scholarly journals Phenotypic Characterisation, Virulence Determination and Antimicrobial Resistance Pattern of Enterococcus Species Isolated from Clinical Specimen in a Tertiary Care Hospital in Kolkata

2021 ◽  
Author(s):  
Subhendu Sikdar ◽  
Sampa Sadhukhan ◽  
Amit Kumar Majumdar ◽  
Somnath Bhunia ◽  
Soma Sarkar ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Clinical Specimen ◽  
High Rate ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Cross Sectional ◽  
Clinical Specimens ◽  
Phenotypic Characterisation ◽  
High Level

Introduction: Enterococci are usually normal human commensal of gastrointestinal tract predominantly. They are considered as an important nosocomial pathogen now a day due to its intrinsic as well as increasing acquired antibiotic resistance resulting in a great threat to modern Medicine. Aim: To determine prevalence of Enterococci isolated from clinical specimens with special reference to its virulence and antibiogram conventionally. Materials and Methods: A cross-sectional observational study was conducted over a period of two years (January 2019 to December 2020) with 326 Enterococci, isolated from various clinical specimens received by Department of Microbiology. Enterococci isolated from stool samples were excluded. They were identified and speciated conventionally as per standard laboratory protocol. Gelatinase, haemolysin and biofilm formation was determined for each isolate. Their antibiogram was also determined by disc diffusion methods over Blood agar followed by Minimum Inhibitory Concentration (MIC) testing (as per Clinical and Laboratory Standards Institute (CLSI) guideline). All statistical analysis was done by Chi-square test using Software Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Among the total 4516 samples collected, growth of Enterococci was noted in 7.22% cases. Out of them, E. faecalis (84.05%) out numbered E. faecium. Urine was the most predominant (55.22%) sample. 73.93% isolates produced biofilm whereas 18.40% produced haemolysin and 19.94% produced gelatinase. Most of the isolates were susceptible to vancomycin (94.79%) and linezolid (98.77%). High level gentamicin resistance was seen in 54.6% cases. Ciprofloxacin was the most resistant antibiotic. Vancomycin Resistance Enterococcus (VRE) was detected in 5.21% cases only, out of which Van A type was detected phenotypically in most cases. Conclusion: The high rate of resistance to high-level gentamicin could fail treatment of gentamicin in combination with penicillin group of antibiotics. In clinical samples, the emergence of VRE strains makes treatment options more challenging.

scholarly journals Anti-microbial sensitivity and resistance of organisms in blood-culture samples from prolonged fever cases: evidence from a tertiary care hospital in West Bengal, India

2018 ◽  
Vol 7 (11) ◽  
pp. 2173
Author(s):  
Somanjana Ghosh ◽  
Arista Lahiri ◽  
Siddhartha Bera ◽  
Soumyajyoti Bandyopadhyay
Keyword(s):  
Blood Culture ◽  
Tertiary Care ◽  
Systemic Infection ◽  
Cross Sectional Study ◽  
Background Information ◽  
Resistance Pattern ◽  
Coagulase Negative Staphylococcus ◽  
Care Hospital ◽  
Cross Sectional ◽  
High Level

Background: Currently there is a rise in resistance to anti-microbials which is a matter of concern in treatment of systemic infections. Blood culture is considered “gold standard” in diagnosis of suspected systemic infection. The susceptibility to antibiotics thereafter determine the future course of treatment. The current study aims to find out the sensitivity and resistance pattern of the blood culture isolates.Methods: A cross-sectional study was performed on the blood culture samples sent within 24hours of admission of the adult patients reporting fever for 7 days or more with no history of consumption of any antibiotics within last month. Total 134 blood samples were analysed. The proportion of sensitivity and resistance to anti-bacterial agents was calculated among those samples which showed growth in the culture. Background information of the patients in terms of age, sex and religion were also noted.Results: Mean age of the patients was 39.33 (±12.19) years. Overall 47.76% were female patients and remaining were male. Among the Hindu patients majority were male while among Muslims majority were female. Of the total number of blood cultures examined 46.27% showed growth of bacteria. Staphylococcus aureus was the most frequently found bacteria isolated in cultures, followed by coagulase negative Staphylococcus and Pseudomonas. Of the frequently used antibiotics, higher sensitivity was seen with vancomycin, amikacin, netilmycin, imipenem, gentamicin. High resistance was observed in use of antibiotics like cefixime, amoxicillin-clavulanic acid and azithromycin.Conclusions: High level of resistance to several commonly used advanced antibiotics warrant judicial and evidence-based use of these drugs. 

