Rapid detection of ceftriaxone resistance in clinical isolates of extensively drug resistant Salmonella enterica serovar Typhi

2021 ◽  
pp. 1-12
Author(s):  
Muhammad Luqman Satti ◽  
Faisal Hanif ◽  
Ashfaq Hussain ◽  
Saman Nadeem ◽  
Faryal Younis ◽  
...  
Keyword(s):  
Salmonella Typhi ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Color Test ◽  
Cross Sectional ◽  
Salmonella Enterica Serovar Typhi ◽  
Extensively Drug Resistant ◽  
Vitek 2

Abstract Objective: To see the efficacy of rapid color test for the sensitivity of ceftriaxone against clinical isolates of Salmonella Typhi. Methods: This descriptive cross sectional study was carried out at the department of Microbiology, Pakistan Navy Ship (PNS) Shifa Hospital, Karachi from Nov 2018 through April 2019.We tested 97 clinical isolates of Salmonella Typhi by this rapid color test. All the isolates were also test by conventional disc diffusion method and MICs by Vitek-2 system. Results: Out of these isolates, 83 were ceftriaxone resistant while 14 isolates were ceftriaxone sensitive. Sensitivity and specificity of rapid color test were 100% when compared with results of disc diffusion, E-test and Vitek 2 system. All the results were readable within 2 hours on color test. Conclusion: This color test is rapid, accurate and inexpensive and can be used as a screening test for ceftriaxone resistance in typhoid endemic areas. Keywords: Ceftriaxone; drug resistance; meropenem Continuous...

scholarly journals Extensively Drug-Resistant Salmonella typhi XDR Infection at Rawalpindi Medical University and Allied Hospitals

2020 ◽  
Vol 24 (4) ◽  
pp. 406-411
Author(s):  
Kausar Izhar ◽  
Kiran Ahmed ◽  
Maryyam Rehan ◽  
Muhammad Umar ◽  
Nadeem Ikram ◽  
...  
Keyword(s):  
Blood Culture ◽  
Simple Random Sampling ◽  
Salmonella Typhi ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Drug Resistant ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Extensively Drug Resistant ◽  
Antibiotics Susceptibility

Objective: To evaluate the prevalence of extensively drug-resistant Salmonella typhi (XDR) in RMU Allied Hospitals. Study Design: A descriptive cross-sectional study. Material and Methods: It is a cross-sectional, prospective study conducted at RMU Allied Hospitals from January 2019–December 2019. Blood culture samples were received in the pathology lab, they were collected by simple random sampling and processed by conventional incubation. Antibiotic susceptibility of the isolates was done on Muller Hinton agar using modified Kirby Bauer disk diffusion method and antibiotic zone diameters were measured according to CLSI guidelines. Results: Out of the total 8045 cultures, 911 (11%) showed growth, among which 179 (20%) were Salmonella typhi and 135 (15%) XDR Salmonella. Meropenem revealed the highest sensitivity, Chloramphenicol, and Augmentin revealed the highest resistance. Conclusion: Blood culture results revealed Salmonella typhi 20% with a significant number of XDR Salmonella 15%. Antibiotics susceptibility pattern exhibits Meropenem and Azithromycin as the only antibiotics for XDR Salmonella. Salmonella typhi infection has a significantly high prevalence among children as compared to adults. (p=0.0017) Injudicious use of antibiotics is one of the important aspects of the occurrence of antibiotic-resistant Salmonella.

scholarly journals Bacterial Etiology of Wound Exudates in Tertiary Care Cancer Patients and Antibiogram of the Isolates

2020 ◽  
Vol 13 ◽  
pp. 117863372095207
Author(s):  
Kiran Duwadi ◽  
Sujan Khadka ◽  
Sanjib Adhikari ◽  
Sanjeep Sapkota ◽  
Pabitra Shrestha
Keyword(s):  
Staphylococcus Aureus ◽  
Pathogenic Bacteria ◽  
Methicillin Resistance ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Biochemical Tests ◽  
Cross Sectional

