Antibiotic Sensitivity Pattern Research Articles

Antibacterial Property of Silver Nanoparticles Green Synthesized from Stachys schtschegleevii Plant Extract on Urinary Tract Infection Bacteria.

Urinary tract infections are one of the most common infections worldwide. Given the increasing antibiotic resistance, monitoring antibiotic sensitivity patterns is crucial. Furthermore, silver nanoparticles synthesized from Stachys schtschegleevii can exhibit potent antibacterial, antibiotic, and antifungal properties. The plant S. schtschegleevii was collected from its natural habitat, dried, and its extract was then exposed to silver nitrate. Under specific conditions, silver nanoparticles were synthesized from it. Subsequently, the production and validation of silver nanoparticles were confirmed through techniques such as FTIR analysis, UV-Vis analysis, TEM, SEM, EDX analysis, and zeta potential analysis. In the in vitro section of the research, the impact of the extracted silver nanoparticles on bacteria isolated from patients' urine and standard bacterial culture (control) was assessed using the disc diffusion and MIC test methods. The results of the analyses are FTIR (high protein content; proteins and phenols serve as stabilizing agents), UV-Vis (peak of 460nm), TEM (spherical to occasionally elliptical shapes), SEM (sizes: 26 to 72nm), EDX (peak at 3keV), and zeta potential (- 15.76 ± 0.05mV). The effect of silver nanoparticles by disc diffusion method (mm) is Enterococcus faecalis = 18.31 ± 0.35, Escherichia coli = 21.51 ± 0.61, and Staphylococcus aureus = 19.02 ± 1.28, and by MIC test (μg/ml), E. faecalis = 19, E. coli = 18, and Staphylococcus aureus = 16. Antibacterial activity of the silver nanoparticles synthesized from S. schtschegleevii means that these herbal nanoparticles treat urinary tract infections caused by some of the test isolates.

Detection of Methicillin Resistance and Methicillin Sensitive Staphylococcus Aureus from Various Clinical Specimens in Tertiary Care Hospital

INTRODUCTION : Staphylococcus aureus is one of the most common Gram-positive pyogenic bacteria responsible for variety of disease. Methicillin resistance Staphylococcus aureus (MRSA) has become a major cause of hospital associated infection. MRSA can also acquire resistance to multiple alternative antimicrobials, further complicating treatment of infection. For the severe infection of MRSA, vancomycin considered one of the last treatments relatively new agents such as Linezolid and Daptomycin is used. MATERIAL AND METHODS: 141 Staphylococcus aureus were isolated from samples such as pus, sputum, urine, blood, body fluid, wound swab received in microbiology department of Krishna institute of medical sciences, karad. They were conformed by microscopy, culture, and biochemical reaction. Then MRSA were detected by using disc diffusion test using cefoxitin (30ug) disc. RESULTS: Majority of Staphylococcus aureus were isolated from pus samples 71 (50.35%). Out of 141 isolates, 81 (57.44%) were MRSA and 60 (42.55%) were MSSA. In MRSA and MSSA isolates, higher percentage of resistance was seen in Penicillin 78 (96.29%) and 55 (90.16%) respectively. CONCLUSION :The present study emphasized the burden of MRSA in patients at our hospital. The determination of antibiotic sensitivity patterns and screening for MRSA among Staphylococcus aureus isolates are important for controlling the clinical Staphylococcal infection. The antibiotic sensitivity pattern helps in judicious use of antimicrobial agents.

BACTERIOLOGICAL PROFILE OF CLINICALLY SUSPECTED SEPTICEMIA AMONG NEONATES AND THE ANTIBIOTIC SUSCEPTIBILITY PATTERN OF THEIR ISOLATES: A CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL OF JHARKHAND

