Antibiotic Sensitivity Profile Research Articles

Pattern of Organisms and their Sensitivity to Antibiotics in Patients Suffering from UTI Attending in Private Chamber a Prospective Study from 2016-2018

Background: Urinary tract infections (UTIs) are a prevalent health concern globally, with bacterial pathogens causing significant morbidity. Effective UTI management requires accurate pathogen identification and antibiotic susceptibility profiling, especially amid rising antibiotic resistance, which complicates treatment. In Bangladesh, private clinics frequently cater to patients seeking prompt care, but limited data exists on UTI pathogen patterns and resistance in these settings. Objective: This study aimed to assess the prevalence of UTI-causing organisms and their antibiotic sensitivity profiles in patients attending a private clinic in Bangladesh from 2016 to 2018, with a focus on understanding regional resistance patterns. Methodology: A prospective observational study was conducted, analyzing urine samples from 63 UTI patients. The pathogens were isolated using standard microbiological techniques, and antibiotic susceptibility was evaluated using disk diffusion methods. Data were analyzed to determine the most and least effective antibiotics for each pathogen, alongside demographic analysis of UTI occurrence. Results: Escherichia coli emerged as the primary UTI pathogen (66.7%), followed by Methicillin-Sensitive Staphylococcus aureus (MSSA) (25.4%). Antibiotic susceptibility showed high sensitivity to Imipenem, Meropenem, and Amikacin for E. coli, while Cephradine and Cefixime exhibited significant resistance. MSSA showed high sensitivity to similar antibiotics but notable resistance to Co-trimoxazole and Doxycycline. The majority of UTI cases were in patients aged 21–30 years (44.4%). Conclusion: The study reveals high resistance to commonly used antibiotics in a private clinical setting, emphasizing the need for localized antibiotic stewardship to manage UTI treatment effectively and mitigate resistance. Ongoing surveillance in private clinics is recommended to tailor interventions and adjust treatment protocols based on resistance trends.

Microbiological Concordance of Subglottic Secretion and Tracheal Aspirate Cultures of Critically Ill Patients with Invasive Airway Devices: A Prospective Observational Study.

Development of ventilator-associated pneumonia (VAP) is attributed to the microaspiration of pooled secretions around the cuff of airway devices. Despite the emphasis on the use of endotracheal tubes (ET) with subglottic secretion (SS) drainage ports to prevent VAP, the quality of the evidence for this recommendation remains moderate. This prospective observational study analyzed microbiological concordance between SS and endotracheal aspirate (ETA) cultures to generate further evidence in this regard. Paired samples (SS and ETA) of 100 consenting patients admitted to intensive care unit (ICU) were sent on day 1, 4, and 7 to the microbiology laboratory where they were transcultured and species identification was performed. The SS and ETA were considered concordant or discordant based on isolated organisms and antibiotic sensitivity profile. Clinical surveillance for VAP was done according to CDC criteria during the first week of ventilation. For a total of 197 paired samples, the overall concordance of SS and ETA cultures was 71.5%, with day-wise concordances of 68, 76.2, and 73.5% for D1, D4, and D7, respectively. Gram-negatives bacteria were the most frequently isolated, with 125 (31.7%) samples reporting A. baumannii. Amongst 18 patients clinically diagnosed with VAP during the first week of MV, the concordance between SS and ETA was 73.5%, and day-wise concordance was 77.2, 72.2, and 76.9% on D1, D4, and D7, respectively. A fairly high microbiological concordance was observed in SS and ETA samples obtained from patients with invasive airway devices, and similar concordance was found in patients developing VAP during the first week of ventilation. Panigrahi P, Ganesh V, Angrup A, Sahni N, Biswal M, Yaddanapudi L. Microbiological Concordance of Subglottic Secretion and Tracheal Aspirate Cultures of Critically Ill Patients with Invasive Airway Devices: A Prospective Observational Study. Indian J Crit Care Med 2024;28(12):1139-1146.

Anti-Tetanus Vaccination Is Associated with Reduced Occurrence and Slower Progression of Parkinson's Disease-A Retrospective Study.

