scholarly journals MOLECULAR CHARACTERIZATION OF EXTENDED-SPECTRUM Β- LACTAMASES PRODUCING CTX-M-15 FROM GRAM NEGATIVE BACTERIA ISOLATED FROM PEDIATRIC AND NEONATAL INTENSIVE CARE UNIT

2012 ◽  
Vol 4 (2) ◽  
pp. 160-163
Author(s):  
JADHAV SV ◽  
◽  
JADHAV R ◽  
GANDHAM N ◽  
MISRA R ◽  
...  
Author(s):  
Ika Puspita Sari ◽  
Titik Nuryastuti ◽  
Djoko Wahyono

Objective: Multidrug-resistance (MDR) is defined as an acquired non-susceptibility to at least one agent in three or more antimicrobial categories. MDR can be caused by several factors, including the misuse of antibiotics.  Resistance to antibiotics still poses a global challenge, especially in Indonesia. This study aimed to identify patterns of MDR in Neonatal Intensive Care Unit (NICU) at the Central Java Hospital, during the period of January 2014 to December 2015.Methods: The study was conducted using a descriptive retrospective design. The research population comprised of 225 patients. Patient inclusion criteria were neonatal patients treated in NICU ward with infection diagnosis. All patients had culture and sensitivity examinations on their bloods. The culture and sensitivity examinations were performed by microbiology clinicians.Results: The most common infection type was sepsis (60%). The most common bacteria found in the blood specimen of patients in the NICU ward was Gram-negative bacteria with a 72% rate, the other was Gram-positive bacteria. Bacteria which infected patients include; Klebsiellapneumoniaessppneumoniae, Pseudomonas aeruginosa, Bulkholderiacepacia, Acinetobacterbaumannii, Enterobactercloacae ssp cloacae, Serratiamarcescens, Staphylococcus haemolyticusand Staphylococcus epidermidis. The research result showed that 97.8% MDR cases were reported in the NICU ward. Antibiotics which were still potent for all bacteria found in NICU patients were tigecycline, meropenem and ciprofloxacin (for Gram-negative bacteria) and tigecycline, linezolid, nitrofurantoin, moxifloksacin and vancomycin (for Gram-positive bacteria).Conclusion: A high percentage of MDR occurred in NICU patients. Sepsis is the most common diagnosis in NICU patients. The usage of third generation antibiotics should be limited and regulated systematically.   


2020 ◽  
Vol 24 (3) ◽  
pp. 219-224
Author(s):  
Saba Mushtaq ◽  
Sohail Ashraf ◽  
Lubna Ghazal ◽  
Rida Zahid ◽  
Basharat Hussain ◽  
...  

Introduction: Neonatal sepsis is a clinical syndrome characterized by multiple symptoms and signs of infection during the first month of life. The objective of this study is to determine the frequency of commonly isolated bacteria from patients of neonatal sepsis and their susceptibility patterns in POF hospital at Wah. Methods: This cross-sectional study was carried out in POF Hospital Neonatal intensive care unit and Microbiology laboratory from January 2018 to December 2019. The blood samples of patients suspected with neonatal sepsis were processed as per standard methodology. Results: Out of ninety blood samples, fifty-one (56.7%) yielded the growth of Gram-negative rods and thirty-nine (43.3%) yielded Gram-positive cocci. Among Gram-positive bacteria, coagulase-negative staphylococci were the most common pathogen isolated from 53.8% cases followed by methicillin-resistant Staphylococcus aureus (15.3%). Among Gram-negative bacteria, Klebsiella pneumoniae (54.90%) was the most frequently identified bacteria followed by Serratia marcescens (27.45%). The Gram-positive cocci were the most susceptible to linezolid (100%) followed by vancomycin (87.2%). The Gram-negative rods depict remarkable resistance to ciprofloxacin (92.2%), gentamicin (100%), and meropenem (54.9%). Conclusions: The study concluded a predominance of Gram-negative bacteria as a causative agent of neonatal sepsis in our setup. The bacterial isolates are highly resistant to commonly prescribed oral as well as injectable antibiotics. Implementation of infection control policies is a dire need to combat the grave situation of increasing antibiotic resistance.