Objectives: Neonatal septicemia is a generalized bacterial infection that occurs during the first 4 weeks of life and is one of the four primary causes of neonatal mortality and morbidity in India. This study aims to determine the bacteriological profile and antibiotic sensitivity patterns of isolates from blood cultures of suspected septicemic neonates in a tertiary care hospital. Methods: Two hundred and twenty-eight blood samples were collected and processed from patients in accordance with standard protocol. The antibiotic susceptibility of the isolates was determined by the disk diffusion method according to Clinical and Laboratory Standards Institute recommendations. Results: Blood culture results were positive in 44.7% of the patients. Late-onset sepsis was present in 53.92%, and early-onset sepsis was observed in 46.08% of the cases. The best overall sensitivity among Gram-negative isolates was to Amikacin, followed by Gentamycin and Meropenem. Gram-positive isolates had sensitivity to Chloramphenicol, tetracycline, Linezolid, Tetracycline, Vancomycin, and Piperacillin. Conclusion: The most common causes of newborn sepsis in this study were Gram-negative organisms (Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii) and Gram-positive organisms (Staphylococcus aureus), the majority of which are antibiotic-resistant.

Frequency of asymptomatic bacteriuria, causative pathogens and antibiotic sensitivity pattern in antenatal women.

Objective: To determine the frequency of asymptomatic bacteriuria (ASB), causative pathogens and antibiotic sensitivity pattern in antenatal women. Study Design: Cross-sectional study. Setting: Department of Obstetrics and Gynaecology, Nishtar Hospital, Multan, Pakistan. Period: February 2022 to July 2023. Methods: A total of 110 women with singleton pregnancy with gestational age 13-42 weeks, and aged 18 to 40 years were included. Once the patients were enrolled, demographic characteristics (age, gestational age, parity (primiparous or multiparous), body mass index (BMI), place of living (rural or urban), gestational diabetes mellitus (yes or no), educational status (illiterate, primary, middle, matric, or graduate)) were noted. Presence or absence of asymptomatic bacteriuria was noted. Results: In a total of 110 pregnant females, the mean age and gestational age were 28.7±3.9 years and 29.4±4.0 weeks, respectively. The frequency of ASB among pregnant women was found in 19 (17.3%) patients. The frequency of causative pathogens showed that E. coli was the most frequent isolates noted among 7 (36.8%) women while staphylococcus aureus, Klebsiella, pseudomonas spp, and Proteus spp were identified in 5 (26.3%), 4 (21.0%), 2 (10.5%), and 1 (5.26%) respectively. Antibiotic susceptibility patterns revealed that Amikacin, Nitrofurantoin, cephalexin, and Ciprofloxacin were the most sensitive antibiotics noted in 18 (94.7%), 17 (89.5%), 15 (79.0%) and 14 (73.7%) samples respectively. Conclusion: The frequency of asymptomatic bacteriuria in pregnant women is high with E. coli as the most common causative organism. Antibiotic susceptibility patterns revealed that Amikacin, Nitrofurantoin, cephalexin, and Ciprofloxacin to have good sensitivities.

Current Microbiological Profile and Antibiotic Sensitivity Pattern in Chronic Suppurative Otitis Media in the Post- Antibiotic Era

Current Microbiological Profile and Antibiotic Sensitivity Pattern in Chronic Suppurative Otitis Media in the Post- Antibiotic Era

Streptococcus sinensis Causing Tricuspid Endocarditis in a Child: An Unusual Pathogen at an Unusual Site: A Case Report with Review of Literature

Background: Infective endocarditis (IE) involving tricuspid valve is rarely reported in children. Common etiological organisms of IE include Staphylococci, viridans group Streptococci, and Enterococci. Other less frequent organisms include Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella (HACEK) group, and Candida, accounting for 1% of cases. We describe the rare case scenario of tricuspid valve endocarditis caused by an unusual pathogen. Clinical Description: An 8-year-old girl presented with complaints of cough, shortness of breath, and intermittent fever for the past 2 months. Since 10 days before presentation, the fever had become high grade, continuous, and associated with chills and rigors. As per parents, the child had incidentally been detected with some congenital heart disease (CHD) at 3 months of age, documents being unavailable, child remaining asymptomatic till this presentation, without any medications. On examination, the child was malnourished with pallor, Grade 3 clubbing, tachypnea, and tachycardia. Auscultation revealed bilateral basal crepitations and a pansystolic murmur of Grade 4 in tricuspid area. Management and Outcome: Along with routine investigations, a two-dimensional echocardiography was done which revealed perimembranous ventricular septal defect with left-to-right shunt, tricuspid valve vegetations with anterior tricuspid leaflet prolapse with ruptured chordea, severe tricuspid regurgitation, and thickened aortic valve with good biventricular function. Blood culture showed growth of Streptococcus sinensis. The child was treated with oxygen, diuretics, and intravenous ciprofloxacin and gentamicin according to antibiotic sensitivity pattern. The child became hemodynamically stable and symptomatically improved after 3 weeks of treatment. Conclusion: This case creates awareness regarding an usual pathogen – S. sinensis as an etiological agent of IE, involving an unusual site – the tricuspid valve, in a child with CHD.

