Antimicrobial Susceptibility Patterns Research Articles

Diversity and antimicrobial susceptibility patterns of clinical and environmental Salmonella enterica serovars in Western Saudi Arabia.

The diverse environmental distribution of Salmonella makes it a global source of human gastrointestinal infections. This study aimed to detect Salmonella spp. and explore their diversity and antimicrobial susceptibility patterns in clinical and environmental samples. Pre-enrichment, selective enrichment, and selective plating techniques were adopted for the Salmonella detection whereas the API 20E test and Vitek Compact 2 system were used to confirm the identity of isolates. Salmonella serovars were subjected to molecular confirmation by 16S rDNA gene sequencing. Disc diffusion method and Vitek 2 Compact system determined the antibiotic susceptibility of Salmonella serovars. Multiple antibiotic resistance index (MARI) was calculated to explore whether Salmonella serovars originate from areas with heavy antibiotic usage. Results depicted low Salmonella prevalence in clinical and environmental samples (3.5%). The main detected serovars included Salmonella Typhimurium, S. enteritidis, S. Infantis, S. Newlands, S. Heidelberg, S. Indian, S. Reading, and S. paratyphi C. All the detected Salmonella serovars (27) exhibited multidrug resistance to three or more antimicrobial classes. The study concludes that the overall Salmonella serovars prevalence was found to be low in environmental and clinical samples of Western Saudi Arabia (Makkah and Jeddah). However, antimicrobial susceptibility patterns of human and environmental Salmonella serovars revealed that all isolates exhibited multidrug-resistance (MDR) patterns to frequently used antibiotics, which might reflect antibiotic overuse in clinical and veterinary medicine. It would be suitable to apply and enforce rules and regulations from the One Health approach, which aim to prevent antibiotic resistance infections, enhance food safety, and improve human and animal health, given that all Salmonella spp. detected in this investigation were exhibiting MDR patterns.

A study on clinico-demographic and microbiological profile of surgical site infection (SSI) in a tertiary care hospital, Kolkata: An alarming trend

The Centres for Disease Control and Prevention (CDC) estimates surgical site infections SSI is major contributor of healthcare associated infections (HAI). Multidrug resistant (MDR) Gram-negative bacilli are emerging pathogens. This study aimed to determine the magnitude of SSI and identify predominant pathogens with their antimicrobial susceptibility patterns. It is a hospital-based descriptive cross-sectional study including 2070 suspected SSI specimens from 25809 surgeries between 1July 2021 to 30 June 2023. Organisms’ identification and AST was done by both conventional and automated methods. Data was collected and analysed on MS-Excel sheet with various charts and tables. In our study SSI rate was 6.3%, much higher than previous study (2.83%) from this institution. SSI rate was highest in plastic surgery (8.2%). Major pathogens of SSI were Gram-negative bacilli e.g., (26.34%), (25.59%) and (74.69%) was predominant among Gram-positive cocci. Gram-negative bacilli including enterobacterales and non-fermenter and showed resistance to major classes of broad- spectrum antibiotics. Methicillin resistance (MRSA) was 43.9%, which indicates need to improve infection control practices. Our study showed significant higher proportion of SSI as compared to previous studies from the same institute with alarming number of isolated MDR Gram-negative bacilli. So, this study focusses the need of robust infection control practices and strict implementation of antimicrobial stewardship to overcome challenges of antimicrobial resistance.

Trends in serotype distribution and antimicrobial susceptibility pattern of invasive Haemophilus influenzae isolates from Brazil, 2009-2021.

