Antibacterial Resistance Patterns Research Articles

EPIMIC: A Simple Homemade Computer Program for Real-Time EPIdemiological Surveillance and Alert Based on MICrobiological Data.

Background and AimsInfectious diseases (IDs) are major causes of morbidity and mortality and their surveillance is critical. In 2002, we implemented a simple and versatile homemade tool, named EPIMIC, for the real-time systematic automated surveillance of IDs at Marseille university hospitals, based on the data from our clinical microbiology laboratory, including clinical samples, tests and diagnoses.MethodsThis tool was specifically designed to detect abnormal events as IDs are rarely predicted and modeled. EPIMIC operates using Microsoft Excel software and requires no particular computer skills or resources. An abnormal event corresponds to an increase above, or a decrease below threshold values calculated based on the mean of historical data plus or minus 2 standard deviations, respectively.ResultsBetween November 2002 and October 2013 (11 years), 293 items were surveyed weekly, including 38 clinical samples, 86 pathogens, 79 diagnosis tests, and 39 antibacterial resistance patterns. The mean duration of surveillance was 7.6 years (range, 1 month-10.9 years). A total of 108,427 Microsoft Excel file cells were filled with counts of clinical samples, and 110,017 cells were filled with counts of diagnoses. A total of 1,390,689 samples were analyzed. Among them, 172,180 were found to be positive for a pathogen. EPIMIC generated a mean number of 0.5 alert/week on abnormal events.ConclusionsEPIMIC proved to be efficient for real-time automated laboratory-based surveillance and alerting at our university hospital clinical microbiology laboratory-scale. It is freely downloadable from the following URL: http://www.mediterranee-infection.com/article.php?larub=157&titre=bulletin-epidemiologique (last accessed: 20/11/2015).

ESBL determination and antibacterial drug resistance pattern of <i>Klebsiella Pneumoniae</i> amongst patients at PIMS Islamabad

Background: A number of life threatening infections due to various bacterial pathogens are major cause of death in Pakistan. In a situation like the other developing countries, there is a general increase in the drug resistance due to the irrational use of the antibiotics. The present study was carried out to evaluate the prevalence and development of resistance in Klebsiella pneumoniae against commonly used antibiotics.Methods and Materials: A total of 200 samples from different wards of the hospitals were received by the pathology laboratory of Pakistan Institute of Medical Sciences, Islamabad, which comprised of urine 65, blood 50 and other miscellaneous samples from various sources. Klebsiella pneumoniae was isolated and characterized using morphological, cultural, and biochemical methods and were further confirmed by using commercially available API 20E kit. The isolates were subjected to culture sensitivity test using Kirby Bauer disc diffusion method.Results: The organism was found to be the most prevalent Gram-negative bacilli. K. pneumoniae showed highest resistance against coamoxiclav and cephalosporins.Conclusion: The study revealed that ESBL producing strains were resistant to most of the beta-lactam antibiotics. This trend therefore has become a significant problem and can be controlled with continued surveillance or monitoring for rationally improved antibiotics usage, in order to prevent the drug resistance and re-emergence of infection.Key words: Klebsiella pneumoniae, ESBL (Extended-spectrum beta-lactamase), API (Analytical Profile Index)

Bacteria Colonizing the Ocular Surface in Eyes With Boston Type 1 Keratoprosthesis: Analysis of Biofilm-Forming Capability and Vancomycin Tolerance.