Etiologies, risk factors, and antibiotic pattern of lower respiratory tract infection in patients coming to Deccan College of Medical Sciences, Hyderabad, South India

Background. Lower Respiratory Tract Infections (LRTI) impose a huge problem on society due to their tenacious and unescapable health problems, and they were the reasons for consultation and hospitalization. Patients with LRTI were present with a wide spectrum of diseases that range from life-threatening infections to minor self-limiting illnesses. Materials and methods. Sputum samples from 310 patients with complaints of lower respiratory tract infections were collected and analyzed. After microscopic analysis, 30 were excluded from the study. Of the 280 that were included in the study, 171 were males and 109 were females. The age group between 56 and 65 years comprised the highest number of patients in the study. Different antibiotics were used to check antibiotic sensitivity patterns against isolated Gram-positive and negative bacteria. Results. Of the 280 samples processed, 122 (43.5%) were culture-positive. Among the 122 bacterial isolates, the predominant organism was Klebsiella pneumoniae 55 (45%). The most common predisposing factor identified in 115 (37%) patients was smoking. Using the Double Disk Synergy Test, 11 (20%) out of a total of 55 K. pneumoniae isolates and 4 (30.7%) out of 13 Pseudomonas isolates showed Extended Spectrum Beta Lactamases (ESBL). The Klebsiella and Pseudomonas isolates showed resistance to 2nd and 3rd generation Cephalosporins. Conclusion. Because of different geographical regions and conditions, the etiology and the antibiotic sensitivity patterns of LRTI vary, so the etiology, predisposing factors, and the antibiotic sensitivity pattern of LRTI need to be updated regularly. The diagnostic facilities for early and rapid identification of LRTI also need to be improved.

Prevalence of surgical site infections and antibiotic resistance pattern in a Tertiary care Orthopaedic unit

Introduction: Surgical site infections (SSIs) in orthopaedic surgeries pose a significant risk to outcomes. These infections ranging from superficial to periprosthetic joint complications result from various factors including patient-related conditions and environmental factors. Staphylococcus aureus, with increasing antibiotic resistance, is a predominant cause. Perioperative antibiotic prophylaxis recommended by the WHO is crucial. Establishing national surveillance considering local antibiotic resistance and continuous auditing are essential for formulating effective guidelines to prevent and manage SSIs. Methods: This is a retrospective study conducted at a tertiary care hospital from December 2022 to November 2023 at the orthopaedic unit. The study population was all the patients who had surgical site infections following clean orthopaedic surgeries during the study period. An institutional-level ethical clearance was obtained. Results: This retrospective study conducted at a tertiary orthopaedic unit in Jaffna, Sri Lanka, aimed to investigate surgical site infections (SSI) following clean orthopaedic surgeries. Analyzing data from 1676 surgeries over one year, the study identified 83 culture-proven SSIs, yielding an annual incidence of 4.95%. The majority of SSIs occurred in males (62.7%) and were associated predominantly with lower limb surgeries (83.1%). Contrary to global trends, Pseudomonas emerged as the most common causative organism (31.3%). Discussion: Notably, the study revealed significant variations in antibiotic sensitivity patterns among isolated organisms. While Pseudomonas exhibited sensitivity to a wide range of antibiotics, coliforms displayed resistance to several agents. This emphasizes regional and institutional differences in antibiotic resistance patterns. Conclusion: Continuous large-scale institutional audits are crucial for shaping effective antibiotic policies. The study underscores the dynamic nature of SSI aetiology, emphasizing the need for tailored preventive measures based on regional data.