Introduction: Patients with malignancies frequently develop infections as a result of surgical procedures and fungating wounds leading to pus formation. This cross-sectional study was conducted to explore the bacteriological spectra of infections of various cancer sites and their antibiotic sensitivity patterns among the patients visiting minor operation theatre (OT) of B.P. Koirala Memorial Cancer Hospital (BPKMCH), Chitwan, Nepal. Methods: Over a period of 3 months from September to November 2018, a total of 183 wound exudates and pus samples were collected and analyzed by standard microbiological procedures. Isolates were identified based on the colony characters, Gram staining and an array of biochemical tests. Antibiotic susceptibility testing was performed by Kirby-Bauer disc diffusion technique according to criteria set by CLSI, 2016. Methicillin resistance in Staphylococcus aureus was tested with the help of cefoxitin using disc diffusion method. Results: Out of the 183 samples, 149 (81.4%) were culture positive. Among 13 different isolates identified, S. aureus (43.0%) was predominant followed by E. coli (14.0%). Higher incidence of bacteria was seen among the males (52.3%), in the age group 51 to 60 years (26.8%) and among the patients undergoing surgical intervention to deal with cancer (34.2%). The prevalence of wound infection was significantly affected by gender, age, and treatment regimen ( P < .01). Out of the total 68 S. aureus isolates, 38 (44.1%) were deemed as Methicillin-resistant Staphylococcus aureus (MRSA). Among the 158 isolates, 85 (53.8%) were multi-drug resistant (MDR). Cefepime was the most effective antibiotic for Gram positive isolates whereas both imipenem and meropenem were found to be equally more effective for Gram negative isolates. Conclusion: This study suggests that patients with malignancies harbor pathogenic bacteria; therefore, prudent use of antibiotics is essential to prevent the emergence of MDR pathogens.

Carbapenem resistance among common Enterobacteriaceae Clinical Isolates in part of North-East India

2021 ◽  
Vol 19 ◽  
Author(s):  
Mohan Sharma ◽  
Pankaj Chetia ◽  
Minakshi Puzari ◽  
Nakul Neog ◽  
Upasana Phukan ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Treatment Options ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Multi Drug Resistance ◽  
Biochemical Tests ◽  
Cross Sectional ◽  
North East

Background: Enterobacteriaceae, the normal dwellers in the human intestine, are commonly associated with a variety of community acquired and nosocomial infections. Emerging trend of antibiotic resistance among these strains is a notable issue globally; more serious threat is the resistance against the available last resort antibiotics- the carbapenems. Objective: The objective of our study was intended to determine the burden of resistance towards common antibiotic classes, so as to address the gap of drug resistance prevalence data, among the Enterobacteriaceae isolates obtained from the health settings in this region. Methodology: A cross-sectional study was done with inclusion of clinical isolates collected from varied sources, from health settings in upper Assam. The isolates were identified based on standard methods of morphology study and biochemical tests. The identified isolates were then subjected to antibiotic susceptibility testing by following Kirby-Bauer disc diffusion method and the result interpreted as per the CLSI guidelines. The resistance of the reported carbapenem resistant isolates was confirmed by minimum inhibitory concentration (MIC) determination using commercial E-strip kit. Results: Among the enterobacterial isolates Klebsiella spp. accounted the majority, followed by Escherichia coli, Citrobacter spp., Shigella spp. and others. Multi-drug resistance (MDR) was noted among 67.6% isolates; however, carbapenem resistance was confirmed in 18.9% of the total Enterobacteriaceae isolates. Conclusion: Higher prevalence of resistance towards carbapenems, among the Enterbacteriaceae isolates of upper Assam seems to be upcoming threat to the region, limiting the treatment options in future.

Phenotypic Detection of Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus in Bharatpur Hospital

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Ramesh Sharma Regmi ◽  
Sujan Khadka ◽  
Sanjeep Sapkota ◽  
Swekshya Thapa Magar ◽  
Sanjib Adhikari ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Treatment Failure ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Cross Sectional ◽  
Inducible Clindamycin Resistance