scholarly journals MUPIROCIN RESISTANCE IN STAPHYLOCOCCUS AUREUS IN A TERTIARY CARE HOSPITAL OF SOUTH INDIA – A PROSPECTIVE STUDY

2019 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Malavalli Venkatesh Bhavana ◽  
Sangeeta Joshi ◽  
Ranjeeta Adhikary ◽  
Hosdurg Bhaskar Beena
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Resistant Strains ◽  
Mupirocin Resistance ◽  
High Level ◽  
A Prospective Study ◽  
Level Resistance

Objective: Mupirocin is a topical antibiotic used for the treatment of skin and soft tissue infections caused by Staphylococcus aureus and for the nasal decolonization of methicillin-resistant S. aureus (MRSA). The increasing reports of resistance to mupirocin are a matter of concern. We undertook this study to detect and differentiate the mupirocin resistance pattern and to analyze the susceptibility pattern among S. aureus isolates of our hospital.Methods: This is a prospective laboratory-based study conducted during the period May–September 2014. Clinical samples that grew S. aureus during the study period were tested for mupirocin resistance using the 5 μg and 200 μg discs. Minimum inhibitory concentration (MIC) detection of resistant strains was performed using the E-test.Results: Mupirocin resistance was seen in 4.81% of our S. aureus isolates; all of which exhibited high-level resistance with MIC ≥1024 μg/ml.Conclusions: The resistance is bound to rise with the increased usage of mupirocin; regular testing will help in tackling this upcoming problem and in preserving this important antibiotic against MRSA.

scholarly journals MUPIROCIN RESISTANCE IN STAPHYLOCOCCUS AUREUS IN A TERTIARY CARE HOSPITAL OF SOUTH INDIA – A PROSPECTIVE STUDY

2019 ◽  
Vol 12 (1) ◽  
pp. 98
Author(s):  
Malavalli Venkatesh Bhavana ◽  
Sangeeta Joshi ◽  
Ranjeeta Adhikary ◽  
Hosdurg Bhaskar Beena
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Resistant Strains ◽  
Mupirocin Resistance ◽  
High Level ◽  
A Prospective Study ◽  
Level Resistance

Objective: Mupirocin is a topical antibiotic used for the treatment of skin and soft tissue infections caused by Staphylococcus aureus and for the nasal decolonization of methicillin-resistant S. aureus (MRSA). The increasing reports of resistance to mupirocin are a matter of concern. We undertook this study to detect and differentiate the mupirocin resistance pattern and to analyze the susceptibility pattern among S. aureus isolates of our hospital.Methods: This is a prospective laboratory-based study conducted during the period May–September 2014. Clinical samples that grew S. aureus during the study period were tested for mupirocin resistance using the 5 μg and 200 μg discs. Minimum inhibitory concentration (MIC) detection of resistant strains was performed using the E-test.Results: Mupirocin resistance was seen in 4.81% of our S. aureus isolates; all of which exhibited high-level resistance with MIC ≥1024 μg/ml.Conclusions: The resistance is bound to rise with the increased usage of mupirocin; regular testing will help in tackling this upcoming problem and in preserving this important antibiotic against MRSA.

scholarly journals Characterization, speciation and antimicrobial resistance pattern of Enterococcus species isolated from clinical specimens at a rural tertiary care hospital