Frequency of drug-resistant bacterial isolates among pregnant women with UTI in maternity and children’s hospital, Bisha, Saudi Arabia

Urinary tract infections (UTIs) are one of the most prevalent bacterial infections affecting humans, with a higher incidence among women. Pregnant women are at an increased risk of developing UTIs, which can have detrimental consequences for both the mother and fetus. UTIs can be caused by various bacteria, and the prevalence of drug-resistant UTIs in maternity and children’s hospitals is a cause for concern due to the potential for severe complications if left untreated. The primary objective of the current study was to determine the distribution of UTI-causing bacteria and investigate the antibiotic sensitivity patterns of isolated cultures obtained from pregnant women with UTIs at the Maternity and Children’s Hospital, Bisha, Saudi Arabia. This cross-sectional study was conducted from October 2021 to October 2023, involving the analysis of urine samples collected from 321 participants who acquired UTIs during pregnancy. Using biochemical tests and standard cultures, the urine samples were examined for pathogenic bacteria and their anti-microbial sensitivity patterns. The study analyzed susceptibility results according to the Clinical Laboratory Standards Institute guidelines (M100, 28th Edition, 2018). Bacterial strains demonstrating resistance to three or more antibiotics were classified as multidrug-resistant (MDR). This study revealed the distribution of UTI-causing bacteria to be as follows: Escherichia coli, 57.01%; Klebsiella pneumoniae, 24.61%; Pseudomonas aeruginosa, 4.36%; Proteus mirabilis and Enterobacter cloacae, 3.74%; Streptococcus agalactiae, 3.11%; Enterococcus faecalis, 2.18%; and Staphylococcus aureus, 1.24%. Antimicrobial susceptibility testing varied among gram-positive and gram-negative bacteria. Gentamicin demonstrated the highest sensitivity among both gram-positive and gram-negative bacteria; piperacillin-tazobactam was the second most effective drug against gram-negative bacteria. The bacterial isolates showed varying susceptibility to different antibiotics, with Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa being mainly sensitive to gentamicin, piperacillin-tazobactam, and ciprofloxacin, respectively. The strategies for reducing the risk of UTIs need to be improved to limit the spread of MDR bacteria. These strategies may include promoting hygienic practices and administering appropriate antibiotics to prevent the emergence and spread of drug-resistant bacteria. Further research is required to monitor the trends in antibiotic resistance among UTI-causing bacteria and develop effective strategies for managing this public health menace.

Evaluation of Mex A' Mex B Efflux Pump Gene in Pseudomonas aeruginosa Isolated from Milk in Qom Province, Iran

Background:: Pseudomonas aeruginosa is an opportunistic pathogen protected from antibiotics' harmful effects by various mechanisms. One of the most important mechanisms is the activation of exudation systems. Therefore, identifying such targets in food contaminating bacteria can help us target them and eliminate bacteria resistant to several drugs, making food safe. Therefore, the present study aimed to trace Mex A and Mex B efflux pump genes in Pseudomonas aeruginosa isolated from dairy products in Qom City, Iran. Methods:: 300 samples of raw milk, 30 samples of pasteurized milk, and 30 samples of local cream were collected. After a 24-hour culture on nutrient agar and blood agar and performing warm staining, confirmatory biochemical tests were performed to identify bacteria. The disk method was used according to CLSI guidelines to determine the antibiotic sensitivity pattern. Then Mex A and Mex B efflux pump genes were detected using specific primers with PCR technique. Results:: 117 strains of Pseudomonas aeruginosa were isolated from 300 raw milk samples, and 7 strains were resistant to ciprofloxacin. Out of 117 Pseudomonas aeruginosa isolates, 51 isolates (43.5%) had Mex A gene and 10 isolates (8.5%) had Mex B gene. Three isolates had both Mex A and Mex B genes. Among the strains with resistance to ciprofloxacin (7 isolates), 4 isolates did not have any of the genes. One isolate had Mex A and Mex B genes; 2 isolates were Mex A positive and Mex B negative, and Mex B positive and Mex A negative isolates were not observed. Conclusions:: Based on the results, among the studied isolates, the Mex A gene was more abundant. In addition, no significant relationship was found between the existence of Mex A and Mex B genes and ciprofloxacin resistance.

