Ludwig’s Angina: Clinical Profile and Microbiology with Antibiotic Resistance and Sensitivity at Referral Hospital

Objective: To assess the distribution of sex and age, comorbidity factors, etiology, management protocol, isolated organisms, antibiotic resistance and sensitivity. Material and Methods: Retrospective observational study based on medical records in 2007 – 2016 and microbiological examination data from 2012 – 2016. Results: The proportion of males was greater than females 1.8 (71): 1 (29). Mean age 41 ±SD 16.99. The most comorbidity diagnoses were type 2 diabetes mellitus (DM) 24.5% (27) and the most complications were sepsis 21.8% (24). The most common etiology was odontogenic infection 92%. Patients underwent drainage incisions and were treated with empiric ceftriaxone and metronidazole for an average of 7 days of treatment. Outcomes recovery were 93.7% (102) and were death 5.4% (6). The three most common types of bacteria as the etiology were Enterobacter spp. 32% (9), Streptococcus spp. 25% (7), Staphylococcus spp. 18% (5). Ceftriaxone showed considerable resistance to gram-negative bacteria as well as to gram-positive bacteria (Streptococcus spp.). Conclusion: The ratio of male to female was 1.8:1 and odontogenic infection was 92%. DM increases the risk of complications of sepsis and prolongs the day of care. A drainage incision should be performed immediately. Gram negative bacteria were the most common bacteria found. The efficacy of using ceftriaxone as empirical therapy needs to be reviewed.

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Pattern of antibiotic resistance of various strains of bacteria causing acute tonsillitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212122 ◽

2021 ◽

Vol 7 (6) ◽

pp. 994

Author(s):

N. Jyothsna ◽

A. Ramya ◽

K. Abhilash ◽

Bathsa Liza Johnson

Keyword(s):

Antibiotic Resistance ◽

Bacterial Growth ◽

Bacterial Strain ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Acute Tonsillitis ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Antibiotic Drugs ◽

Significant Difference

Background: Our study was done to determine the pattern of antibiotic resistance of various strains of bacteria causing acute tonsillitis.Methods: the study was a randomized cross sectional study. Patients matching the inclusion criteria were included. Duration of study was 6 months.Results: Out of 120 cases, 46 cases showed no bacterial growth (NBG) and 74 cases showed bacterial growth. 42 cases were gram-negative bacterial strain and 32 cases were positive bacterial strain out of 72 bacterial grown cases. A list of 25 antibiotic drugs in gram-negative and 31 drugs in gram-positive strain, their sensitivity and resistance were taken and noted. Among gram-negative bacteria imipenem (71.4%) showed highest sensitivity. Highest antibiotic resistance was seen in ampicillin (85.71%). Least sensitivity is observed in clindamycin, amoxicillin+clavulanic acid with 2.38%. Among gram-positive bacteria, highest sensitivity was noted in cefotaxime (75%). Highest antibiotic resistance was seen in cotrimoxazole (46.8%). Least sensitivity is observed in netilmicin, sulbactam with 3.12%.Conclusions: The number of drugs resistant to the gram-positive bacteria are lesser than number of drugs sensitive, which showed significant difference (p<0.05). Significant difference of antibiotic drugs was not found in gram-negative bacteria. Our study findings helped in appropriate and guarded use of the antibiotic drugs in acute tonsillitis, minimizing the exposure of individuals to antibiotic resistance by choosing an appropriate sensitive drug, therefore improving the quality of therapy.

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Recalibration of the Antimicrobial MIC

Journal of Clinical and Laboratory Research ◽

10.31579/2768-0487/021 ◽

2021 ◽

Vol 2 (4) ◽

pp. 01-02

Author(s):

Daniel Amsterdam

Keyword(s):

Antibiotic Resistance ◽

The United States ◽

World Health ◽

Gram Negative Bacteria ◽

Antibiotic Resistant ◽

Gram Negative ◽

Gram Positive Bacteria ◽

The World ◽

Health Organization ◽

Laboratory Assay

In 2009, the World health organization (WHO) referred to the problem of antibiotics and antibiotic resistance stating, “Antibiotic Resistance – one of the three greatest threats to human health.” In 2019 (i.e., just as the COVID-19 pandemic was evolving), more than 2.8 million antibiotic-resistant infections were identified in the United States, resulting in more than 35,000 deaths (CDC 2019). The initial laboratory assay which demonstrated the activity of an antibacterial compound was performed by Alexander Fleming. He showed that an extract from the mold, Penicillium rubens, could inhibit the growth of several species of Gram-positive bacteria – but not Gram-negative bacteria that were cross-streaked on agar against the diffused Penicillium compound.