2020 ◽  
Author(s):  
Laura Saporito ◽  
Giorgio Graziano ◽  
Federica Mescolo ◽  
Emanuele Amodio ◽  
Vincenzo Insinga ◽  
...  

Abstract Background: Antimicrobial resistance in Neonatal Intensive Care Unit (NICU) patients is a threat, due to the large use of antimicrobial treatment and invasive devices in fragile babies.Since 2014 an active surveillance program of multidrug-resistant Gram-negative bacteria (MDR-GNB) carriage is in place in the five NICUs of Palermo, Italy. In 2017 an increase in the prevalence of MDR-GNB and in particular of extended-spectrum β-lactamases-producing Klebsiella pneumoniae (ESBL-KP) was observed in “Civico” hospital NICU.Aim: To estimate the impact of a coordinated intervention strategy in achieving long-lasting reduction of MDR-GNB prevalence in the NICU.Methods: Rectal swabs were obtained monthly and processed to detect MDR-GNB using standard methods. MDR-GNB were characterized by pulsed-field gel electrophoresis (PFGE). From November 2017 the following intervention measures were applied: a) two-months strengthening of sample collection; b) stakeholders’ meetings; c) improvement of prevention measures and antimicrobial policy.Findings: During the strengthened microbiological surveillance MDR-GNB and ESBL-KP were detected in rectal swabs (34.8%; 23.2%), nasal swabs (24.6%; 14.5%), oral swabs (14.5%; 5.4%), milk samples (32.1%; 17.9%), soother swabs (30.8%; 17.9%) and from a sub-intensive room surface. Thirteen ESBL-KP strains isolated from clinical and environmental samples showed identical PFGE patterns.Prevalence of MDR-GNB and ESBL-KP carriage significantly decreased in the year after intervention compared to the previous year (20.6% vs 62.2 %; p<0.001 and 11.1% vs 57.8%; p<0.001). MDR-GNB were not detected for three months and ESBL-KP for five months. Multivariate analysis of principal exposure variables showed that admission in post-intervention period significantly reduced the risk of MDR-GNB carriage (adj-OR=0.21, 95% CI=0.076-0.629; p<0.001).Conclusions: MDR-GNB broadly circulate in NICU setting and can colonize different body sites and spread by various vehicles. A coordinated strategy of multiple interventions with active cooperation between epidemiologists and clinicians in the NICU can effectively reduce their circulation and in particular the carriage of most dangerous ESBL-KP strains.


2002 ◽  
Vol 23 (8) ◽  
pp. 447-451 ◽  
Author(s):  
Isabel Bogado ◽  
Adriana Limansky ◽  
Emma Sutich ◽  
Patricia Marchiaro ◽  
Marta Marzi ◽  
...  

Objective:To evaluate clonal dissemination of methicillin-resistant coagulase-negative staphylococci (CNS).Setting:Neonatal intensive care unit of a 180-bed, university-affiliated general hospital.Patients:Neonates admitted to the neonatal intensive care unit between March 1999 and October 2000, from whom CNS were isolated as a unique pathogen. Patients from other wards from whom epidemiologically unrelated staphylococci strains were obtained served as control-patients.Methods:Conventional methods were used for phenotypic characterization of CNS. Methicillin resistance was determined bymecA polymerase chain reaction (PCR) amplification. Genotypic characterization was done by random amplification of DNA with degenerated primers (RAPD) and repetitive element sequence-based PCR (rep-PCR).Results:Forty methicillin-resistant CNS isolates obtained from neonates were characterized asStaphylococcus epidermidis(33),S. hominis(5),S. warneri(1), andS. auricularis(1). Both RAPD and rep-PCR indicated the presence of 4 different clones among the 33S. epidermidisisolates. In turn, the 4 randomly selected, epidemiologically unrelated methicillin-resistant CNS strains obtained from control-patients showed 3 new profiles by RAPD and 2 by rep-PCR, which differed from the corresponding patterns mentioned earlier. Persistence ofS. hominisin a neonate could be assessed by both genotypic techniques.Conclusions:The molecular characterization of the methicillin-resistant CNS studied indicated dissemination of one particular methicillin-resistant CNS clone among the neonates in the ward studied. Although RAPD showed a superior power to discriminate among methicillin-resistant CNS isolates, both RAPD and rep-PCR detected intraspecific and interspecific genomic diversity.


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