Investigation of the Multidrug Resistance Pattern of Bacteria Isolated from Car and Office Door Handles in a Tertiary Institution

Multidrug-resistant bacteria have posed a public health concern over the years, especially with the difficulty and cost of treatment of infections they cause. Fomites such as door handles are thus potent means through which pathogens are transmitted from one person to another as contact with them is made. This study thus involves isolating antibiotic-resistant bacteria from car and office door handles in a university environment. Using the simple random sampling method, twenty samples (20) from car door handles and twenty samples (20) from office door handles were collected, the isolation of bacteria was done using standard microbiological procedures and identification of the isolates was done using cultural, microscopic and biochemical characterization. Determination of the antibiotic sensitivity pattern of the isolates was done using the Kirby-Bauer disc diffusion method on Muller Hinton agar. Antibiotics used included Ofloxacin (5 µg), Gentamicin (10 µg), Ceftriaxone (30 µg), Augmentin (30 µg), Ciprofloxacin (5 µg), Erythromycin (5 µg), Streptomycin (30 µg) and Cloxacillin (30 µg). The results showed a significant frequency of occurrence of Staphylococcus aureus at 35% and Klebsiella pneumoniae having least at 5%. From car door handles, S. epidermidis recorded 37% while K. pneumoniae recorded the least with 17.4%. The isolates exhibited resistance to antibiotics including Augmentin and Ceftriaxone (≤22 mm) while they were more susceptible to Ofloxacin (≥16 mm). All the K. pneumoniae isolated from car door handles exhibited resistance to Augmentin and Ceftriaxone. These results show that these surfaces could be a possible reservoir of infections caused by resistant bacteria, leading to difficulty in the treatment of infections caused by them.

Acute conjunctivitis – antibiotic susceptibility and resistance to different antibiotics in main Eye Hospital, Tripoli, Libya

Acute conjunctivitis is characterized by inflammation of the conjunctiva of less than 3 to 4 weeks duration, cellular infiltration, and exudation. It may also result in corneal, lid, or orbital involvement which may lead to various complications. Bacterial conjunctivitis is a self-limiting process, but topical antibiotic treatment is recommended to eradicate the pathogen and reduce symptom duration. A hospital-based prospective study was conducted in the emergency and casualty department in Zawyat Aldahmani Eye Hospital, Tripoli /Libya comprising out-patients (OPD) visiting the department from June to December 2019 (186 cases). The primary objective was to evaluate the bacteriological pattern and the secondary objectives were to evaluate seasonal variation and antibiotic sensitivity pattern of the isolates. Conjunctival swabs included patients from both sexes (males n_106 and females n_80) and different ages; 80.1% of adults of the whole studied cases and the rest were children under 12 years old. Staph. hominis (26.17%) was the predominant organism isolated throughout the study. The commonest single organism isolates were Staph. haemolyticus (11.21%) Staph. aureus (9.35%). All isolates were identified and susceptibility patterns towards about 34 different antibiotics were studied. There were 186 patients enrolled. Of all cultures, 57.5% (107) yielded one of the study pathogens. Gram-positive organisms were isolated from 83 (77.57%) of cultures, gram-negative organisms were isolated from 15 (14.02%), and 9 (8.4%) were fungal growth. From 107 gram-positive isolates, 19 samples (22.9%) gave coagulase-positive results and 64 samples (77.1%) gave negative results. All the major organisms (S. aureus, S. hominis, S. hemolytic, S. epidermidis, E. coli, Mycobacterium, and Moraxilla catarrhalis) susceptible to cephalosporins, macrolides, aminoglycosides and fluoroquinolones (levofloxacin). Tetracycline has the lowest effect on both gram-positive and gram-negative isolates. In conclusion, our findings should alert physicians on the choice of appropriate antibiotic treatment after applying AST to the identified strains and on the potential role of conjunctivitis in the spread of antibiotic-resistant pathogens. In addition, external bacterial infections of the eye were most frequently caused by the common skin bacteria. Staphylococci spp. was by far the most common bacterial pathogen.