Background: Clindamycin is regarded as a reserve drug in the treatment of staphylococcal infections. Among few therapeutic alternatives available for treatment of erythromycin-resistant Staphylococcus aureus infections, clindamycin has several advantages but major limitation in its use is the development of resistance resulting in treatment failure. Routine clindamycin susceptibility test may fail to detect such inducible resistance which can be detected by Double disc diffusion test (D-test). The present study was undertaken to determine the incidence of inducible clindamycin resistance among clinical isolates of S. aureus in a tertiary care hospital in central Nepal. Methods: A cross-sectional study was carried out among the patients visiting Bharatpur Hospital from September to November 2019. A total of 1279 clinical samples were examined for the identification of S. aureus by standard microbiological procedures. Antibiotic susceptibility testing of the isolates was done by Kirby-Bauer disc diffusion method and all the erythromycin-resistant isolates were subjected to D-test for the phenotypic detection of inducible clindamycin resistance according to CLSI guidelines (2016). Results: S. aureus was recovered from 4.5% (58/1279) samples of which 35 isolates were Methicillin-Resistant Staphylococcus aureus (MRSA) and 23 were multi-drug resistant (MDR). Tetracycline was found to be the most effective antibiotic whereas erythromycin was the least effective. D-test revealed that 39.7% isolates showed iMLSB phenotype, 3.5% showed cMLSB phenotype and 56.8% showed MS phenotype. The percentage of inducible and constitutive resistance was seen higher amongst MRSA isolates compared to Methicillin-Sensitive Staphylococcus aureus (MSSA) isolates. Incidence of S. aureus was found higher among females and in the age group 20-30 years and in pus samples (p<0.01). Conclusions: Routine testing of inducible clindamycin resistance is suggested among the clinical isolates of erythromycin-resistant Staphylococci to avoid treatment failure.  

scholarly journals PREVALENCE OF INDUCIBLE CLINDAMYCIN RESISTANCE IN CLINICAL ISOLATES OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS MEDIATED THROUGH GENE ERMC EXPRESSION

2018 ◽  
Vol 11 (9) ◽  
pp. 106
Author(s):  
Nimisha Tandon ◽  
Madhuri Kulkarni ◽  
Sowmya Gs ◽  
Fauzia Tabassum ◽  
Sayeed Akhtar Md
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Good Alternative ◽  
Clinical Isolates ◽  
University Teaching ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

Objective: The objective of this study is to determine the phenotypic and genotypic expression of inducible clindamycin resistance due to the expression of ermA, ermB, and ermC genes in clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) by double disc diffusion and uniplex PCR.Method: This cross-sectional study was conducted in microbiology department of an university teaching hospital. A total of 604 non-duplicate clinical isolates of S. aureus evaluated for MRSA and were subjected to uniplex PCR for ermA, ermB, and ermC genes, respectively.Result: The analysis of 604 isolates showed that 220 (36.42%) were of MRSA. Out of which, 69 (11.42%) were demonstrated as inducible clindamycin resistance by double-disc diffusion method, and among inducible resistant isolates, 25 isolates of ermC (84%) were positive and 4 (16%) were negative, whereas, ermA and ermB genes could not be demonstrated by the genotypic method.Conclusion: We observed that clindamycin may serve as a good alternative and advocated in severe MRSA infection based on susceptibility pattern. We observed D test as a mandatory method to detect inducible clindamycin Staphylococcus. Importantly, ermC gene is a major determinant of resistance to macrolides among MRSA.

scholarly journals Spontaneous emergence of azithromycin resistance in independent lineages of Salmonella Typhi in Northern India

2020 ◽  
Author(s):  
Megan E. Carey ◽  
Ruby Jain ◽  
Mohammad Yousuf ◽  
Mailis Maes ◽  
Zoe A. Dyson ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
South Asia ◽  
Salmonella Typhi ◽  
Cross Sectional Study ◽  
Drug Resistant ◽  
Cross Sectional ◽  
Northern India ◽  
Extensively Drug Resistant ◽  
Key Points ◽  
And Control