To analyze the bacterial microbiota colonizing the ocular surface of patients with Boston type 1 keratoprostheses (K-Pros) for antibacterial resistance patterns and capacity to form biofilms. Twenty-seven eyes with a Boston type 1 K-Pro and 16 fellow control eyes from 26 patients were enrolled. The surface of the K-Pro optic and/or the inferior conjunctival fornix was swabbed and plated separately on culture media. Positive cultures were processed to assess for biofilm-forming capability. Microtiter plate adherence assay and polymerase chain reaction for ica and atlE genes were used. An in vitro assay of vancomycin tolerance was performed on isolated strains and compared to standard controls with and without biofilm-forming capability. Eighty-five percent of K-Pro eyes and 69% of control eyes had positive cultures (P = 0.20). All Gram-positive strains exhibited susceptibility to vancomycin by standard testing. Biofilm-forming bacterial isolates were detected in 57.7% of K-Pro eyes and 53.3% of control eyes. A vancomycin tolerance assay showed that the antibiotic susceptibility of coagulase-negative staphylococcus (CNS) within biofilms was significant in only three of five biofilm-forming strains (P < 0.05). In all strains, bacterial cells in planktonic form were more susceptible to vancomycin than in biofilm form (P < 0.001). Coagulase-negative staphylococcus can be isolated from K-Pro surfaces despite the use of vancomycin prophylaxis. In this study, the majority of isolated strains had biofilm-forming capability. In vitro vancomycin tolerance assays suggest that biofilm formation decreases susceptibility to vancomycin. This may contribute to higher rates of infectious complications observed in these patients.

Detection of Salmonella spp. and Microbiological Analysis of Milk and Milk Based Products Available within Dhaka Metropolis, Bangladesh

Aims: With a previous observation of pathogenic drug-resistant microorganisms in raw milk samples, current investigation further endeavored to determine the presence of Salmonella spp. and portrayed a complete map of the overall microbiological feature of milk and milk based products available within Dhaka metropolis, Bangladesh. Methodology: Conventional cultural and biochemical methods were carried out to isolate and enumerate the milk and milk based products accessing microorganisms. Standard agar disc diffusion method was conducted to assess the anti-bacterial resistance pattern of the isolated Salmonella spp. Original Research Article Yasmin et al.; BMRJ, 5(6): 474-480, 2015; Article no.BMRJ.2015.050 475 Results: Out of 35 samples studied, 16 were found to be contaminated with E. coli (~10 6 cfu/ml) and 9 samples were found to be contaminated with Salmonella spp. (~10 5 cfu/ml). Fungal growth was also observed in all samples (~10). The Salmonella isolates were found to be resistant against ampicillin (10 μg), cotrimoxazole (25 μg), chloramphenicol (30 μg), ciprofloxacin (5 μg), cefixime (5 μg) and sensitive against ofloxacin (5 μg). Conclusion: As projected from the current study, the proliferation of Salmonella spp. along with their drug-resistance traits could impart the morbidity and mortality associated risk to the overall public health safety.

Prevalence and Resistance Profiles of Enteropathogenic and Shiga ToxinProducing Escherichia coli in Diarrheic Calves in Mashhad and Garmsar Districts, Iran

Background: Shiga toxin-producing Escherichia coli (STEC) strains are considered as one of the most important widespread food-borne pathogens, which cause diarrhea and life threatening diseases, such as hemolytic uremic syndrome, in humans. More recently, the STEC strains have also been incriminated to cause diarrhea and hemorrhagic colitis in calves; enteropathogenic E. coli (EPEC) also causes diarrhea in neonate animals. Objectives: This study aimed to study the prevalence and antibacterial resistance patterns of STEC and EPEC in fecal samples from diarrheic calves in Mashhad and Garmsar districts, Iran. Materials and Methods: A total of 115 fecal samples were collected from diarrheic animals, 75 from Mashhad and 40 from Garmsar districts. A total of 146 E. coli isolates were obtained from culture and subjected to multiplex-PCR assay targeting stx1, stx2, eaeA and ehly virulence genes. The antibacterial resistance patterns of the virulence-positive isolates were determined using disc diffusion method. Results: Eight samples (6.9%) carried the strains with positive results for at least one of the tested virulence genes. Five samples (4.3%) contained the stx-positive strains (STEC) and three (2.6%) carried the eaeA-positive and stx-negative strains, which were categorized as EPEC. In nine virulence-positive E. coli isolates, stx1 (n = 6) was the predominant virulence gene, followed by ehly (n = 5), eae (n = 4), and stx2 (n = 2). Antibacterial resistance patterns of virulence-positive isolates were also determined and nine resistance profiles were discriminated; higher rates of resistance were observed in isolates from Mashhad. Conclusions: This study indicated that other pathologic factors might play a more important role in calf diarrhea in the studied areas, but public health significance of these strains should not be overlooked.