The Enterics for Global Health (EFGH) Shigella Surveillance Study in Mali.

In 2002, the Centre pour le Développement des Vaccins du Mali (CVD-Mali) was established as a partnership between the Mali Ministry of Health and the University of Maryland, Baltimore. Since its creation, CVD-Mali has been dedicated to describing the epidemiology of infectious diseases, supporting the development of vaccines, and training a team of local researchers. CVD-Mali participated in the Global Enteric Multicenter Study from 2007 to 2010 and the Vaccine Impact on Diarrhea in Africa study from 2015 to 2018, where the importance of Shigella as an enteric pathogen was established. In the Enterics for Global Health (EFGH) Shigella surveillance study, CVD-Mali will conduct Shigella surveillance at 4 health centers serving the population currently participating in a demographic surveillance system and will measure the local incidence of Shigella diarrhea and related outcomes in 6- to 35-month-old children. Antibiotic sensitivity patterns and the costs related to these cases will also be measured. We anticipate reporting the number of diarrhea episodes that are positive by stool culture, the antibiotic susceptibility of these isolates, and the management and outcomes of these cases. In Mali, the EFGH study will contribute valuable information to understanding the burden of Shigella in this population. These data will inform the evaluation of vaccine candidates.

Different Bacteria and their Antibiotic Sensitivity Patterns in Patients of Chronic Otitis Media-Active Mucosal Disease at a Secondary Care Centre in Delhi.

Chronic Otitis Media is characterized by distinct bacteriology compared with Acute Otitis Media, with COM being highly likely to harbor multiple bacteria of anaerobic and aerobic types of organisms (Cameron and Hussam K. El-Kashlan, xxx). In some patients, chronic infection with otorrhea will persist despite aggressive medical therapy. With the large number of cases of COM which presents to Sanjay Gandhi Memorial Hospital, and a majority being resistant to the common medications, we decided to undertake this study to have a better understanding of the bacterial epidemiology, the resistance, and what antibiotic to use in such cases. To determine the prevalence of different bacteriological agents and their antibiotic sensitivity pattern in patients of Chronic Otitis Media-Active Mucosal Disease presenting to ENT OPD at Sanjay Gandhi Memorial Hospital, Mangolpuri, Delhi. An observational cross-sectional study of 200 patients. After an initial examination, two sterile cotton swab sticks were introduced to collect pus samples from the medial part of the external auditory canal. The swabs were sent to the microbiology lab for Gram Staining, Culture, and Biochemical Tests, for identification of the different bacteriological agents and their antibiotic sensitivity patterns. Most common organism seen was Pseudomonas aeruginosa, followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus mirabilis, mixed bacterial growth, and Candida spp. If regular monitoring of bacteriological profile is done in each hospital, this will help us to choose the antibiotics in a better manner and hence prevent the appearance of newer resistant strains.

Multidrug Resistance Pattern of Pseudomonas aeruginosa Isolated from Patients with Nosocomial Infection

