NEONATAL BACTERIAL CONJUNCTIVITIS IN TERTIARY HOSPITALS IN SANA'A CITY, YEMEN

Background: Ophthalmia neonatorum (ON) is the most widespread eye infection occurring in the first 28 days of life. Although most of these cases are benign, some may progress to systemic complications or blindness if left untreated. Objectives: The current study was conducted with the aim of revealing the bacteriological causes of conjunctivitis in neonates and the antibiotic sensitivity pattern of these bacteria. Subjects and methods: The study included all neonates at the age of 1 to 28 days presenting at the neonatal nurseries with Neonatal Intensive Care Unit (NICU) and level II care beds in three hospitals; Authority of Al-Thawra General Hospital, Al-Kuwait University Hospital and Al-Sabeen Maternity and Child Hospital in Sana’a city, Yemen. A full history was taken from each nurse and mothers of the neonates included in the study in which the findings were recorded in a predesigned questionnaire including socio demographic, maternal clinical information and therapeutic interventions. To isolate the causative agent, the conjunctival swabs were inoculated on proper media and bacteria were identified by standard microbiological methods and antibiotic resistance was done for the isolates. Results: 203 swabs were collected from newborns with eye discharge over a nine-month period. Positive growth rate was 51.7%, males were more affected (57.1%), 80% of affected neonates had low birth weight, 71.4% of preterm infants were most affected (p <0.01). There was a significant relationship between invasive and non-invasive mechanical ventilation with neonatal conjunctivitis (p<0.05). Gentamicin showed good in vitro sensitivity to all bacteria isolated, Staphylococcus aureus (83%), Escherichia coli 84.6%, with P. aeruginosa it was 60%. Conclusion: The vast majority of cases of neonatal conjunctivitis were mild with a high level of occurrence, Staphylococcus aureus and Klebsiella pneumoniae were the major bacterial agents, neonatal conjunctivitis most likely to be a hospital-acquired infection. There was a significant association between phototherapy, non-invasive ventilation and incidence of neonatal conjunctivitis . Gentamicin had high activity against the bacteria isolated in this study. Peer Review History: Received: 9 November 2021; Revised: 11 December; Accepted: 27 December, Available online: 15 January 2022 Academic Editor: Dr. Sally A. El-Zahaby, Pharos University in Alexandria, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, [email protected] Dr. Jucimary Vieira dos Santos, Hemonorte Dalton Barbosa Cunha, Brazil, [email protected] Similar Articles: BACTERIAL CONJUNCTIVITIS OF ADULTS: CAUSES AND OPHTHALMIC ANTIBIOTIC RESISTANCE PATTERNS FOR THE COMMON BACTERIAL ISOLATES BACTERIAL CAUSES AND ANTIMICROBIAL SENSITIVITY PATTERN OF EXTERNAL OCULAR INFECTIONS IN SELECTED OPHTHALMOLOGY CLINICS IN SANA’A CITY

Evaluation of Pathogens Causing Urinary Tract Infection and Their Sensitivity Pattern

Background: UTI constitute a major public health problem in India accounting 2nd most common infection next to respiratory tract infection. They are responsible for increasing treatment cost and significant morbidity.Aim:-To determine the incidence of UTI, evaluation of pathogens responsible and their antimicrobial susceptibility pattern in the population.Methods:Urine samples were collected from 300 patients attending the OPD Patna medical college, Patna during the period of 18 months (January 2017 to June 2018) Antimicrobial sensitivity testing was done for the bacterial isolates present in the sample by Kirby- Bauer disc diffusion method. Only those samples were taken into consideration which develops count equal to or greater than 1*105CFU/ml as indicated by Kass.Results:Out of 300 samples collected 146 (48.66%)) yielded bacterial growth. Out of 146 culture isolates E.Coli was the most common pathogen followed by klebsiella, CoNS and staphylococcus. Antibiotic sensitivity was performed on all the isolates. It was observed that highest sensitivity was 49.31% to amikacin, gentamycin (45.89%), nitrofurantoin (38.35%) meropenem (27.39%).Conclusions:It was observed that high grade of resistance to ampicillin, cotrimoxazole, ciprofloxacin, cefuroxime, chloramphenicol, cefotaxime, cefazolin, amoxicillin + clavulanic acid and gentamycin is present as a result of misuse or improper use of antibiotic in the community. Hence urine culture is necessary for the diagnostic screening of UTI before the treatment.