Background: Parkinson's disease (PD) is a neurodegenerative disorder that progressively damages the autonomic and central nervous systems, leading to hallmark symptoms such as resting tremor, bradykinesia, and rigidity. Despite extensive research, the underlying cause of PD remains unclear, and current treatments are unable to halt the progression of the disease. In this retrospective study, based on historical electronic health records (EHR) from a national health provider covering the period from 2003 to 2023, we investigated the impact of vaccination and medication purchases on PD occurrence and severity. Methods: Using a case-control design, we compared the vaccination histories of 1446 PD patients with 7230 matched controls to assess the association between vaccination and PD onset. Additionally, we explored statistical associations between vaccination, medication purchases, and PD severity over an average of 9 years of follow-up, utilizing a machine learning algorithm to quantify disease severity based on annual antiparkinsonian medication purchases. Results: Our analysis revealed a significant reduction in PD occurrence following tetanus-diphtheria (Td) vaccination, with an adjusted odds ratio of 0.17 (95% CI [0.04, 0.70]) for PD onset within 5 years post-vaccination. Furthermore, a time-dependent relationship was identified between the duration since vaccination and both the rate of PD onset and disease progression. Notably, we observed that antimicrobial treatments significantly influenced disease severity, consistent with the antibiotic sensitivity profile of Clostridium tetani. Conclusions: These findings support the hypothesis that tetanus vaccination and/or C. tetani eradication may reduce PD occurrence and slow its progression, suggesting promising directions for future research in PD prevention and treatment.

Bacteriological profile and antimicrobial sensitivity pattern of wound infections in burns ward of a tertiary care hospital: a retro-prospective study

Abstract Background: Nosocomial infections pose a significant risk to burn patients, contributing to high rates of morbidity and mortality. Burn injuries, particularly in developing countries, present a major public health concern. Therefore, it is crucial to identify the microorganisms present in burn wounds to guide effective treatment strategies. This study aims to determine the prevalence of bacteria isolated from burn wounds and to evaluate their antimicrobial sensitivity profiles. Materials and Methods: This retrospective observational study collected data from January to July 2022 and from January to July 2023. Lab reports of all swabs collected from burn wounds for microbial identification and antibiotic sensitivity profile were noted down. The data were analyzed manually using MS Excel and presented as frequencies and graphs. Results: Of the 152 wound samples, 82% showed bacterial growth, whereas 18% showed no growth. The most frequently isolated organism was Pseudomonas (40%), followed by Staphylococcus (20%), Acinetobacter (17.6%), Klebsiella (16.8%), Enterobacter (3.2%), Citrobacter (1.6%), and Chryseobacterium (0.8%). Colistin, polymyxin B, vancomycin, and linezolid were the most effective antibiotics. Conclusion: The predominant bacterial isolates were Pseudomonas aeruginosa and Staphylococcus aureus. For treatment, colistin or levofloxacin may be used against Pseudomonas, vancomycin or rifampicin against Staphylococcus, colistin or tigecycline against Acinetobacter, and cefoperazone–sulbactam or linezolid against Klebsiella as reserved antibiotic options.

Trends of Antimicrobial Sensitivity Among Common Isolates in a Tertiary Care Hospital, Rawalpindi

Objective: To evaluate the resistance patterns of frequently found pathogens to different antimicrobial agents, aiding physicians in choosing appropriate treatment strategies for patients within our locality. Materials and Method: This retrospective observational study took place at Pakistan Railway hospital (PRH) Rawalpindi; from January 2021 to December 2021. Data was obtained from the institute's database, the Hospital Information Management System (HIMS). Pathogens were identified in the laboratory through Gram staining and biochemical tests, and their antibiotic sensitivity profiles using disk diffusion method assessed following protocols established by the Clinical & Laboratory Standards Institute. Statistical analysis was conducted using SPSS version 24, and data entry was carried out accordingly. Results: Overall, 1128 positive cultures were reported in study period including urine, pus, HVS, sputum cultures, stool, blood, catheter tip, and others (tissue fluid, wound, and cannula tip etc.). They comprised 32.8 %, 30.9 %, 16.6%, 5.05 %, 3.81%, 3.72 %, 1.15%, 0.70 % and 0.08% of the other specimens respectively. Among the isolates, Escherichia coli revealed 31.4% resistance against one of the third-generation cephalosporin and 8% to imipenem while Klebsiella pneumoniae exhibited 58.7% resistance. Moreover 82% Staphylococcus aureus were resistant to oxacillin, and 6% to vancomycin. Conclusion: Moderate to reduced susceptibility to frequently utilized antimicrobials has been noted across diverse gram-positive and gram-negative species, apart from Penicillin. To address the escalating resistance to carbapenems and cephalosporins, it is essential to establish and enforce rigorous infection control measures.