Invasive Haemophilus influenzae (Hi) disease poses a significant global health challenge. With the relaxation of COVID-19 pandemic measures and declining H. influenzae serotype b (Hib) vaccination coverage, there is concern about a potential increase in Hi cases worldwide. This study analyzed 1437 invasive Hi isolates in Brazil over 13years, determining capsular serotypes, antimicrobial susceptibility, and genetic relatedness through multilocus sequence typing. The primary source of isolation for these invasive H. influenzae isolates was blood (54.4%), followed by cerebrospinal fluid (37.1%) and lung specimens (8.5%), respectively. Consequently, bacteremia (47%) was the most common clinical presentation, followed by meningitis (39.6%) and pneumonia (13.4%). Non-encapsulated Hi (NTHi) predominated among the isolates (51.4%), along with serotype a (22%) and serotype b (21.5%) among the encapsulated isolates. The majority of the encapsulated isolates were isolated from children under 14years of age (76.7%), while NTHi isolates were identified in patients older than 15years, particularly those ≥ 60years old (40%). Ampicillin resistance was observed in 17.1% of cases, displaying β-lactamase production as the principal resistance mechanism. MLST revealed a diverse NTHi population, whereas the encapsulated isolates presented a clonal structure. This study describes the prevalence of NTHi isolates circulating in Brazil after two decades of the Hib vaccine immunization program. Continuous universal surveillance is crucial for implementing prompt public health measures to prevent and control invasive Hi disease and monitor changes in antibiotic resistance profiles.

Molecular Characterization and Antimicrobial Susceptibility Pattern of Microorganisms from Port Harcourt Correctional Center, Rivers State Nigeria

Correctional centers have been reported to be associated with several conditions predisposing inmates to health challenges as a result of exposure to disease causing microbial population. This study therefore targeted the Molecular Characterization and Antimicrobial susceptibility pattern of Microorganisms from Port Harcourt Correctional Center, Rivers State Nigeria. A total of 150 samples (100 from skin (upper arm) and 50 from wall surfaces) were collected using sterile swab sticks and immediately transported to Department of Microbiology Laboratory, Rivers State University for analyses, using standard microbiological techniques. Molecular characterization was done using Polymerase Chain reaction (PCR) and subjected to gene sequencing. The Kirby-Bauer Disc Diffusion method was used for the antimicrobial susceptibility test. Well in agar method was used to assess the susceptibility of the isolates to honey and Aloe Vera extract. The study revealed that 100% of all the bacterial isolates were resistant to Meropenem, Vancomycin, cefuroxime, and Ceftazidine, while 90% of the bacterial isolates were susceptible to Gentamicin, Cepftriaxone, Erythromycin, and Ciproflozaxine. Data showed the MAR index ranged from 0.3 to 0.8. Statistical analysis revealed there were no significant differences in the mean values of data obtained from the animate and inanimate surfaces (p > 0.05). Molecular identification confirmed the isolates to be Kocuria palustris, Serretia liquefaciens, Klebsiella pneumonia, Enterococcus feacalis, Bacillus flexus, and Aspergillus niger. The results revealed that honey was more effective (100%) than Aloe Vera extract which inhibited only one of the Escherichia coli isolates. The study displayed the antimicrobial effect of honey against both Gram positive and Gram negative bacterial isolates. While adequate personal hygiene, proper sanitation, and spaced room should be encouraged, honey can be used in correctional centers to control bacterial skin infections.

Bacteriological profile and their antimicrobial susceptibility pattern among clinical suspected adult septicemia admitted patients: A study from tertiary care and teaching hospital

Objectives: The objective of this study is to determine the bacteriological profile and their antimicrobial susceptibility pattern among clinically suspected adult septicemia admitted patients and to study the correlation between the clinical presentation and inflammatory biomarkers (C-reactive protein [CRP] and Procalcitonin [PCT]) in the final outcomes of nosocomial sepsis in adult septicemia patients. Material and Methods: This is a descriptive cross-sectional study of 1-year duration from November 2022 to November 2023. The study has been approved from the Institutional Ethical Committee. Adult patients with a clinical suspected diagnosis of sepsis were admitted to the medicine ward of the tertiary hospital. Blood samples of adult sepsis suspected patients samples were taken for as a part of septicemia screening. Blood culture and sensitivity were performed according to standard guidelines. The sepsis inflammatory prognostic markers CRP and PCT test were evaluated according to manufactures instruction. Results: Out of 300 clinically suspected adult septicemia patients, 93 (31%) patients were isolated culture-positive sepsis while 207 (69%) patients were culture-negative sepsis. Gram-positive organisms were more (69%) as compared to Gram-negative organisms (31%). Staphylococcus aureus was predominant among Gram-positive organisms while Acinetobacter baumanii complex (9%) followed by Enterobacter spp. (8%) isolated in Gram-negative bacilli. Culture-positive sepsis patients have CRP level ≥3.2 mg/dL (80%) and the majority (80%) of these patients have reactive PCT. Conclusions: Successful treatment of bloodstream infection depends on early diagnosis and appropriate use of antimicrobial agents. Rapid identification results and antimicrobial susceptibility tests are essential for guiding clinicians in the selection of the most appropriate treatment for patients with bloodstream infections.