BACTERIAL AND SENSITIVITY PATTERN OF PATHOGENS CAUSING VENTILATOR-ASSOCIATED PNEUMONIA IN INTENSIVE CARE UNIT

Highlight:1. Antimicrobial resistance bacteria isolated from VAP patients are often associated with high mortality and length of hospital stay. 2. Mortality in VAP patients was 33.3% and the VAP group had a longer hospital stay compared to the non-VAP group. 3. The three most predominant bacteria that were found were A. baumannii, P. aeruginosa, K. pneumoniae. Cefoperazone-sulbactam, meropenem and amikacin were more than 70% sensitive against these bacteria.Abstract:Background: Ventilator-Associated Pneumonia (VAP) is the most common nosocomial infection in Intensive Care Unit (ICU). Antimicrobial resistant bacteria isolated from VAP patients are often associated with high mortality and length of hospital stay. Objective: This study aimed to analyze the pattern and sensitivity among pathogens that caused VAP in ICU. Materials and Methods: The study was conducted retrospectively by extracting the data of bacterial isolates from sputum specimens in the Laboratory of Clinical Microbiology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia and confirming the clinical data on patients suffering from VAP in ICU ward. The study started from January until December 2017. Results: The total 148 pathogens were isolated, 18 of them were diagnosed as VAP, and 130 were not VAP. The most predominant isolates in the VAP group were Acinetobacter baumannii as many as 38 (9%) followed by Pseudomonas aeruginosa 22 (2%), E. coli 16 (7%), and Klebsiella pneumoniae 11 (1%). The pathogens showed a sensitivity rate above 70% to cefoperazone-sulbactam (SCF), meropenem (MEM) and amikacin (AK). Mortality in VAP patients was 33.3% and the VAP group had a longer hospital stay compared to non-VAP group. Conclusion: The three most predominant bacteria that were found were A. baumannii, P. aeruginosa, K. pneumoniae. The pathogens had sensitivity rate above 70% to cefoperazone-sulbactam, meropenem, and amikacin.

Bacteriological profile, antibiotic susceptibility pattern and other factors related to neonatal meningitis: A cross-sectional hospital-based study from West Bengal

Background: Neonatal sepsis and meningitis is an important cause of neonatal mortality and morbidity especially in the developing countries. Bacteriological profile of meningitis and antibiotic sensitivity pattern may vary from one region to another. Aims and Objectives: We have planned this study to know the etiological agent of neonatal meningitis with its antibiotic sensitivity profile and to evaluate some other associated risk factors of meningitis. Materials and Methods: This observational, cross-sectional study was done for a period of 1 year in the SNCU and NICU of a district Medical College of West Bengal in neonates presented with clinical sepsis and meningitis. Sepsis screen, blood culture, cerebrospinal fluid (CSF) study, and culture sensitivity was done and recorded along with demographic data, clinical presentation, outcome, and other associated factors. Results: We found meningitis in 55 neonates out of 250 clinical sepsis. CSF culture was positive in 42 cases with Escherichia coli (30.9%), Klebsiella (26.1%), Staphylococcus aureus (16.6%), Acinetobacter (14.2%) and Coagulase negative Staphylococcus (CoNS 11.9%) as prevalent organism. E. coli and Klebsiella were mostly sensitive to Amikacin, Levofloxacin, and Colistin whereas less sensitive to Cefotaxime, Pipercilin-tazobactam or Meropenem and Acinetobacter showed good sensitivity only to Levofloxacin. Among the gram-positive organism, S. aureus and CoNS were only sensitive to Linezolid, Vancomycin, and Teicoplanin. Conclusion: This type of study should help to make a proper antibiotic policy for an institution so that the empirical first-line antibiotic can be started with good effect in cases of neonatal sepsis and meningitis before the arrival of culture sensitivity report.