Drug resistance and genomic variations among Mycobacterium tuberculosis isolates from The Nile Delta, Egypt

Tuberculosis is a global public health concern. Earlier reports suggested the emergence of high rates of drug resistant tuberculosis in Egypt. This study included 102 isolates of Mycobacterium tuberculosis collected from two reference laboratories in Cairo and Alexandria. All clinical isolates were sub-cultured on Löwenstein–Jensen medium and analyzed using both BD BACTEC MGIT 960 SIRE Kit and standard diffusion disk assays to identify the antibiotic sensitivity profile. Extracted genomic DNA was subjected to whole genome sequencing (WGS) using Illumina platform. Isolates that belong to lineage 4 represented > 80%, while lineage 3 represented only 11% of the isolates. The percentage of drug resistance for the streptomycin, isoniazid, rifampicin and ethambutol were 31.0, 17.2, 19.5 and 20.7, respectively. Nearly 47.1% of the isolates were sensitive to the four anti-tuberculous drugs, while only one isolate was resistant to all four drugs. In addition, several new and known mutations were identified by WGS. High rates of drug resistance and new mutations were identified in our isolates. Tuberculosis control measures should focus on the spread of mono (S, I, R, E)- and double (S, E)-drug resistant strains present at higher rates throughout the whole Nile Delta, Egypt.

Respiratory diphtheria in the time of Omicron.

Diphtheria is a potentially fatal bacterial infection caused by toxin-producing strains of corynebacteria, most often Corynebacterium diphtheriae and less commonly Corynebacterium ulcerans. Incidence of the disease has fallen significantly since the introduction of vaccination programs; it is now rare in countries with high vaccination coverage such as Australia. This article presents the most recent respiratory cases of diphtheria in two children in New South Wales-the first locally acquired childhood cases in Australia in 30 years-and discusses potential contributing factors. These encompass the lack of clinical awareness and the delays in laboratory diagnosis in regional laboratories. The cases also highlight the problem of vaccine hesitancy and the role that primary carers play in addressing these anxieties. While clinical management of the cases progressed well, factors in the public health responses were complicated by access to appropriate care and by delays in antibiotic sensitivity profiles. The public health response to these cases raises important considerations for clinicians and public health practitioners, including preparedness for rare and re-emerging diseases, the need for culturally safe environments and the importance of addressing vaccine hesitancy. Preparedness requires consideration of the capacity of regional health systems with fewer resources and of how public health departments can support response to multiple crises. Preparedness also relies on access to necessary diagnostic laboratory resources, on up-to-date guidelines, and on maintaining awareness among clinicians for these rare infections.

Genomic diversity and nutritional analysis of multi-drug resistant extended spectrum β-lactamase Producing-Klebsiella pneumoniae genes isolated from mastitic cattle milk in district peshawar, Pakistan

The increasing incidence of resistance extended spectrum-beta lactamase (ESBL) producing Klebsiella pneumonia become worldwide issue. The current study aimed to determine the genomic diversity of ESBL-producing K. pneumoniae in milk samples collected from cows with mastitis as well as their antibiotic sensitivity profiles and genetic identification in Peshawar, Pakistan. The california mastitis test (CMT) was initially used to verify the presence for mastitis in 700 collected milk samples. The molecular identification of the 16SrRNA gene confirmed 120/700 (17.14 %) propagation of K. pneumonia. Out of these isolates MDR ESBL-producing isolates were 60/120 (50 %). The lactose were found (M = 3.96 ± 0.28, SD = 2.19), followed by fats (M = 3.12 ± 0.11, SD = 0.90), protein (M = 5.97 ± 0.24, SD = 1.84), sodium (M = 55.74 ± 2.07, SD = 15.81), potassium (M = 138.5 ± 1.53, SD = 11.71), chloride (M = 0.74 ± 0.03, SD = 0.24), calcium (M = 10.27 ± 0.31, SD = 2.42), and chlorine (M = 2.80 ± 0.22, SD = 1.70), respectively. Amikacin (80 %), ceftazidime (71 %), and tetracycline (71 %) were shown to be the most effective antimicrobials against all of the isolates. The occurrence of the blaSHV gene was observed at 56.00 % whereas the blaTEM gene and blaCTX-M gene were 36.00 %, and 30.00 %. The distribution of blaCTX-M subgroup genes was followed by blaCTX-M-1 (38.00 %), blaCTX-M-9 (22.20 %), and blaCTX-M-15 (61.10 %). Co-occurrence of blaCTX-M+ blaSHV was (15.00 %), blaCTX-M+ blaTEM were (6.60 %), and blaSHV + blaTEM were (10.00 %), respectively. The inappropriate, prolonged and common use of antibiotics may apply selective pressure for propagation and the occurrence of resistant isolates.