Multidrug resistant (MDR) Pseudomonas aeruginosa is a threat to the patients having nosocomial infections as this pathogen increases the inpatients’ morbidity and mortality by slowing down the whole treatment process. The aim of this study was to evaluate multidrug resistant phenotypes among nosocomial strains of P. aeruginosa for analyzing their antibiotic susceptibility pattern. A total of 108 P. aeruginosa clinical isolates were recovered from various samples (pus, wound swab, urine, sputum, blood and tracheal aspirate) of patients with nosocomial infections. Antibiogram was performed by disc diffusion according to Kirby-Bauer method to study the antibiotic sensitivity pattern of the pathogen against 14 regularly used antibiotics (amikacin, aztreonam, ceftazidime, ceftriaxone, co-trimoxazole, ciprofloxacin, gentamicin, levofloxacin, meropenem, netilmicin, doxycycline, amoxicillin/clavulanic acid, piperacillin/tazobactam, and tigecycline) in Bangladesh. The overall frequency of drug resistance was found to be very high (53.7% - 98.1%) to all of the anti-pseudomonal drugs tested. Resistance of P. aeruginosa strains against piperacillin-tazobactam was significantly less (53.7%) as compared to other thirteen antibiotics. However, isolates showed highest resistance (98.1%) to aztreonam. Next in order of resistance were doxycycline (95.4%), ceftriaxone (94.4%), amoxiclav (93.5%), and the others. The present study suggests that regularly used medications can no longer be utilized as first line therapies for suspected pseudomonad infections. This study claims for urgent epidemiological monitoring of the MDR P. aeruginosa strains in all hospitals of Bangladesh to prevent rapid dissemination of this opportunistic pathogen.
 Bangladesh J Microbiol, Volume 40, Number 1, June 2023, pp 7-13

The microbial spectrum and antimicrobial resistance pattern in pediatric cancer patients with febrile neutropenia at King Abdullah University Hospital, Jordan

BackgroundFebrile neutropenia (FN) is a life-threatening complication of cancer therapy. Appropriate antibiotic treatment improves the clinical outcome in these patients; however, the increasing rate of anti-microbial resistance makes its therapy particularly challenging.AimThis study aims to investigate the microbial spectrum and antimicrobial resistance pattern in cancer patients with FN at King Abdullah University Hospital, Jordan.MethodBlood cultures of 261 FN patients pre-diagnosed with malignancy (age 1–18 years) were enrolled in this study.ResultsThe most common isolated microorganisms were gram-positive bacteria (50.2℅). Gram-infections with coagulase-negative Staphylococcus (CONS) are the most prevalent pathogens, followed by gram-negative infections with Klebseilla pneumonia and fungal infections with nonalbicans strains. All CONS, Methicillin-resistant Staphylococcus aureus (MRSA), and enterococcus species were sensitive to Vancomycin and Teicoplanin. Ten percent of the gram-negative organisms were Extended-spectrum beta-lactamase (ESBL) and all were sensitive to carbapenems. 66.7% of pseudomonas aeruginosa blood cultures were sensitive to Piperacillin-Tazobactam and 83.4% were sensitive to carbapenems. All Enterobacter species were sensitive to Carbapenems.ConclusionIsolates showed various antibiotic sensitivity and resistance patterns; therefore, a judicious management plan is essential to establish an appropriate and effective institutional policy for the use of empirical antibiotics in patients of FN.

Bile Culture May Guide Antibiotic Stewardship in Acute Bacterial Cholangitis.

Bile cultures are often sent with blood cultures in patients with acute bacterial cholangitis. To assess the yield of blood and bile cultures in patients with cholangitis and the clinical utility of bile cultures in guiding therapy. All patients diagnosed with cholangitis, based on the Tokyo 2013/2018 guidelines were recruited retrospectively over ten years. The clinical and investigation details were recorded. The results of bile and blood cultures including antibiotic sensitivity patterns were noted. The concordance of microorganisms grown in blood and bile cultures and their sensitivity pattern were assessed. A total of 1063 patients with cholangitis were included. Their mean age was 52.7 ± 14years and 65.4% were males. Blood cultures were positive in 372 (35%) patients. Bile culture was performed in 384 patients with 84.4% being positive, which was significantly higher than the yield of blood culture (p < 0.001). Polymicrobial growth was more in bile (59.3%) than in blood cultures (13.5%, p < 0.001). E.coli, Klebsiella, Enterococcus and Pseudomonas were the four most common organisms isolated from both blood and bile. Extended spectrum betalactamase producing organisms were isolated in 57.7% and 58.8% of positive blood and bile cultures, respectively. Among 127 patients with both blood and bile cultures positive, complete or partial concordance of organisms was noted in about 90%. Bile and blood cultures have a similar microbial profile in most patients with cholangitis. As bile cultures have a significantly higher yield than blood cultures, they could effectively guide antimicrobial therapy, especially in those with negative blood cultures.