AbstractBackgroundThe emergence and spread of antimicrobial resistance (AMR) pose a major threat to the effective treatment and control of typhoid fever. The ongoing outbreak of extensively drug resistant (XDR) Salmonella Typhi (S. Typhi) in Pakistan has left azithromycin as the only remaining broadly efficacious oral antimicrobial for typhoid in South Asia. Ominously, azithromycin resistant S. Typhi organisms have been subsequently reported in Bangladesh, Pakistan, and Nepal.MethodsHere, we aimed to understand the molecular basis of AMR in 66 S. Typhi isolated in a cross-sectional study performed in a suburb of Chandigarh in Northern India using whole genome sequencing (WGS) and phylogenetic analysis.ResultsWe identified seven S. Typhi organisms with the R717Q mutation in the acrB gene that was recently found to confer resistance to azithromycin in Bangladesh. Six out of the azithromycin-resistant S. Typhi isolates also exhibited triple mutations in gyrA (S83F and D87N) and parC (S80I) genes and were resistant to ciprofloxacin. These contemporary ciprofloxacin/azithromycin-resistant isolates were phylogenetically distinct from each other and from those reported from Bangladesh, Pakistan, and Nepal.ConclusionsThe independent emergence of azithromycin resistant typhoid in Northern India reflects an emerging broader problem across South Asia and illustrates the urgent need for the introduction of typhoid conjugate vaccines (TCVs) in the region.Key pointsWe identified ciprofloxacin/azithromycin-resistant Salmonella Typhi (S. Typhi) in Chandigarh in Northern India. The independent emergence of ciprofloxacin/azithromycin-resistant typhoid in Bangladesh, Pakistan, Nepal, and India and the continued spread of extensively-drug resistant (XDR) typhoid in Pakistan highlight the limitations of licensed oral treatments for typhoid fever in South Asia.

scholarly journals Zoonotic Escherichia coli is a potential Driver of Antimicrobial Resistance among Pastoralist Communities in Uganda: A Laboratory based Cross sectional Study

2019 ◽  
Author(s):  
Abdul Walusansa ◽  
Jacob Stanly Iramiot ◽  
Florence Najjuka ◽  
Henry Kajumbula ◽  
Benon Asiimwe
Keyword(s):  
Antimicrobial Resistance ◽  
Agricultural Sector ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Toxin Gene ◽  
Disc Diffusion ◽  
Sectional Study ◽  
Cross Sectional ◽  
E Coli ◽  
Pastoralist Communities

Abstract Background Non-prescribed use of antimicrobials in Agriculture incurs a transfer risk of resistant pathogens to humans, complicating treatment. The aim of this study was to determine the potential of Zoonotic E. coli to serve as drivers of antimicrobial resistance among animals and humans in pastoralist communities in Kasese district, so as to protect the community.Materials and methods A laboratory based cross-sectional study was done using archived E. coli isolates previously obtained from humans in pastoralist communities of Kasese district, Uganda. Recovery of the isolates was done by conventional culture, and Identification by biochemical methods, serotyping and PCR. Antimicrobial resistance profiling was done by using Kirby Bauer disc diffusion method. The isolates were also screened for resistance mechanisms including Extended Spectrum β-lactamase (ESBL), Carbapenemase and AmpC production using disc diffusion based methods.Results The prevalence of Enterohemorrhagic E.coli (EHEC) was 16% (28/180). These EHEC isolates belonged to phylogroups; B 1 (94%, 26/28), B2 (3%, 1/28) and A (3%, 1/28). The most prevalent virulence gene was Stx1 (100%, 28/28) followed by Stx2e (94%, 26/28); none of the isolates was Stx2 positive. Highest resistance was seen to Cotrimoxazole (89%, 25/28), Tetracycline (71%, 20/28), Ampicillin (65%, 18/28) and Nitrofurantoin (28%, 8/28), these are the most commonly used antimicrobials in the agricultural sector in Uganda. Minimal resistance was observed to the antimicrobials that are commonly used in human medicine especially β-lactams, β-lactam+inhibitors and Carbapenems. Of the 28 zoonotic E. coli isolates, 17%, (5/28) were ESBL positive and among these 1 (3%, 1/28) was a Carbapenemase producer.Conclusion There is a high prevalence of highly pathogenic and resistant zoonotic E. coli among humans in pastoralist communities in Uganda. We suspect that these pathogens, along with their AMR genes, were acquired from animals because they largely contained the animal specific Vero toxin gene VT2e and majority belonged Pylo-group B 1 which has been documented as the most common EHEC phylo-group inhabiting domestic animals. We recommend that studies involving relatedness of drug resistant isolates from humans and animals should be conducted to ascertain the role of enterohemorrhagic E. coli in the zoonotic spread of antimicrobial resistance in pastoralist communities.