Antibacterial Sensitivity and Resistance Pattern of Yak Intramammary Infection from Arunachal Pradesh, India

Antibacterial Sensitivity and Resistance Pattern of Yak Intramammary Infection from Arunachal Pradesh, India

Detection of tetracycline resistance determinant tetA gene and antimicrobial resistance pattern in Escherichia coli isolates recovered from healthy layer chickens

Aim: The aim was to study the occurrence of tetracycline resistance determinant tetA gene, and antibacterial resistance pattern in commensal Escherichia coli recovered from healthy non-clinical layer chickens. Materials and Methods: Twenty-four cloacal swabs were obtained from 15 flocks in five different layer farms located at around Namakkal, which is a place of high-intensity layer chicken rearing in south India. Identification of E. coli was carried out by performing cultural and biochemical tests. Antimicrobial resistance test was carried out using disc diffusion method. The polymerase chain reaction employing tetAC forward and tetAC reverse primers were carried out to detect tetA gene conferring resistance to tetracycline. Result: All the collected cloacal swabs yielded E. coli. Twenty-one isolates (88%) were resistant to tetracycline antibiotic in disc diffusion method. All the isolates showed resistance to more than six antibiotics, which implied existence of multidrug resistant microbiota in intestine of poultry. Only seven (29%) isolates showed the presence of tetA gene indicating the involvement of either other one or more efflux gene(s), namely tetB, tetC and tetD or ribosomal protection encoded by tetM, tetO, tetQ and tetS genes than tetA gene. Conclusion: Based on the presence of tetA gene among tetracycline-resistant bacteria in healthy non-clinical food-producing animals such as layer chickens, it can be significant in human medicine as tetA gene could easily be spread to other bacteria. This kind of phenomenon can be extrapolated in transfer of resistance for other antibacterial essential for treating bacterial infections in human. We conclude that preventing the spread of antimicrobial resistance through direct or indirect contact, consumed food/feed and through the environment is empirical in reduction of failures while treating bacterial infections.

Antibacterial Resistance Patterns of Helicobacter pylori Clinical Isolates From Gastric Biopsy of Patients in Yazd

Background: Helicobacter pylori related-infections are common in developing countries, including Iran. However, little information is available on the antibiotic susceptibility of H. pylori in Yazd. Objectives: The aim of this study was to investigate the antibiotic resistance patterns of H. pylori isolates from gastric biopsy of patients in Yazd. Materials and method: In this descriptive-analytical study, 651 gastric biopsy specimens were taken from May 2012 to February 2013. Samples were cultured into selective Brucella agar media. After 3 to 10 days of incubation and identification of bacteria by using gram stain and biochemical tests, antibacterial susceptibility assay was performed by disk diffusion method. Results: All of 651 gastric biopsy specimens were cultured and 144 (22.12%) isolates of H. pylori were collected. In total, 76 (52.7%) of 144 H. pylori isolates were isolated from females and 68 (47.2%) from males. Rate of antibiotic resistance to metronidazole, tetracycline, clarithromycin, levofloxacin, ciprofloxacin and amoxicillin were 77.8%, 21.5%, 18.8%, 14.6%, 19.4% and 7.6%, respectively. No antibiotic resistance was found against furazolidone. There was no significant association between these isolates antibiotics resistance with sex, age and endoscopic diagnoses (P > 0.05). Conclusions: H. pylori isolates resistance was high to antibiotics, especially metronidazole. Therefore, determining resistance pattern of H. pylori isolates is recommended in all parts of the country.