Isolation and characterization of mercury and multidrug-resistant Citrobacter freundii strains from tannery effluents in Kolkata, India.

Mercury (Hg) is one of the most potent toxic heavy metals that distresses livestock, humans, and ecological health. Owing to uncontrolled exposure to untreated tannery industrial effluents, metals such as Hg are increasing in nature and are, therefore, becoming a global concern. As a result, understanding the thriving microflora in that severe condition and their characteristics becomes immensely important. During the course of this study, two Hg-resistant bacteria were isolated from tannery wastewater effluents from leather factories in Kolkata, India, which were able to tolerate 2.211 × 10- 3 M (600µg/ml) Hg. 16S rDNA analysis revealed strong sequence homology with Citrobacter freundii, were named as BNC22A and BNC22C for this study. In addition they showed high tolerance to nickel (Ni) and Chromium (Cr) at 6.31 × 10- 3 M (1500µg/ml) and 6.792 × 10- 3 M (2000µg/ml) respectively. However, both the isolates were sensitive to arsenic (As) and cadmium (Cd). Furthermore, their antibiotic sensitivity profiles reveal a concerning trend towards resistance to multiple drugs. Overuse and misuse of antibiotics in healthcare systems and agriculture has been identified as two of the main reasons for the decline in efficacy of antibiotics. Though their ability to produce lipase makes them industrially potent organisms, their competence to resist several antibiotics and metals that are toxic makes this study immensely relevant. In addition, their ability to negate heavy metal toxicity makes them potential candidates for bioremediation. Finally, the green mung bean seed germination test showed a significant favourable effect of BNC22A and BNC22C against Hg-stimulated toxicity.

Morphogenetic characterization of Xanthomonas citri pv. citri and its management

BackgroundPakistan’s economy largely depends on citrus cultivation, and citrus fruits generate significant foreign exchange. Xanthomonas citri pv. citri (Xcc) is the primary cause of citrus canker (CC), which poses a significant threat to the industry. The management of disease is made more difficult by the lack of resistant variants against different Xcc races. Understanding and addressing Xcc are critical for maintaining the industry given the economic reliance on citrus. MethodsIn order to isolate Xcc in a lab, a thorough survey was conducted in the districts of Bahawalpur, Multan, and Dera Ghazi Khan to collect samples showing canker symptoms. Gram-negative bacteria were identified in the isolates by biochemical analysis, and Koch’s postulates confirmed Xcc as the CC causing agent. DNA extraction and sequencing were used in the molecular characterization, which confirmed the phylogenetic relationship with Xcc. Using the disc sensitivity method, nine antibiotics were tested at 300, 500, and 700 ppm concentrations to evaluate CC management. Amoxicillin was found to be highly effective in inhibiting the growth of Xcc colonies. ResultsThe study provided morphogenetic insights and established Xcc as the causal agent of CC. All strains matched Xcc in molecular characterization, but antibiotic sensitivity testing revealed inconsistent efficacy. Amoxicillin proved to be very effective at stopping the growth of Xcc colonies at every tested dosage. ConclusionThis study makes an important contribution to our understanding of XCC and helps the citrus industry develop better disease control plans. Future interventions against citrus canker can benefit greatly from the understanding provided by morphogenetic characterization and antibiotic sensitivity profiles. The discovery of amoxicillin’s high efficacy highlights the drug’s potential for treating diseases linked to Xcc. These results help to protect citrus growing, maintaining the viability of an important industry in Pakistan’s agricultural landscape.

Antibiotic Indexing and Heavy Metal Reduction Potential of Four Multi-metal Tolerant Bacterial Strains in Real-Time Sanitary Landfill Leachate Matrix.

Sanitary leachate from urban landfills is known to be contaminated with multi-metals and residual antibiotics. Current research edges on exploring the multi-metal and antibiotic sensitivity profile of four indigenous strains, "Brevibacillus spp. Leclercia spp. Pseudescherichia spp., and Brucella spp." isolated from the leachate of a sanitary landfill in a tropical region. Indigenous isolates were observed to be antibiotic-resistant and have high tolerance against eight of the ten tested metals except Cu & Co. It was observed that interaction with multi-metals in laboratory conditions significantly altered the cell morphology of bacterial strains, as depicted by Scanning Electron Microscope. Metal adsorption onto the microbial surface was deciphered through Electron Dispersive Spectrometer analysis and elemental mapping. Application of isolated strains into real-time leachate matrix exhibits a complete reduction of Ag and Zn and for other tested metals. Their response to these toxicants may facilitate their application in bioremediation-based treatment technologies for urban landfill leachate.