2017 ◽  
Vol 5 (8) ◽  
pp. 3484
Author(s):  
Shweta Jaiswal ◽  
Amit Singh ◽  
Rajesh K. Verma ◽  
Dharmendra P. Singh ◽  
Sunita Kumari
Keyword(s):  
Tertiary Care ◽  
Vancomycin Resistance ◽  
High Rate ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Antimicrobial Susceptibility Pattern ◽  
Resistance To Penicillin

Background: Enterococci have attracted much attention in recent years due to their increased recognition as a cause of nosocomial infection. They exhibit vancomycin resistance with increasing frequency so that determination of antimicrobial susceptibility pattern is necessary. Aim of present study is to determine the prevalence and susceptibility pattern of Enterococci in rural tertiary care hospital.Methods: Total of 100 Enterococcus isolated from various clinical samples were identified and speciated by Vitek®2 compact system (BIOMERIEUX). Antibiotic susceptibility was determined by modified Kirby Bauer disc diffusion method. Results were interpreted as per CLSI guidelines and vancomycin MIC was determined by E-test method.Results: Out of 100 Enterococcus strains 47 were E. faecalis, 51 were E. faecium, 02 were E. gallinarum and 01 was E. cassaliflavus. Resistance to penicillin, ampicillin, ciprofloxacin, elevated level gentamycin and high-level streptomycin were observed. All isolates were sensitive to linezolid and teicoplanin, 6% strains showed vancomycin resistance by E-test.Conclusions: High rate of resistance to penicillin, ciprofloxacin and aminoglycosides is observed and emergence of VRE has further worsened this situation. So, there is an urgent need for more rational use of antimicrobials and infection control.

scholarly journals Burden of Shigella spp and Vibrio spp, and their antibiotic sensitivity pattern in the patients with acute gastroenteritis in tertiary care hospital in Nepal

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Shiv Kumar Sah ◽  
Shreejana Basnet ◽  
Sushma Shrestha ◽  
Kusum Ghale ◽  
Sabita Tamang ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Nalidixic Acid ◽  
Acute Gastroenteritis ◽  
Tertiary Care ◽  
High Rate ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Cross Sectional ◽  
Vibrio Cholera ◽  
Sensitivity Pattern

Abstract Objectives The present study aims to investigate the etiology, clinical profile and resistance pattern of the isolated pathogens in Nepalese adults with acute gastroenteritis. This cross-sectional study was conducted at Sukraraj Tropical and Infectious Disease Hospital, from April 2016 to Sep 2017. Subjects’ ages 14 or above, presenting with gastroenteritis with positive stool culture were enrolled for analysis. Results Of total 153 patients, 47.72% subjects confirmed the presence of bacterial infection. Vibrio cholerae spp and Shigella spp were detected in 36.6% and 23.28% respectively. The most common resistance among Vibrio cholerae was to nitrofurantoin (92.8%), cotrimoxazole (92.8%) and nalidixic acid (92.8%). Among 17 isolates of Shigella spp, the most frequent drug resistant was observed in ampicillin (64.7%), nalidixic acid (58.8%), ceftriaxone (47%). Chloramphenicol (94.1%), tetracycline (88.2%), and cotrimoxazole (82.3%) were found to be the most sensitive towards this pathogen. High rate of diarrhea due to bacterial infection, especially Shigella spp and Vibrio spp and their high rate of drug resistance emphasize an urgent need of designing a surveillance system for antimicrobial resistance in Nepalese setting.

scholarly journals Antibiotic Susceptibility Pattern of Nosocomial Isolates of Staphylococcus aureus in a Tertiary Care Hospital, Nepal

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Bidya Shrestha ◽  
B M Pokhrel ◽  
T M Mohapatra
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Test Method ◽  
University Teaching ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Biochemical Tests ◽  
Methicillin Resistant