scholarly journals Minimum inhibitory concentration of Ceftazidime-Avibactam against Clinical isolates of XDR Salmonella enterica Serovar Typhi

2021 ◽  
Author(s):  
Kokab Jabeen ◽  
Sidrah Saleem ◽  
Summiya Nizam-ud-din ◽  
Faiqa Arshad ◽  
Zill-e-huma ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Salmonella Enterica ◽  
Clinical Laboratory ◽  
Test Method ◽  
Clinical Isolates ◽  
Automated System ◽  
Diffusion Method ◽  
Drug Resistant ◽  
Disc Diffusion ◽  
Extensively Drug Resistant

Abstract Background: Typhoid fever is a major healthcare problem in low and middle-income countries. The emergence of extensively drug-resistant (XDR) typhoid has further narrowed down the way to already limited therapeutic options. WHO has listed S.Typhi amongst the priority pathogens against which new treatment options should be discovered.Objective: To determine In-vitro activity of Ceftazidime-avibactam against clinical isolates of XDR S.Typhi.Study design: This is a cross-sectional studyPlace and duration of the study: The Department of Microbiology, University of health sciences, Lahore from January to June 2021.Methodology: Antimicrobial susceptibility was performed initially by Kirby Bauer disc diffusion method for 150 of XDR Salmonella enterica Serovar Typhi and MICs of all the recommended antibiotics was determined by VITEK 2 (bioMérieux) fully automated system using Clinical Laboratory Standard Institute (CLSI) 2021 guidelines. MICs by the E-test method were determined for Ceftazidime-avibactam and Azithromycin only. All tests were done in duplicate.Results: All 150 (100%) isolates were sensitive to Ceftazidime-avibactam by disc diffusion and E-test methods. Out of 150 isolates 8(5.3%) were having high MICs against Azithromycin.Conclusions: Ceftazidime-avibactam can be used wisely to treat ESBL producing XDR typhoid fever cases especially in countries like Pakistan where Typhoid fever is endemic and majority of isolates are extensively drug resistant.

scholarly journals The foodborne diseases antimicrobial resistance development in food animals: A case of Salmonella isolates from diarrheic sheep in and around Gondar city, Ethiopia: A cross-sectional study

2020 ◽  
Author(s):  
Daniel Teshome Gebeyehu
Keyword(s):  
Cross Sectional Study ◽  
Animal Production ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Disc Diffusion ◽  
Sectional Study ◽  
Cross Sectional ◽  
Resistance Development ◽  
Animal Populations ◽  
Wide Range

Abstract Background: In recent years, an increase in the occurrence of antimicrobial-resistant pathogens especially foodborne zoonotic bacteria has been observed in several countries. As a result, fatality rates are increasing due to those resistant bacteria in both human and animal populations, particularly in developing countries like Ethiopia where the risk of infection is high due to poor biosecurity measures, close animal-human interactions, and extensive use of antimicrobials for animal productions. One of those zoonotic diseases, which commonly contaminates food and having zoonotic characteristics is Salmonella.Methodology: A cross-sectional study on samples collected from diarrheic sheep in and around Gondar city, to assess the risk of antibiotic resistance development of Salmonella in food animal production was conducted. A total of 80 positively isolated Salmonellae were taken from 165 diarrheic sheep and antibiotics resistance test was conducted by Kirby-Bauer Disc diffusion method. The disc diffusion test was performed using ten commonly used antibiotic discs in the study area.Result: Salmonellae were 100% resistant for amoxicillin and ampicillin. In addition to this, the bacteria were sensitive for kanamycin, gentamicin, and ciprofloxacin with some level of intermediate resistance. Salmonellae were 75% sensitive with 25% resistance for chloramphenicol while trimethoprim, tetracycline, doxycycline and nalidixic acid showed 37.5%, 37.5%, 25% and 12.5% of resistance respectively. Generally, this study revealed that Salmonellae were developed a wide range of resistance to different antibiotics in the study area.Conclusion: In general, majority of previously curative antibiotics are developed resistance against Salmonella. Therefore, the rational use of antibiotics, antimicrobial use governance in animal production, further studies, and integrative approaches among animal-human health professionals are recommended for the reduction and mitigation of health risks arising from antibiotic-resistant zoonotic pathogens like Salmonellae.

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