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Antibiotic resistance pattern in intensive care unit of a tertiary care teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20181633 ◽

2018 ◽

Vol 7 (5) ◽

pp. 906

Author(s):

Amit Bhatia ◽

Juhi Kalra ◽

Saurabh Kohli ◽

Barnali Kakati ◽

Reshma Kaushik

Keyword(s):

Intensive Care Unit ◽

Drug Resistance ◽

Antibiotic Resistance ◽

Intensive Care ◽

Teaching Hospital ◽

Tertiary Care ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents.

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Antibiotic resistance pattern of bacterial isolates retrieved from febrile neutropenic patients with hematological disorders

10.21203/rs.3.rs-24936/v1 ◽

2020 ◽

Author(s):

Gayatri Prajapati ◽

Bishesh Sharma Poudyal ◽

Krishna Kumar Maharjan ◽

Sunita Prajapati ◽

Janak Raj Dhungana

Keyword(s):

Staphylococcus Aureus ◽

Antibiotic Resistance ◽

Effective Treatment ◽

Resistance Pattern ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Hematological Disorders ◽

Gram Positive Bacteria ◽

Neutropenic Patients

Abstract Background Antibiotic resistance is nowadays becoming a threat in the treatment of immunosuppressed patients. The aim of this study was to find out the antibiotic resistance pattern of bacteria isolated from febrile neutropenic patients with hematological disorders so that it would help to select the empirical antibiotic for prompt effective treatment of the febrile neutropenic patients. Methods A cross-sectional descriptive study was conducted at a tertiary care hospital of Nepal from October 2018 to November 2019. Blood was drawn aseptically in blood culture bottles. The bacteria were identified by standard microbiological methods with observation of colony morphology, gram staining and biochemical tests of bacteria. The antibiotic susceptibility tests were done by Kirby Bauer disc diffusion method. Extended Spectrum Beta Lactamase (ESBL) and Metallo Beta Lactamase (MBL) producers, and Methicillin Resistant Staphylococcus aureus (MRSA) were detected by phenotypic methods. Results Of the total 214 blood samples, 33.9% (71) yielded the bacterial growth. Gram negative bacteria were isolated from 23.8% of total samples and Gram-positive bacteria were isolated from 9.3% of the total samples. The Gram negative bacteria isolated were Escherichia coli (7.9%), Klebsiella pneumoniae (4.7%), Citrobacter spp. (4.7%), Acinetobacter spp. (3.7%) and Pseudomonas aeruginosa (2.8%). The Gram-positive bacteria isolated were Staphylococcus aureus (5.6%), Coagulase Negative Staphylococcus (2.3%) and Enterococcus spp. (1.4%). About 66.7% of the total Gram-negative bacteria isolated and 50% of the total Gram-positive bacteria were MDR (Multidrug-resistant). About 19.6% of the total Gram-negative bacteria were ESBL producers and 19.6% of them were MBL producers. About 41.6% of Staphylococcus aureus isolated were MRSA (Methicillin Resistant S. aureus). In our institution, piperacillin-tazobactam is the preferred first choice empirical antibiotic. But 58.8% of the Gram negative organisms were found to be resistant towards piperacillin-tazobactam. Hence there is a prompt necessity to switch to another antibiotic with high sensitivity for effective treatment of the febrile neutropenic patients in our institution. Conclusion Antibiotic surveillance data should be evaluated periodically to select the empirical therapeutic antibiotic for effective treatment of febrile neutropenic patients.

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Deep tissue culture and hemoculture in dogs with wounds and sepsis

Pesquisa Veterinária Brasileira ◽

10.1590/s0100-736x2017001200020 ◽

2017 ◽

Vol 37 (12) ◽

pp. 1483-1490

Author(s):

Mônica V. Bahr Arias ◽

Flávia N. Padilha ◽

Marcia R.E. Perugini

Keyword(s):

Patient Survival ◽

Punch Biopsy ◽

Microbial Culture ◽

Gram Negative Bacteria ◽

Deep Tissue ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Enterococcus Spp ◽

Infected Wounds ◽

Staphylococcus Spp

ABSTRACT: Contaminated and infected wounds occur very frequently in veterinary medicine and can cause systemic inflammatory response syndrome, sepsis, and death. This study aimed to test the feasibility of collecting wound material by deep-tissue or punch biopsy for microbial culture, determine the frequency of bacteria in the wound(s) and blood cultures and the susceptibility of these microbes to antimicrobials, and evaluate clinical parameters that could be related to prognosis. Thirty dogs with wounds and signs of SIRS/sepsis were included in this study. Bacteria were isolated from all wounds and 41 bacterial isolates could be identified based on culture of the materials collected by punch biopsy; 53.66% of the isolates were gram-negative, mainly involving Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus spp., and 46.34% were gram-positive bacteria such as Streptococcus spp., Enterococcus spp., and Staphylococcus spp. The survival rate was 66.67%. Based on blood culture analysis, we identified bacteremia in seven patients, predominantly of gram-negative bacteria, which negatively affected patient survival, as six dogs died. Hypoglycemia (≤60mg/dL) and severe hyperglycemia (≥180mg/dL) also negatively affected survival as 23.33% of the hypo/hyperglycemic dogs died. Factors such as blood lactate level at admission and hematocrit levels, and mean arterial pressure were not significantly correlated with death or survival of the dogs.