Prevalence, associated factors and antimicrobial susceptibility patterns of Salmonella and Shigella species among diarrheic under five children in Sultan Sheik Hassan Yabere referral Hospital, Jigjiga, Eastern Ethiopia

BackgroundDiarrhea caused by Salmonella and Shigella species are the leading cause of illness especially in developing countries. These infections are considered as the main public health problems in children, including Ethiopia. This study aimed to assess the prevalence, associated factors, and antimicrobial susceptibility patterns of Salmonella and Shigella species in Sheik Hassan Yabere Referral Hospital Jigjiga, Eastern Ethiopia from August 05 to November 15, 2022.MethodA cross-sectional study was conducted among 239 under-five children with diarrhea selected through a convenient sampling technique. A structured questionnaire was used to collect associated factors. A stool sample was collected and processed for the identification of Salmonella and Shigella species using MacConkey adar, Xylose Lysine Deoxycholate agar (Oxoid Ltd) and Biochemical tests. The antimicrobial susceptibility pattern of isolates was performed using the Kirby-Bauer disc diffusion technique. The data was entered into Epi-data version 4.6 and exported to the statistical package of social science version 22 for analysis. The association between outcome and independent variables was assessed using bivariate, multivariable, and chi-square and P-value < 0.05 was considered as statistical significance.ResultOverall prevalence of Salmonella and Shigella species was 6.3% (95% CI, 5.7–6.9%), of which 3.8% (95 CI, 3.2–4.4%) were Salmonella species and 2.5% (95% CI, 1.95-3%) were Shigella species. Unimproved water source (AOR = 5.08, 95% CI = 1.45, 17.25), open field (AOR = 2.3, 95% CI = 1.3, 5.03), rural residence (AOR = 1.8, 95% CI = 1.4, 7.5), Hand-washing practice (p = 0.001), and raw meat consumption (p = 0.002) were associated with occurrence of Salmonella and Shigella species. Salmonella and Shigella isolates were resistant to Ampicilin (100%). However, Salmonella isolates was sensitive to Norfloxacin (100%). About 22.2% and 16.7% of Salmonella and Shigella isolates were multi-drug resistant, respectively.ConclusionPrevalence of Salmonella and Shigella species were lower than most studies done in Ethiopia. Hand-washing habit, water source type, Open field waste disposal habit, raw meat consumption and rural residence were associated with Salmonellosis and shigellosis. All isolated Salmonella were sensitive to norfloxacin. The evidence from this study underscores the need for improved water, sanitation and hygiene (WASH) system and the imperative to implement drug susceptibility tests for the treatment of Salmonella and Shigella infection.

Prevalence of Asymptomatic Bacteriuria among Patients Attending Diabetic Clinic at Fort Port Regional Referral Hospital, Uganda Patients

The availability of high concentration of sugar in the blood of diabetic patients makes them more susceptible to developing bacterial infections which are asymptomatic commonly referred to as asymptomatic bacteriuria (ASB) than the non-diabetic patients. Diabetes patients with ASB have a much higher risk of developing diabetic complications than individuals without ASB. There is a paucity of data on the burden of ASB and antimicrobial susceptibility in diabetes patients in Uganda. Between March and May 2023, a cross-sectional study was carried out at the Fort Portal Regional Referral Hospital, Uganda outpatient diabetic clinic and 160 diabetes patients were recruited for the study. Mid-stream urine was taken for culture and sensitivity. Data analysis were performed using IBM SPSS version 20. A pie chart was used to display the prevalence and antimicrobial susceptibility patterns of common uropathogens described in frequency and percentages. The overall prevalence of ASB among the study participants was 11%. The most common uropathogen isolated was Escherichia coli, followed by Klebsiella and S. aureus. The most sensitive drug in all the isolates was Nitrofrantoin and resistant drug was Ampicillin. In conclusion, routine testing for ASB and treatment should be according to the antimicrobial susceptibility of diabetic patients.