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), the most common cause ofnosocomial infection has been a major cause of morbidity and mortality around the world. They arenormally resistant to most of the antibiotics used in clinical practice. This study has been carried outto fi nd out the resistance pattern among S. aureus.Methods: During November 2007 to June 2008, clinical samples from patients with nosocomialinfection were processed for culture and sensitivity following standard methodology in microbiologylaboratory, Tribhuvan University teaching hospital, Kathmandu, Nepal.Results: Among 149 Staphylococcus aureus isolates, highest resistance was observed against Penicillin(91.94%) followed by Fluoroquinolone (61.74%), Erythromycin (52.94%), Gentamicin (46.98%),Cotrimoxazole (42.95%), Tetracycline (40.94%) and others, whereas susceptibility was observedmaximum against Chloramphenicol (94.85%) followed by Rifampicin (92.61%), Tetracycline(59.06%), Cotrimoxazole (57.04%), and others. None of the isolates were resistant to Vancomycinand Teicoplanin. Of these isolates 44.96 % of the isolates were Methicillin resistant S. aureus (MRSA).Resistance to Penicillin, Fluoroquinolone, Erythromycin, Gentamicin, Co-trimoxazole and Tetracyclinewere associated signifi cantly with MRSA isolates (X2= 8.779, p<0.05, X2= 74.233, p<0.05, X2= 84.2842,p<0.05, X2= 108.2032, p<0.05, X2= 88.1512, p<0.05 and X2= 79.1876, p<0.05 respectively). Althoughmost of the Methicillin sensitive S. aureus (MSSA) isolates were susceptible to both Rifampicinand Chloramphenicol, only Rifampicin susceptibility was signifi cantly associated with them (X2=10.1299, p<0.05). Among three Biochemical tests for the detection of β lactamase detection namelychromogenic, iodometric and acidimetric test, chromogenic test method had highest sensitivity andspecifi city.Conclusions: Since MRSA comprised a greater part of S. aureus isolates and were multi-resistant,patients infected by such strains should be identifi ed and kept in isolation for hospital infectioncontrol and treated with second line of drug like vancomycin.Key Words: β lactamase, methicillin resistant Staphylococcus aureus,methicillin sensitive Staphylococcus aureus, resistance pattern

scholarly journals Detection of bla NDM-1 Encoding Imepenemase among the Imipenem-Resistant Gram-Negative Bacilli Isolated from Various Clinical Samples at a Tertiary Care Hospital of Eastern Nepal: A Descriptive Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
S. Gautam ◽  
N. R. Bhattarai ◽  
K. Rai ◽  
A. Poudyal ◽  
B. Khanal
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Clinical Samples ◽  
Care Hospital ◽  
Disc Diffusion ◽  
Diffusion Test ◽  
Cross Sectional ◽  
Gram Negative ◽  
Synergy Test

Background. Carbapenem resistance among Gram-negative isolates caused by the production of the metallo-β-lactamase (MBL) enzyme is being increasingly reported worldwide. One of the newly emerged metallo-β-lactamases is New Delhi metallo-β-lactamase. Data regarding its occurrence in hospital setting and percentage prevalence among different Gram-negative bacterial isolates are lacking in our part. This study has been undertaken for determining the presence of the bla NDM-1 gene among the clinical isolates of imipenem-resistant Gram-negative bacteria in a tertiary care center in Dharan, Nepal. Methods. A total of 75 imipenem-resistant Gram-negative isolates were studied. These were screened for metallo-β-lactamase (MBL) production by phenotypic assays such as double-disc synergy test (DDST) and combined disc diffusion test (CDDT). PCR was performed for the molecular detection of gene NDM-1. Ten-disc method was performed to detect the presence of ESBL, AmpC, carbapenamase, and K1 β-lactamase production. Results. Using the molecular method, bla NDM-1 was detected in 36% of the isolates. Phenotypically, double-disc synergy test (DDST) and combined disc diffusion test (CDST) detected MBL production in 38.7% and 37.3% of the isolates, respectively. Ten-disc method detected ESBL in 26.6% of the isolates, but none of the isolates was found to be AmpC, carbapenamase, and K1 β-lactamase producers. Conclusion. A high percentage of the NDM-1 producer was noted among imipenem-resistant GNB. Apart from performing only antimicrobial sensitivity test, phenotypic and molecular screening should be employed to find out the actual number of metallo-β-lactamase producers and the existence of the resistance gene.