Robust and safe: Unveiling Bacillus clausii OHRC1's potential as a versatile probiotic for enhanced food quality and safety

This research underscores the exceptional potential of Bacillus clausii as a probiotic for food products. Our study assessed Bacillus clausii under simulated gastrointestinal conditions, revealing its impressive resilience: 58% resistance to pepsin, 70% to bile salts and pancreatin, and 41% viability at low pH. It also showed significant auto-aggregation (42.87%) and co-aggregation with Escherichia coli ATCC 35150 (44.6%), Bacillus cereus ATCC 13061 (59.7%), and Staphylococcus aureus ATCC 13150 (30.9%). The strain's antibiotic sensitivity profile—susceptible to ampicillin and vancomycin, resistant to trimethoprim and erythromycin—ensures its safety for food use, confirmed by the absence of hemolysis, gelatinase activity, biogenic amine production, and toxicity in Caenorhabditis elegans. Remarkably, Bacillus clausii exhibited high thermal stability, with survival rates up to 96.31% at 90 °C for 30 min and 82.76% at 100 °C for 60 min, and a broad pH tolerance (41%–99.7% survival from pH 2 to 12). The strain's response to heat stress involved key antimicrobial and spore formation genes (spaS, sboA, BAC A, and SPO). This study establishes Bacillus clausii OHRC1 as a robust, safe, and versatile probiotic, suitable for enhancing food quality and safety in ready-to-eat products.

Antibiotic resistance and plasmid profile of bacteria associated with nosocomial infections: A case study of Ekiti -State Teaching Hospital

Many serious health problems resulting in an enormous burden of morbidity and high health care costs are traceable to infections caused by the nosocomial pathogens; major victims are relatives of patients, the care givers who are doing their legal duties and at times the patients whose conditions could be complicated. The causative organisms of these infections and their sensitivity to antibiotics need to be ascertained. This study investigated the antibiotic sensitivity and plasmid profile of bacteria associated with nosocomial infections. A total of 45 samples were collected from children, male and female surgical wards in Ekiti State Teaching Hospital, Ado-Ekiti by using swab sticks and settling plates method. Isolation of bacteria, antibiotic sensitivity and plasmid profiling of the isolates were carried out using standard microbiological methods. The results showed that a total of 56 bacterial isolates were obtained from the 3 different wards, this includes Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Lactobacillus fermenti, Bacillus subtilis, Bacillus cereus and Micrococcus luteus. Staphylococcus aureus had the highest frequency of occurrence with 30(53.6%), followed by Staphylococcus epidermidis 10(17.7%), Escherichia coli 7(12.5%), Lactobacillus fermentii and Micrococcus luteus 3(5.4%) and Bacillus subtilis 2(3.6%) respectively, while Bacillus cereus 1(1.8%) had the least frequency of occurrence. The gram positive isolates were more resistant to the antibiotics compare to the gram negative isolates, Staphylococcus aureus was the most resistant of all the isolates followed by Staphylococcus epidermidis, the five representative resistant isolates harbored plasmid of different sizes. The findings of this study suggests that patients, care givers and visitors to the hospital should maintain good personal hygiene and proper sanitary measures to avoid nosocomial infections, therefore, surveillance of nosocomial pathogens is important to reduce hospital stay, cost, morbidity and mortality rate.

Phenotypic identification of different β-Lactamases in intrinsic and acquired colistin resistant uropathogenic gram negative bacteria.