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Survey on bacterial contamination of bidet toilets and relation to the interval of scrubbing these units

Journal of Water and Health ◽

10.2166/wh.2019.234 ◽

2019 ◽

Vol 17 (6) ◽

pp. 863-869

Author(s):

Akira Tsunoda ◽

Yoshihito Otsuka ◽

Akihiro Toguchi ◽

Kumiko Watanabe ◽

Ryou Nishino ◽

...

Keyword(s):

Escherichia Coli ◽

Bacterial Contamination ◽

District Hospital ◽

Gram Negative Bacteria ◽

Candida Spp ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Wide Range ◽

Enterococcus Spp ◽

Staphylococcus Spp

Abstract We conducted a survey to investigate the distribution of bacteria recovered from the bidet toilets at a district hospital. The nozzle surface and spray water of 192 bidet toilets were sampled for contamination. Of the 192 toilets sampled, the nozzle surface of 167 (87%) and the spray water of 181 (94%) were found to be contaminated by one or more of the following organisms: Enterobacteriaceae, Enterococcus spp., Staphylococcus spp., non-glucose-fermenting rods, other Gram-negative bacteria, other Gram-positive bacteria, and Candida spp. An extended spectrum of β-lactamase producing Escherichia coli was found in one nozzle surface and one spray water. The frequency of colonization with 104 or more recovered from the nozzle surface was significantly greater in the toilets scrubbed every week than that in the units scrubbed every day, but that from the spray water was not significantly different between the groups. The nozzle surface and the spray water in the bidet toilets were contaminated with a wide range of bacteria. Because the interval of scrubbing the toilets did not have an influence on the contamination of the spray water, self-cleaning mechanisms of spray water should be developed to prevent patients' possible infections.

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Conjugative Plasmid Transfer in Gram-Positive Bacteria

Microbiology and Molecular Biology Reviews ◽

10.1128/mmbr.67.2.277-301.2003 ◽

2003 ◽

Vol 67 (2) ◽

pp. 277-301 ◽

Cited By ~ 373

Author(s):

Elisabeth Grohmann ◽

Günther Muth ◽

Manuel Espinosa

Keyword(s):

Antibiotic Resistance ◽

Plasmid Transfer ◽

Translocator Protein ◽

Conjugative Plasmid ◽

Gram Negative Bacteria ◽

Secretion Systems ◽

Gram Positive ◽

Severe Problem ◽

Gram Negative ◽

Gram Positive Bacteria

SUMMARY Conjugative transfer of bacterial plasmids is the most efficient way of horizontal gene spread, and it is therefore considered one of the major reasons for the increase in the number of bacteria exhibiting multiple-antibiotic resistance. Thus, conjugation and spread of antibiotic resistance represents a severe problem in antibiotic treatment, especially of immunosuppressed patients and in intensive care units. While conjugation in gram-negative bacteria has been studied in great detail over the last decades, the transfer mechanisms of antibiotic resistance plasmids in gram-positive bacteria remained obscure. In the last few years, the entire nucleotide sequences of several large conjugative plasmids from gram-positive bacteria have been determined. Sequence analyses and data bank comparisons of their putative transfer (tra) regions have revealed significant similarities to tra regions of plasmids from gram-negative bacteria with regard to the respective DNA relaxases and their targets, the origins of transfer (oriT), and putative nucleoside triphosphatases NTP-ases with homologies to type IV secretion systems. In contrast, a single gene encoding a septal DNA translocator protein is involved in plasmid transfer between micelle-forming streptomycetes. Based on these clues, we propose the existence of two fundamentally different plasmid-mediated conjugative mechanisms in gram-positive microorganisms, namely, the mechanism taking place in unicellular gram-positive bacteria, which is functionally similar to that in gram-negative bacteria, and a second type that occurs in multicellular gram-positive bacteria, which seems to be characterized by double-stranded DNA transfer.

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Catheter-related bloodstream infections: predictive factors for Gram-negative bacteria aetiology and 30 day mortality in a multicentre prospective cohort

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/dkaa262 ◽

2020 ◽

Vol 75 (10) ◽

pp. 3056-3061

Author(s):

Federica Calò ◽

Pilar Retamar ◽

Pedro María Martínez Pérez-Crespo ◽

Joaquín Lanz-García ◽

Adrian Sousa ◽

...