scholarly journals Antimicrobial Resistance Patterns in Clinically Significant Isolates from Medical Wards of a Tertiary Care Hospital in North India

2020 ◽  
Vol 12 (03) ◽  
pp. 196-202
Author(s):  
Venkatesh Sudharsan Vaithiyam ◽  
Neha Rastogi ◽  
Piyush Ranjan ◽  
Niranjan Mahishi ◽  
Arti Kapil ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
North India ◽  
Resistance Pattern ◽  
Resistant Organism ◽  
Care Hospital ◽  
Cross Sectional ◽  
Drug Resistance Pattern ◽  
Clinically Significant ◽  
Medical Wards

Abstract Background The global burden of infections due to multidrug-resistant organism (MDRO) has a significant impact on patients’ morbidity and mortality along with increased healthcare expenditure. Aim This article estimates the prevalence of MDRO and the spectrum of clinical infectious syndromes caused by these organisms in medical wards of a tertiary care hospital in India. Design and Methods A cross-sectional observational study was performed among patients admitted in medicine wards diagnosed with the various infectious syndromes and one or more clinically significant positive culture at a tertiary care hospital in North India over a period of 18 months. Results Out of 323 clinically significant microbiological culture isolates from 229 patients included in the study, 86 (27%) isolates showed multidrug resistance (MDR) pattern, 197 (61%) isolates showed possible extremely drug-resistance pattern, and only 40 (12%) isolates showed nonmultidrug-resistance pattern of antibiogram. Conclusion The prevalence of MRDOs is high in clinically significant culture isolates from medicine wards in India. This emphasizes the importance of appropriate antibiotic usage and implementation of antibiotic stewardship programs in this part of the world.

scholarly journals A study on the bacterial isolates from blood cultures of a tertiary care hospital

2021 ◽  
Vol 7 (3) ◽  
pp. 171-174
Author(s):  
KMS Mohamed Ali ◽  
K Girija
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Bacterial Isolates ◽  
Tertiary Care Centre ◽  
Sensitivity Testing ◽  
Cross Sectional ◽  
Blood Samples

Blood stream infections are the most important and common cause of morbidity and mortality in tertiary care hospitals. Since the results are usually not available promptly a knowledge of epidemiologic and antimicrobial susceptibility pattern of blood pathogens is life saving and very useful for early treatment and recovery of patients. The aim of this study is to describe the epidemiological, bacterial profile and antimicrobial resistance pattern of bloodstream infections in a tertiary care centre.A prospective cross-sectional study was done on seven hundred and eight blood samples collected over a period of six months in the Microbiology laboratory. Blood samples collected under aseptic conditions were cultured by aerobic culture method. Identification of bacterial isolates were done using standard bacteriologic and biochemical testing methods and antibiotic sensitivity testing done by Kirby - Bauer disc diffusion method.Bacteria was isolated in 201 (28.3%) samples with highest rates among newborns 84(41.8%). The most frequent isolates were 111 (55.2%) followed by 49 (24.4%). Results showed high susceptibilities of CoNS 111 (100%) to Vancomycin, Linezolid and 51 (98%) to Meropenem. This study highlights the common prevalent bacteriological agents in bacteremia, their antibiotic susceptibility & resistance patterns. and multi drug resistant were the leading causes of septicaemia in our hospital with Vancomycin, Linezolid and Carbapenems the effective antibiotics against these pathogens respectively.

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