STUDY OF ANTIBIOTIC-RESISTANCE AND SENSITIVITY PATTERN IN A TERTIARY CARE TEACHING HOSPITAL

Introduction: Antibiotics are helpful in bacterial infection control and management. Irrational antibiotic use leads to resistance, which puts modern medicines achievements at risk. This study aims to know antibiotic resistance and sensitivity patterns and to assess possible factors that favor the development of antibiotic resistance. Methods: It is a retrospective observational study. Data collected from June 2019 to May 2020 from the culture & sensitivity records of various clinical isolates at the Microbiology department of SMC, Vijayawada, and analyzed by descriptive statistics. Results: Total samples collected 2905. Only746 samples showed significant growth. Most commonly, isolated organisms were from Pus and Body fluids Staphylococcus aureus (31.16%), Klebsiella (23.02%), from blood samples Staphylococcus aureus (44%,) Klebsiella (32%), from urine samples Escherichia coli (27.31%),Staphylococcus aureus (16.66%). Bacteria isolated from, Blood and Pus & body fluid samples showed more resistance to Amoxicillin + Clavulanic acid, 60% &58.60%, and urine samples showed more resistance to Norfloxacin69.44%. Conclusion: In this study, bacteria isolated from, blood, pus, and body fluid samples showed more resistance to Amoxicillin + Clavulanic acid, from urine samples showed more resistance to Norfloxacin. Parenterally used drugs like aminoglycosides and vancomycin have retained their sensitivity but bacteria also showed resistance to Imipenem, Vancomycin, new combinations like Cefoperazone + Sulbactam. A culture & sensitivity test and following antibiotic stewardship guidelines before prescribing antibiotics will give good results to prevent antibiotic resistance.

Prevalence and Antibiotic Sensitivity pattern of Bacterial Isolates from Catheterized UTI Patients: A Local Study

Prevalence and multidrug resistance among bacteria in catheter-associated urinary tract infections (CAUTIs) has been on the rise in recent times. Hence, the prevalence rate and antibacterial susceptibility of bacteria in CAUTIs in ICU patients was evaluated. A total of 120 patients admitted to the ICU of Nishtar Hospital, Multan, were recruited for this study. Both gram-positive and gram-negative bacterial isolates were characterized based on biochemical tests including catalase test, oxidase test, indole test, TSI test, citrate test, coagulase test and growth on 6.5% NaCl agar. The prevalence of bacterial species was Escherichia coli (32%), Staphylococcus aureus (26%), Pseudomonas spp. (18%), Proteus spp. (14%) and Enterococcus spp. (2%). A considerable degree of resistance against commonly prescribed antibiotics was observed. Gram negative bacteria showed resistance to ciprofloxacin, piperacillin-tazobactam and amikacin as well as susceptibility to imipenem, tigecycline and polymixin. Gram positive bacteria showed resistance to antibiotics such as piperacillin-tazobactam, ampicillin, gentamicin, oxacillin and ceftazidime suggesting the ineffectiveness of these antibiotics for treating bacterial infections among CAUTI patients and demonstrating the latest trends in antimicrobial drug resistance profile in local population.

Prevalence and Antifungal Susceptibility Pattern of Candida species Isolated from Patients with Urinary Tract Infections

