). The susceptibility patterns of antimicrobial agents currently available or under evaluation against pathogens causing TD in four different areas of the world were evaluated. Pathogens were identified in stool samples from U.S., Canadian, or European adults (18 years of age or older) with TD during 1997, visiting India, Mexico, Jamaica, or Kenya. MICs of 11different antimicrobials were determined against 284 bacterial enteropathogens by the agar dilution method. Ciprofloxacin, levofloxacin, ceftriaxone, and azithromycin were highly active in vitro against the enteropathogens, while traditional antimicrobials such as ampicillin, trimethoprim, and trimethoprim/sulfamethoxazole showed high levels and high frequencies of resistance. Rifaximin, a promising and poorly absorbable drug, had an MIC at which 90% of the strains tested were inhibited of 32 μg/ml, 250 times lower than the concentration of this drug in the stools. Amdinocillin, nalidixic acid, and doxycycline showed moderate activity. Fluoroquinolones are still the drugs of choice for TD in most regions of the world, although our study has a limitation due to the lack of Escherichia coli samples from Kenya and possible bias in selection of the patients for evaluation. Azithromycin and rifaximin should be considered as promising new agents. The widespread in vitro resistance of the traditional antimicrobial agents reported since the 1980s and the new finding of resistance to fluoroquinolones in Southeast Asia are the main reasons for monitoring carefully the antimicrobial susceptibility patterns worldwide and for developing and evaluating new antimicrobial agents for the treatment of TD.

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Etest Cannot Be Recommended forIn VitroSusceptibility Testing of Mucorales

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00004-15 ◽

2015 ◽

Vol 59 (6) ◽

pp. 3663-3665 ◽

Cited By ~ 20

Author(s):

Rita Caramalho ◽

Elisabeth Maurer ◽

Ulrike Binder ◽

Ricardo Araújo ◽

Somayeh Dolatabadi ◽

...

Keyword(s):

Amphotericin B ◽

Antimicrobial Susceptibility ◽

Active Drug ◽

Susceptibility Testing ◽

Antifungal Susceptibility ◽

Antifungal Susceptibility Testing ◽

Broth Microdilution ◽

European Committee ◽

Susceptibility Patterns

ABSTRACTAmphotericin B and posaconazole susceptibility patterns were determined for the most prevalent Mucorales, following EUCAST (European Committee on Antimicrobial Susceptibility Testing) broth microdilution guidelines. In parallel, Etest was performed and evaluated against EUCAST. The overall agreement of MICs gained with Etest and EUCAST was 75.1%; therefore, Etest cannot be recommended for antifungal susceptibility testing of Mucorales. Amphotericin B was the most active drug against Mucorales speciesin vitro, while the activities of posaconazole were more restricted.

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Evaluation of blood cultures in a children’s hospital located in Southeastern Anatolia

Türk Pediatri Arşivi ◽

10.5152/tpa.2015.2593 ◽

2015 ◽

Vol 50 (2) ◽

pp. 102-107 ◽

Cited By ~ 2

Author(s):

Reyhan Yis

Keyword(s):

Blood Cultures ◽

Children's Hospital ◽

Children’S Hospital

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487. Prevalence of Antimicrobial Resistance in Gram-Negative Bacilli Bloodstream Infections at a Tertiary Teaching Hospital in the Dominican Republic

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.560 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S238-S238

Author(s):

Alfredo J Mena Lora ◽

Julia Rodriguez Abreu ◽

Claudia Blanco ◽

Jacquelin de Lara ◽

Susan C Bleasdale

Keyword(s):

Antimicrobial Resistance ◽

Dominican Republic ◽

Bloodstream Infections ◽

Blood Cultures ◽

Mechanisms Of Resistance ◽

Gram Negative ◽

Empiric Treatment ◽

Tertiary Teaching ◽

Susceptibility Patterns

Abstract Background Bloodstream infections (BSI) with gram-negative bacilli (GNB) are a major cause of morbidity and mortality worldwide. Sepsis due to BSI can carry a mortality rate as high as 40%, with higher mortality in developing nations. Early and appropriate empiric therapeutic selection plays an important role in survival. The rising incidence of antimicrobial resistance (AMR) limits empiric treatment options. Local susceptibility patterns can vary per region, institution or setting. Understanding local AMR may help guide empiric treatment choices. We seek to describe resistance rates for GNB BSI in the Dominican Republic (DR). Methods This is a retrospective review of antimicrobial susceptibility patterns from bloodstream infections in a tertiary hospital in the DR. Susceptibility data from all adult inpatient blood cultures were collected from January 1 to December 31, 2017. Results A total of 124 blood cultures were reported. The most common organisms were Escherichia coli (43%) and Klebsiella pneumoniae (23%). Fluoroquinolone resistance was present in 70% of E. coli. Phenotypic susceptibility patterns consistent with extended-spectrum β-lactamase (ESBL) producing GNB were present in 46% of isolates. Carbapenem resistance was found in 4 samples and was most common in P. aeruginosa. Susceptibility profile is described on Table 1. Conclusion AMR was high in GNB BSIs in the DR. High rates of ESBL render common cephalosporins sub-optimal for empiric treatment. PTZ retains in vitro susceptibilities despite cefepime resistance but clinical efficacy is controversial. CTX-M ESBLs may cause these resistance pattern in vitro. Further studies are needed to determine genetic mechanisms of resistance. Establishing antimicrobial stewardship programs with rapid diagnostic testing that identify mechanisms of resistance may promote judicious use of carbapenems and reduce further the risk of further development of AMR. Disclosures All authors: No reported disclosures.

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