English

The antibacterial resistance pattern of 118 isolates from burn wounds in patients with thermal burns showing growth of Pseudomonas aeruginosa mixed with other aerobic bacteria over a period of two years (January 2009-December2010) were studied. Pseudomonas aeruginosa was found to be mixed with Klebsiella pneumoniae 63 (53.38%) the most followed by Escherichia coli 27 (22.88%) and other aerobic isolates. Pseudomonas aeruginosa was found to be highly resistant to Ceftazidime (72.88%) and least to Imipenem (9.32%). Klebsiella pneumoniae was found to be most resistant to Ampicillin (100%) and least to Amikacin (23.72%). Antibiotic susceptibility testing was performed for the other isolates as well.

305Changes in antibacterial resistance patterns in Staphylococcus aureus strains which are related to microbiologically confirmed nosocomial bacteraemia in a tertiary care educational hospital in Turkey: A perspective through 2001-2013

305Changes in antibacterial resistance patterns in Staphylococcus aureus strains which are related to microbiologically confirmed nosocomial bacteraemia in a tertiary care educational hospital in Turkey: A perspective through 2001-2013

Bacterial isolate and antibacterial resistance pattern of ear infection among patients attending at Hawassa university referral Hospital, Hawassa, Ethiopia

Background: Ear infection is highly prevalent worldwide. In the older child, long-standing Chronic Supparative Ottitis Media can result in a severe conductive hearing loss with significant drawbacks in learning, communication, and social adjustment. It is associated with hearing impairment, death, and severe disability due to central nervous system involvement in developing countries. Objective: To determine the bacteriological profile and antibacterial resistance of ear infection from patients seen at Ear Nose and Throat clinic of Hawassa University Referral Hospital. Materials and Methods: A cross-sectional study was conducted at clinic of Hawassa University Referal Hospital. Result: A total 117 study subjects included in this study from June 2013 to October 2013. Among these, 57 (48.7%) were male and 53 (45.3%) were children. Bacteria identified from positive ear swabs were: Staphylococcus aureus 24 (20.5%), Pseudomonas aeroginosa 17 (14.5%), Klebsiella species 10 (8.5%), Proteus species 7 (6.0%), Entrobacter species 4 (3.4%), Escherchia coli 3 (2.6%), Citrobacter species 2 (1.7%), and Providentia species 2 (1.7%). The overall sensitivity and resistance profile of antibacterial agent, Amikacin (90.0%) and Gentamycin (89.1) showed high level of antibacterial effect on all identified bacterial species. On other hand, all isolates were highly resistance to ampicilin (87.5%), oxacillin (84.0%), ceftriaxone (82.8%), cephalotin (81.4%), and penicillin G (73.8%). Conclusion: Most of the isolates were resistant to commonly prescribed drug in the area. However, Amikacin and Gentamycin were highly active against the isolated organism, whereas Ciprofloxacilin was moderately active. Therefore, culture and susceptibility test is vital for appropriate management of ear infection in study area.

Profile of microorganisms isolated from blood and wound in the first week of post burn infections and antibacterial resistance pattern

Infection of burn wounds is a serious problem leading to death and need critical care.The purpose of this study is to identify common microorganisms isolated from blood and wound in the first week of post burn infections and assess their susceptibility to the commonly used antibacterial agents.Blood and wound swabs from 62 patients with burn wound infections were collected on Third and Sixth day of post burn infections.The microorganisms were isolated and identified by standard microbiological methods. Susceptibility test were performed by Kirby–Bauer disk diffusion method. Out of 62 patients, female (62.9%) were found to be affected more than males (37.1%) while (53.2%) of the patients were paediatric and the remaining (46.8%)were adults. The flame burn was the predominant cause of burn among patients; (51.6%) had flame burns, (33.9%) a scald, and (14.5%) had an electrical burn.It was found that predominant aerobic and anaerobic bacteria were Pseudomonas aeruginosa (15.3%)and Bacteroides spp.(4.8%), respectively. While Candida tropicalis (0.8%) was the most common fungal organi followed by Candida albicans (0.4%). In most of the cases, the same microorganisms were found in blood and pus samples. All the bacterial isolates showed high resistance to used antibiotics.Imipenem was the most effective antibiotic followed by Meropenem and Ceftriaxone.