Background: The presence of Candida species in the urine is termed candiduria, and it is a common form of urinary tract infection (UTI). Many other species of Candida organism apart from Candida albicans are known with increasing the occurrence of resistance to available antifungal agents. Objectives: To determine the prevalence and sensitivity pattern of Candida isolates obtained from urine samples of diagnosed urinary tract infections. Methods: Midstream urine of patients attending the Lagos University Teaching Hospital, Ikeja Lagos, were collected and inoculated on Sabouraud Dextrose Agar (SDA). Microbiological processing was done with Gram reaction, germ tube test, CHROME agar TM and sugar fermentation test using API 32C system. Antifungal susceptibility tests were done using the agar disc diffusion method. Results: Candida species were obtained from 36 (12.9%) of 280 patients with UTI. Candida albicans (CA) had the highest frequency (12; 33.3%) compared to 24 (66.7%) for Non-albicans Candida (NAC). The speciation of Candida using Chrome Agar showed some misidentification from the API32C identification, but there was a significant correlation between API32C and Chrome Agar methods (r = 0. 9793). Half of the C. albicans species were sensitive to fluconazole while C. hellenica was only sensitive to Nystatin. The C. parapsilopsis had the highest susceptibility pattern, with 86% and 71% for fluconazole and ketoconazole, respectively. Generally, ketoconazole had the highest effectiveness on Candida species. Conclusion: This study demonstrated the role of Candida species in UTIs and their high susceptibility to ketoconazole.

Antibiotic sensitivity and bacteriology of chronic suppurative otitis media in department of ENT in tertiary care centre St. John’s Medical College and Hospital Bangalore

<p><strong>Background: </strong>Chronic suppurative otitis media (CSOM) is a disease of middle ear. The aim of this study is to know the antibiotic sensitivity pattern in CSOM cases attending to ENT out patient department (OPD) in a tertiary care hospital and device an appropriate antibiotic protocol to treat CSOM cases.</p><p><strong>Methods: </strong>This is a prospective observational study. Fifty-eight patients of CSOM who present to the ENT OPD with ear discharge will be studied. Ear swabs of these patients will be collected and sent to microbiology to know the causative bacteria and their drug susceptibility.</p><p><strong>Results: </strong>Of the 58 patients studied 64% were males and 36% were females. Of the organisms isolated Stap aureus (53%) was most common followed by <em>Pseudomonas</em> (36%). All the gram-positive organisms were sensitive to cotimaxozole, amikacin and gentamycin and all gram-negative organisms were sensitive to ciprofloxacin, amikacin and netlimycin. </p><p><strong>Conclusions: </strong>It is better to collect an ear swab in all CSOM cases and then start antibiotics based upon the culture and sensitivity reports in order to improve the results and reduce the emergence of resistant strains, which can happen when antibiotics are prescribed randomly.</p>

Age-related Distribution of Mycoplasma pneumoniae in Respiratory Tract Infection in a Developing Country

Mycoplasma pneumoniae is an organism that belongs to the family mycoplasmataceae. Its role as a disease causing agent continues to draw interest especially with the advent of highly sensitive detection techniques. This bacterium poses a health problem to both animals and humans resulting in serious illnesses such as community-acquired pneumonia, lung damage and this work investigated the prevalence of M. pneumoniae as agent of respiratory tract infections using culture and molecular methods of identification, in patients attending Pulmonary Tuberculosis Clinic at Nnamdi Azikiwe Teaching, Hospital, Nnewi as well as detecting the most virulence gene of this organism. A total of 263 sputum samples were collected: 188 test subjects and 75 control subjects. These samples were examined bacteriologically using PPLO broth and agar, MacConkey, blood and chocolate agars. The overall prevalence rates of M. pneumoniae among the 263 subjects were 4.9% by culture. The prevalence rate of the organism was significantly higher among the test subjects 11(5.9%) by culture than the control subjects 2(2.7%) by culture. The colonization of the organism was significant among the age groups 31-40 years (P<0.05). The antibiotic sensitivity pattern of M. pneumoniae showed that the organism was susceptible to Lyntriaxone, Levofloxacin, Ciprofloxacin, Azithromycin and Doxycycline while it showed resistance to Septrin, Peflacine, Rifampicin, Erythromycin and Norbactin. M. pneumoniae is an additional bacterium that might contribute to respiratory tract infections and consequently to death when it disseminates to various organs of the body, hence their presence in the respiratory tract of children, adolescent and adults should not be treated with levity.