Identification of MBL, AmpC and ESBLs in colistin intrinsic and acquired resistant uropathogenic gram negative bacteria. Urine samples were collected from Hayatabad Medical Complex, Peshawar during 17 January to 30 June 2019. Collected urine samples were aseptically transported microbiology lab of Health Research Institution (HRI), National Institute of Health (NIH), Khyber Medical College, Peshawar and streaked on different media. Positive growth was identified by API-10s. Antibiotic sensitivity profile was done by Modified Kirby Bauer disc diffusion method. Detection of metallo βlactamases (MBL) production by Imipenem EDTA synergy test, Double Disc Synergy Test (DDST) for detection of ESBLs and D-test for the detection of inducible AmpC beta lactamases test was used. Colistin resistance was identified via broth micro dilution according to CLSI manual. Colistin resistant bacteria was divided in two categories; acquired and intrinsic resistant bacteria according to CLSI manual. Out of 2000 urine samples, 281(14%) gram-negative bacteria were isolated. Among positive samples, acquired colistin resistant bacteria were 241 and intrinsic resistant bacteria were 40 isolates. MBL was produce by twenty one (11.7%) E.coli and seventeen (40.5%) Pseudomonas aeruginosa. E. coli, Pseudomonas aeruginosa, Klebsiella Pneumoniae, Serratia Oderifora and Proteus Marblis were ESBLs producing bacteria. AmpC production was prevalent in fourteen (7.8%) E. coli and twelve (28.6%) Pseudomonas aeruginosa. Fifty-five samples showed resistance to colistin out of 241 samples. In colistin resistant bacteria, two E.coli were MBL, ESBLs, while one E.coli was ESBLs, AmpC co-producing bacteria. The most prevalent extended drug resistant bacteria were Pseudomonas aeruginosa (28.6%) and Escherichia coli (6.1%), While 155(86.6%) Escherichia coli, 25 (59.5%) Pseudomonas aeruginosa and 22 (95.7%) Serratia Oderifora was multi drug resistant bacteria. Current study concluded that ESBL, MBL AmpC enzymes and their co-expression was observed with colistin resistance in E.coli and Pseudomonas aeruginosa.

Prevalence and Antibiotic Sensitivity Profile of Pseudomonas aeruginosa Isolated from Patients with Otitis Media in Kirkuk City

Background: Otitis media (OM) is middle ear inflammation, it is a prevalent health care disorder that affects people of all ages and both genders. Pseudomonas aeruginosa (P. aeruginosa) is the most prevalent pathogen bacteria that causes the disease and has a high level of antibiotic resistance. The P. aeruginosa possess virulence characteristics which cause damages to the middle ear mucosa.Antibiotic resistance constitutes the main threat to people's health. Objective: The objective of the current study is to evaluate the frequency of P. aeruginosa isolated from Otitis media patients and investigate their antibiotic susceptibility pattern. Materials and Methods: total of 235 ear swabs were collected from otitis media patients who visited a specialized outpatient center in Kirkuk City and the ENT consultation facility at Kirkuk Hospitals. Antibiotic susceptibility testing by the VITEK 2 AST card and bacterial isolation and identification were both done. Results: The results of this study reveal that out of 235 ear swabs collected from patients with otitis media showed 22/235 (9.4 %) isolation rate for P. aeruginosa. And among the most effective antibiotics against the most of the detected pathogenic bacteria were Amikacin (95.4%), followed by Ceftazidime/ Avibactam, Piperacillin /Tazobactam, and Ceftolozane/ Tazobactam each with (91%), Colistin (86%), Imipenemand and Meropenem (81.8%, 86.4%) respectively, Ceftazidime, Cefeime, Levofloxacin, and Azreonam each with ( 77.3%), Ciprofloxacin and Ofloxacin both (72.7%) with Gentamicin (68.2%). Conclusion: The bacteria P. aeruginosa was most common prevalent isolate in the ear swabs, and this bacteria is multidrugs resistance (MDR). Additionally, the most efficient antibiotic against P. aeruginosa isolates responsible for otitis media was Amikacin.

Antibiotic Susceptibility Profiling of Gram-Positive and Gram-Negative Bacterial Isolates in a Tertiary Care Hospital: Establishment of an Antibiogram.