THE PREVALENCE, ISOLATION, AND ANTIMICROBIAL SUSCEPTIBILITY TESTING OF ENTEROCOCCUS SPECIES FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL

Background: Enterococcus is routinely considered a low-grade pathogen. The synergistic action of Enterococci with other bacteria increases the risk of infection. Enterococci are currently the next most common cause of healthcare-associated infections after E. coli. Greater understanding is needed regarding Enterococcus stress survival, virulence, and resistance patterns to assess the complexity of disease-causing Enterococcus. Purpose: Analyze the prevalence of Enterococcus and assess the antibiotic sensitivity pattern of Enterococcus. Method: A descriptive cross-sectional study was designed and carried out in the Department of Microbiology at Bangladesh University of Health Sciences, Dhaka, over a period of 3 months. Bacterial culture and sensitivity were the methods employed for microbiological examination. Result: A total of 558 bacterial strains were isolated, among which the growth of Enterococcus spp. was 27 (4.83%). The prevalence of Enterococcus spp. among different samples was 4.83%. The number of highly sensitive strains ranged from 66.66% to 77.77% for antibiotics, namely gentamycin, ampicillin, amoxicillin, and meropenem. Moderately high sensitivity to levofloxacin (29.62%) and low sensitivity to doxycycline (14.81%) were also analyzed. Conclusion: The study recommends that antibiotics should be used after proper laboratory procedures are undertake, and it should be selected based on antimicrobial susceptibility tests.

Positive Bacterial Culture among Adults with Suspected Urinary Tract Infections Presenting to the Department of Medicine of a Tertiary Care Centre.

Urinary tract infections are the most common infections encountered in clinical practice. Treatment needs to take into account the likely organism, comorbidities and local antibiotic sensitivity pattern. This study aimed to find the prevalence of positive bacterial culture among adults with suspected urinary tract infections presenting to the department of medicine of a tertiary care centre. A descriptive cross-sectional study was conducted among adults with suspected urinary tract infections. Data was collected between 1 July 2022 to 31 December 2022 after obtaining ethical approval from the Institutional Review Committee. Individuals with symptomatic urinary tract infections were included in the study. The antibiotic susceptibility tests of the isolates were done. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 355 patients, positive cultures were obtained in 148 (41.69%) (36.56-46.82, 95% Confidence Interval). Escherichia coli 120 (81.08%) was the predominant organism cultured among the positive bacterial culture cases. The prevalence of positive bacterial culture was found to be higher than other studies done in similar settings. aminoglycosides; Escherichia coli; prevalence; urinary tract infections.

Postoperative Incidence of Symptomatic Urinary Tract Infection (UTI) and Microbial Pattern Seen in TURP Patients with Negative Cultures Preoperatively

Background: Transurethral Resection of the Prostate (TURP) is the gold standard for surgical treatment of benign prostate hyperplasia (BPH). One of the postoperative complications of TURP is urinary tract infection (UTI). Symptomatic UTI occur despite preoperative sterile urine, prophylactic antibiotics and a closed drainage system. We studied the incidence of such symptomatic UTI and the microbial pattern observed. Material and Methods: This was a prospective study of 220 patients who had monopolar TURP in our centre from 2015 to 2020. All patients had sterile urine before surgery. Catheters were removed three days postoperatively. Patients presenting with symptoms of UTI were subjected to urine culture and antibiotic sensitivity. The recorded variables include patient demographics, co-morbid factors; Diabetes, hypertension, presence or absence of preoperative catheterization, duration of surgery, presence of postoperative UTI, microbial patterns and antibiotic sensitivity patterns. Results: The mean age of the patient was 66.25 years. 35.5% had preoperative catheterization. 42 (19%) patients were established to have symptomatic UTI. Age ≥ 65 years, duration of surgery ≥60 mins led to higher infection rates but preoperative catheterization, diabetes and hypertension did not influence UTI rates. The commonest organism was E. Coli and the most common sensitive antibiotic was levofloxacin (quinolone). Conclusions: Symptomatic UTI post-TURP still occurs despite preoperative sterile urine and routine prophylactic antibiotics.