Evaluation of Bactereuria and Antimicrobial Susceptibility among Hospitalized Patients With and Without Catheter in Kerman Province- Iran in 2011.

Nearly 15% to 25% of patients in general hospitals have a catheter at some time during their stay. Up to 97% of nosocomial urinary tract infections (UTIs) are related to catheter. The type of bacteremia is usually polymicrobial which makes the treatment more difficult. Previous studies showed an increase in mortality from bacteremia in these patients. The aim of the present study was to compare the prevalence of UTIs among patients with and without catheter, and to detect the type of bacteriuria and antibacterial resistance pattern. In this cross sectional study, samples were taken between Jan 2011 and July 2011. 678 hospitalized patients in different wards of Afzalipour hospital, Kerman- Iran, were enrolled in the study. E-test was applied to detect the pattern of resistance to gentamicin, nitrofurantoin, ciprofloxacin, ceftriaxon and co-trimoxazole. Results showed positive culture samples in 86% of female patients. Escherichia coli, Candida and Staphylococcus aureus were detected in 72, 20 and 7 percent of the positive cultures, respectively. 52.3% of detected E.coli was sensitive to gentamicin , 62% to ceftriaxone, 71.4% to ciprofloxacin, and 91.9% were sensitive to nitrofurantoin. Therefore, the most sensitive antibiotics in UTIs were ciprofloxacin and ceftriaxone. Unfortunately, the rate of antibacterial drug resistance was high in comparison with developed countries. Wise selection of antibiotics at hospitals and increasing the knowledge of patients to prevent self use of antibiotics can reduce antimicrobial resistance.

Antibiotic resistance patterns of Pseudomonas aeruginosa in a tertiary care hospital in Central India

Background: Antimicrobial resistance is the major problem of the modern world, thus it needs urgent attention. Pseudomonas aeruginosa has the inherent property of developing the resistance. Hence, it is necessary to know the current resistance pattern for proper use of antipseudomonal agents. Aims & Objective: (i) To evaluate the antibacterial resistance pattern in Pseudomonas aeruginosa in a tertiary care hospital in Central India; (ii) To provide base for formulating rational antibacterial guidelines to treat the infections caused by pseudomonas aeruginosa. Material and Methods: The present study was an observational, longitudinal study over a period of three years from April 2007 to March 2010. The necessary data was obtained from Central Microbiology Laboratory of Government Medical College, Nagpur, India. Total 1001 samples were reported the presence of Pseudomonas aeruginosa in all the 11 types of biological sample. Antimicrobial susceptibility testing was performed using disk diffusion method with Pseudomonas species ATCC 27853, as per CLSI guidelines. Appropriate statistical analysis methods were applied to the data to fulfil the objectives of the study with the latest version of Graph pad prism software. Results: Pus samples showed highest culture positivity for P. aeruginosa followed by sputum. The highest resistance was reported to ciprofloxacin while the lowest resistance to Meropenem. Conclusion: Wound infection was the most common hospital acquired infection. The use of Meropenem and Amikacin should be restricted to avoid the emergence of resistance against them. Such studies should be performed regularly to recognize the recent trends.

Pola Resistensi Bakteri Penyebab Infeksi Saluran Kemih (ISK) Terhadap Antibakteri di Pekanbaru

Urinary Tract Infection (UTI) is caused by a variety of microorganism, but bacteries are more often. Antibacterial isthe empiric treatment for UTI. The antibacterial resistance pattern of UTI can be changed by the place and time.Urine culture test and sensitivity test will help us to choose the effective treatment. The purpose of this researchis to find out the pattern of UTI in Pekanbaru. Results of this research showed that UTI bacterial resistancy mostlyfound in Gram negative bacateria with penicillin and 1 st cephalosporin antibiotic.