Introduction Antimicrobial resistance poses a significant global healthcare challenge in the management of bacterial infections, which is frequently attributed to rapid bacterial adaptations. This study aims to develop an antibiogram for a tertiary care hospital, providing comprehensive antibiotic sensitivity profiles for Gram-positive and Gram-negative bacteria. It informs healthcare providers of antibiotic resistance trends, enabling informed treatment decisions and enhanced infection control measures. Methods We conducted a six-month prospective observational study, during which we gathered and analyzed data from the microbiology laboratory to identify patterns of antimicrobial sensitivity. Subsequently, the data underwent analysis and interpretation using the respected WHONET software, a readily available tool designed for this specific task. Our methodology adhered to the guidelines established by the Clinical & Laboratory Standards Institute for the standardization of antibiogram generation procedures, and these guidelines are easily integrated into the WHONET software for analytical purposes. Results There were a total of 357 isolates across various hospital departments, comprising 13 distinct bacterial species. Among them, nine were identified as Gram-negative bacteria, accounting for 262 (73.3%) isolates. Escherichia coli accounted for 131 (36.6%) isolates, while Klebsiella accounted for 62 (17.3%), emerging as the predominant species among them. The remaining four bacterial species were identified as Gram-positive bacteria, totaling 95 (26.6%) isolates, with Staphylococcus aureus being the most frequently isolated species at 51 (14.2%), followed by Enterococcus at 26 (7.2%). Subsequent analysis using the WHONET software facilitated the creation of an antibiogram. Among the Gram-negative bacteria, E. coli displayed high sensitivity (100%) to aztreonam and clindamycin, followed by nitrofurantoin (98%), imipenem (94%), and meropenem (95%). However, it exhibited decreased sensitivity to ampicillin (25%), cefuroxime (34%), and ceftriaxone (39%). Conversely, among the Gram-positive bacteria, S. aureus demonstrated 100% sensitivity to ampicillin, amoxiclav, cefazolin, teicoplanin, linezolid, rifampicin, nitrofurantoin, and cefotaxime. However, it exhibited zero sensitivity to vancomycin and only 6% sensitivity to cotrimoxazole. Conclusion This study advances the understanding of antibiotic susceptibility in a tertiary care setting and provides an invaluable tool for optimizing treatment strategies, enhancing infection control measures, and combating antibiotic resistance.

Assessing Respiratory Tract Infections' Prevalence and Microbial Profiles in Mechanically Ventilated Patients: Insights From Broncho Alveolar Lavage Examination.

Introduction Chest infections represent a significant challenge in mechanically ventilated patients, often leading to adverse outcomes despite advancements in critical care. This prospective study was conducted in the intensive care unit of tertiary referral care, with objectives to assess chest infection prevalence, microbial profiles, and outcomes in mechanically ventilated patients through broncho-alveolar lavage (BAL) examination. Methodology This prospective study involved 38 patientsaged 15 to 65 yearswho were receiving mechanical ventilation and underwent BAL. The procedureof BALwas followed as per the guidelines and recommendations outlined by the American Thoracic Society for Bronchoscopic Lavage. Microbial analysis involves the use of microscopic examination and quantitative culture methods. Different staining techniques were utilized to identify bacteria, fungi, and mycobacteria. Complications and adverse events were monitored and recorded. Results Out of the 38 patients who underwent BAL, the majority, 30 (78.94%), were found to have chest infections, with gram-negative bacteria, including Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii, being the causative agents. The antibiotic sensitivity profiles indicated that the organisms were susceptible to carbapenems and broad-spectrum β-lactam/β-lactamase inhibitor combinations while showing resistance to fluoroquinolones. Despite adequate treatment, mortality remained significant in 12 (31.57%) patients. Conclusion Study findings underscore the importance of proactive surveillance, early diagnosis, and targeted management strategies to mitigate the burden of respiratory infections in critical care settings.

Spectrum and antibiotic sensitivity of bacterial keratitis: a retrospective analysis of eight years in a Tertiary Referral Hospital in Southwest China.

The objective of this study was to investigate the epidemiological characteristics, distribution of isolates, prevailing patterns, and antibiotic susceptibility of bacterial keratitis (BK) in a Tertiary Referral Hospital located in Southwest China. A retrospective analysis was conducted on 660 cases of bacterial keratitis occurring between January 2015 and December 2022. The demographic data, predisposing factors, microbial findings, and antibiotic sensitivity profiles were examined. Corneal trauma emerged as the most prevalent predisposing factor, accounting for 37.1% of cases. Among these cases, bacterial culture results were positive in 318 cases, 68 species of bacteria were identified. The most common Gram-Positive bacteria isolated overall was the staphylococcus epidermis and the most common Gram-Negative bacteria isolated was Pseudomonas aeruginosa. Methicillin-Resistant Staphylococci accounted for 18.1% of all Gram-Positive bacteria. The detection rate of P. aeruginosa showed an increasing trend over time (Rs=0.738, P=0.037). There was a significant decrease in the percentage of Gram-Negative microorganisms over time (Rs=0.743, P=0.035). The sensitivity of Gram-Positive bacteria to linezolid, vancomycin, tigecycline, quinupristin/dalfopristin, and rifampicin was over 98%. The sensitivity rates of Gram-Negative bacteria to amikacin, meropenem, piperacillin/tazobactam, cefoperazone sodium/sulbactam, ceftazidime, and cefepime were all above 85%. In patients with a history of vegetative trauma, the possibility of BK should be taken into account in addition to the focus on fungal keratitis. The microbial composition primarily consists of Gram-Positive cocci and Gram-Negative bacilli. Among the Gram-Positive bacteria, S. epidermidis and Streptococcus pneumoniae are the most frequently encountered, while P. aeruginosa is the predominant Gram-Negative bacteria. To combat Gram-Positive bacteria, vancomycin, linezolid, and rifampicin are considered excellent antimicrobial agents. When targeting Gram-Negative pathogens, third-generation cephalosporins exhibit superior sensitivity compared to first and second-generation counterparts. As an initial empirical treatment for severe cases of bacterial keratitis and those unresponsive to fourth-generation fluoroquinolones in community settings, the combination therapy of vancomycin and tobramycin is a justifiable approach. Bacterial keratitis can be better managed by understanding the local etiology and antibacterial drug susceptibility patterns.