Keyword(s):

Septic Shock ◽

Protective Factors ◽

Empirical Therapy ◽

Bloodstream Infections ◽

Venous Catheter ◽

Empirical Treatment ◽

Gram Negative Bacteria ◽

Gram Negative ◽

Gram Positive Bacteria ◽

National Cohort

Abstract Background Catheter-related bloodstream infections (CRBSIs) increase morbidity and mortality, prolong hospitalization and generate considerable medical costs. Recent guidelines for CRBSI recommend empirical therapy against Gram-positive bacteria (GPB) and restrict coverage for Gram-negative bacteria (GNB) only to specific circumstances. Objectives To investigate predictors of GNB aetiology in CRBSI and to assess the predictors of outcome in patients with CRBSI. Methods Patients with CRBSI were selected from the PROBAC cohort, a prospective, observational, multicentre national cohort study including patients with bloodstream infections consecutively admitted to 26 Spanish hospitals in a 6 month period (October 2016–March 2017). Outcome variables were GNB aetiology and 30 day mortality. Adjusted analyses were performed by logistic regression. Results Six hundred and thirty-one episodes of CRBSI were included in the study. Risk factors independently related to GNB aetiology were central venous catheter (CVC) [OR 1.60 (95% CI: 1.05–2.44), P = 0.028], sepsis/septic shock [OR: 1.76 (95% CI: 1.11–2.80), P = 0.016], antibiotic therapy in the previous 30 days [OR: 1.56 (95% CI: 1.02–2.36), P = 0.037], neutropenia <500/μL [OR: 2.01 (95% CI: 1.04–3.87), P = 0.037] and peripheral vascular disease [OR: 2.04 (95% CI: 1.13–3.68), P = 0.018]. GNB were not associated with increased mortality in adjusted analysis, while removal of catheter [OR: 0.24 (95% CI: 0.09–0.61), P = 0.002] and adequate empirical treatment [OR: 0.37 (95% CI: 0.18–0.77), P = 0.008] were strong protective factors. Conclusions Our study reinforces the recommendation that empirical coverage should cover GNB in patients presenting with sepsis/septic shock and in neutropenic patients. Catheter removal and adequate empirical treatment were both protective factors against mortality in patients with CRBSI.

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Comment on “the IS6 family, a clinically important group of insertion sequences including IS26” by Varani and co-authors

Mobile DNA ◽

10.1186/s13100-021-00257-9 ◽

2022 ◽

Vol 13 (1) ◽

Author(s):

Ruth M. Hall

Keyword(s):

Antibiotic Resistance ◽

Insertion Sequence ◽

Antibiotic Resistance Genes ◽

Insertion Sequences ◽

Gram Negative Bacteria ◽

Mobile Dna ◽

Gram Negative ◽

Gram Positive Bacteria ◽

Important Group ◽

Recent Demonstration

AbstractThe insertion sequence IS26 has long been known to play a major role in the recruitment of antibiotic resistance genes into the mobile resistance gene pool of Gram-negative bacteria and IS26 also plays a major role in their subsequent broad dissemination. Related IS, IS431/257 and IS1216 are important in the same roles in Gram positive bacteria. However, until recently the properties of IS26 movement that could potentially explain this ability had not been explored. A much needed insight has come from our recent demonstration that IS26 uses a novel targeted mechanism that is conservative. The targeted conservative mechanism is much more efficient than the known replicative mechanism, which is now more accurately called copy-in. A recent review “The IS6 family, a clinically important group of insertion sequences including IS26” by Varani, He, Siguier, Ross and Chandler published in Mobile DNA has substantially misrepresented the recent studies on the targeted conservative mechanism and at the same time incorrectly implied that any mechanism established for IS26 can be assumed to apply to a range of IS that are at best very distantly related. A few of the most important issues are examined in this comment. Readers are advised to consult the original literature to check facts before drawing firm conclusions.

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Rapid demonstration of septic or infectious arthritis due to Gram-negative bacteria

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100123830 ◽

1992 ◽

Vol 50 (1) ◽

pp. 686-687

Author(s):

Jacob S. Hanker ◽

Paul R. Gross ◽

Beverly L. Giammara

Keyword(s):

Chronic Arthritis ◽

Blood Cultures ◽

Gram Negative Bacteria ◽

Infectious Arthritis ◽

Bacterial Arthritis ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria

Blood cultures are positive in approximately only 50 per cent of the patients with nongonococcal bacterial infectious arthritis and about 20 per cent of those with gonococcal arthritis. But the concept that gram-negative bacteria could be involved even in chronic arthritis is well-supported. Gram stains are more definitive in staphylococcal arthritis caused by gram-positive bacteria than in bacterial arthritis due to gram-negative bacteria. In the latter situation where gram-negative bacilli are the problem, Gram stains are helpful for 50% of the patients; they are only helpful for 25% of the patients, however, where gram-negative gonococci are the problem. In arthritis due to gram-positive Staphylococci. Gramstained smears are positive for 75% of the patients.

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