Antibacterial drug resistance patterns in poultry isolated enterococci

The increasing use of antibiotics in both human medicine and animal agriculture leads to the decline in the effectiveness of antibiotics. Enterococci are natural intestinal flora which are important reservoir of antibiotic resistance genes and have the ability to transfer their resistance traits to other bacteria. In this report, antibacterial drug resistance of broiler chickens isolated Enterococcus faecalis and Enterococcus faecium were examined using Kibry-Bauer disk diffusion method. 93% of E. faecalis and 98% of E. faecium isolates were resistant to one or more antibiotics. The most frequent resistance properties were resistance to erythromycin (80% in E. faecalis and 82% in E. faecium) and tetracycline (73% in E. faecalis and 75% in E. faecium). No vancomycin-resistant E. faecalis were isolated but 9% of E. faecium isolates were resistant to vancomycin (VRE). These high amounts of drug resistant enterococci can be transfer from animal to human and suggest the need for restriction on the use of antibiotics as food additives and rational use of antimicrobial therapy of infections. Key words: Antibacterial drug resistance, enterococci, poultry.

Therapeutic Management of Recurrent Peptic Ulcer Disease

The epidemiology of peptic ulcer disease (PUD) has undergone significant changes since the discovery of Helicobacter pylori. Various aetiologies contribute to recurrent PUD. Ulcers related to untreated H. pylori infection tend to recur. Use of NSAIDs, low-dose aspirin and dual anti-platelet therapy have become important risk factors for recurrent ulcers and their complications as the proportion of H. pylori-related ulcers declines. Recent data have shown that H. pylori-negative, NSAID-negative idiopathic peptic ulcers are on the rise and carry a higher risk of recurrent ulcer bleeding and mortality. Effective management of recurrent PUD relies on identification and modification of treatable risk factors. Persistent H. pylori infection should be carefully ruled out. Choice of an effective H. pylori eradication regimen should be based on local antibacterial resistance patterns. For patients who need long-term NSAID therapy, the initial choice of an NSAID relates to a patient's cardiovascular risk, and the need for therapy to decrease gastrointestinal (GI) complications is determined by the severity and number of GI risk factors. For patients on dual anti-platelet therapy, strategies to prevent recurrent ulcer disease and its complications centre on balancing the bleeding and thrombotic risks of individual patients. Long-term proton pump inhibitor maintenance therapy may be necessary to prevent recurrent ulcer bleeding for patients with ulcer bleeding from H. pylori-negative, NSAID-negative ulcers, and for patients who require NSAID or aspirin maintenance therapy.

Bacteriological Analysis and Antibacterial Resistance Pattern in Burn Sepsis

Bacteriological Analysis and Antibacterial Resistance Pattern in Burn Sepsis

A Study of Antibacterial Susceptibility and Resistance Pattern of E. coli Causing Urinary Tract Infection in Chittagong, Bangladesh

A Study of Antibacterial Susceptibility and Resistance Pattern of E. coli Causing Urinary Tract Infection in Chittagong, Bangladesh

Current concepts in the management of bacterial skin infections in children

Bacterial skin infections in children vary widely clinically, starting from mild superficial folliculitis to deep necrotizing fasciitis. The causative organisms are mostly Staphylococcus aureus and Streptococcus, with occasional involvement of Gram-negative organisms. Treatment of even the milder forms of bacterial skin infections is of importance because of the long-term morbidity associated with them. However, because of global emergence of resistant strains of bacteria, treatment of these conditions is becoming increasingly difficult. The current antibacterial resistance patterns in organisms causing skin and soft tissue infections and the problems encountered in their management in children have been discussed.