Survey of Cholera Outbreak and its Resistant Pattern in Baluchistan, Pakistan

Objective: The present study was conducted to identify the isolates of V. cholerae as causative agent for the current outbreak in Baluchistan and evaluate the antibiotic sensitivity profile of the isolates Methodology; This cross-sectional study was conducted at Bolan Medical Complex Hospital Quetta from March to October 2022. Suspected stool samples were received with a history of untreated severe diarrhea within 12-hour duration from different affected districts of Baluchistan Province, Suspected colonies were subjected to gram staining, biochemical analysis and antibiotic susceptibility testing was performed by the Kirby-Bauer disk diffusion method. Results; Total 483 diarrheal samples were collected out of which 43 (8.90 %) were positive and 440 (91.09%) were negative. The all isolates 100 % were resistant to common antibiotics were whereas Ciprofloxacin100%, Levofloxacin 100% and Azithromycin 100% were sensitive to all isolates. Conclusion: Culture methods and biochemical identification of V. cholerae from suspected cholera may be helpful. There needs to be systematic surveillance of commonly used antibiotics and encourage the design and implementation of the cholera control policy advised by the WHO

Pathogen-wise Clinical Profile, Outcome and Antibiotic Sensitivity Profile of Septic Newborns in Level III Neonatal Intensive Care Unit of a Tertiary Teaching Hospital: A Retrospective Study

Introduction: Culture positive sepsis remains to be a leading cause of death in Neonatal Intensive Care Unit (NICU) mainly among preterm and low birth weight newborns. The objective was to analyze the initial signs of sepsis, antibiotic sensitivity, and outcome of septic newborns in NICU. Methods: The demographic data, initial clinical features at suspicion of sepsis, diagnosis, laboratory abnormalities, pathogen isolated and antibiotic sensitivity patterns of the septic neonates, and their outcome were documented from their case records. Results: A total of 161 culture positive septic newborns, 76.4% were preterm and 54 died of sepsis (33.54%). Early and late onset sepsis was seen in 56 and 109 neonates, respectively. The initial clinical findings at suspicion of sepsis which had a statistical significance were tachycardia in Escherichia coli and Pseudomonas sepsis, hyperglycemia in Burkholderia, fever in Candida, sclerema in Klebsiella pneumoniae (KP), and seizures in E. coli sepsis. The cerebrospinal fluid culture positive newborns commonly presented with apnea, poor perfusion, and lethargy. Raised C reactive protein was seen in a higher proportion of newborns with Candida (60%) sepsis and E. coli (50%) sepsis. Severe thrombocytopenia was seen in 53%–62% newborns with gram-negative and fungal sepsis. Metabolic acidosis was seen in all gram-negative sepsis neonates, particularly in >80% cases of Klebsiella and Candida sepsis. Mortality was highest and statistically significant in KP (55.4%) and Citrobacter koseri (55.6%) sepsis ( p = .004). The statistically significant risk factors for mortality included neonates with raised C Reactive Protein (CRP). Most of the gram-negative pathogens were sensitive to colistin and aminoglycosides and resistant to carbapenems. Conclusion: Observing the initial clinical features at suspicion of sepsis may help predicting the likely pathogen awaiting the final blood/CSF culture report and knowing the antibiotic sensitivity profile of commonly isolated organisms in our NICU helps in the selection of a rational empirical antibiotic.