Bacteriological profile and antimicrobial susceptibility patterns of organisms responsible for blood stream infections in intensive care unit patients

Bacteriological profile and antimicrobial susceptibility patterns of organisms responsible for blood stream infections in intensive care unit patients

Bacterial profile, antimicrobial susceptibility pattern and associated risk factors of urinary tract infection among pregnant women attending tertiary care hospital in Rawalpindi

The study objective to enhance treatment effectiveness by assessing risk factors, bacterial profiles, and antimicrobial susceptibility of uropathogens in pregnant women. During the period from March 2023 to August 2023, we examined 210 urine samples obtained frompregnant women. The samples were subjected to uropathogens isolation, identification and susceptibility testing against thirteen antibiotic classes using the Kirby Bauer disk diffusion method, following standard procedures, to identify uropathogens in cases of significant bacteriuria. In our study there is no significant link found between age, educational level, socioeconomic status, and parity in relation to UTI during pregnancy. In 42% of the samples with significant bacteriuria, Escherichia coli emerged as the predominant uropathogens, followed by Pseudomonas aeruginosa, Staphylococcus saprophyticus, and Klebsiella pneumoniae, in that order. E. coli displayed the greatest resistance to ciprofloxacin and ceftazidime, yet demonstrated high susceptibility to meropenem, imipenem, fosfomycin,and amikacin. Furthermore, a significant portion of K. pneumonia isolates exhibited resistance to ceftazidime and ciprofloxacin. For S. saprophytic, resistance was observed against penicillin and gentamicin, although they displayed 100% sensitivity to vancomycin and 81.2% sensitivity to Nitrofurantoin. The current study findings revealed that factors influencing pregnant women's UTI risk, include age, literacy, residence, multigravida, multipara, infection history, and trimester status. Access to clean water sources also played a role, highlighting the importance of addressing these variables in maternal health toreduce UTI incidence. Screening antenatal patients for UTIs is imperative, and it is advisable to conduct regular screenings for pregnant women. This practice helps monitor uropathogens sensitivity patterns and facilitates the development of antibiotic protocols based on local susceptibility data.

Antimicrobial susceptibility patterns of Listeria monocytogenes isolated from fresh produce in KwaZulu-Natal Province, South Africa

Fresh, ready-to-eat produce is frequently irrigated with untreated water, making it a leading cause of food-borne illness outbreaks worldwide. This study investigated the presence of Listeria monocytogenes in fresh produce that was grown using river water. Standard biochemical tests were used for the identification of L. monocytogenes isolated from river water used for irrigation, and from fresh produce including lettuce, spinach, and pumpkin. The inlA gene of L. monocytogenes was molecularly identified using PCR amplification. The susceptibility of L. monocytogenes isolates to antimicrobial agents was assessed using the Kirby-Bauer disc diffusion method. The presence of the amplified inlA gene (800 bp) indicated that all of the fresh produce and river water samples were contaminated with virulent L. monocytogenes. Lettuce and spinach exhibited higher quantities of L. monocytogenes, with lettuce recording 87 CFU/g and spinach recording 71 CFU/g. The L. monocytogenes isolates from spinach and lettuce sources showed significant resistance to colistin (56.2% and 53.3%, respectively) as well as ampicillin (68.8% and 53.3%, respectively). Moreover, lettuce (40%) and spinach (31%) exhibited a common resistance pattern of AMP-CHL-CT-KAN-PIP-ERY-TET, with a maximum MAR index value of 0.54. Our research demonstrates the transmission of multidrug-resistant L. monocytogenes from irrigation river water to fresh produce. Hence, the ingestion of ready-to-eat fresh produce carries the potential for human listeriosis, particularly among individuals with compromised immune systems.

Species distribution and antimicrobial sensitivity pattern of etiologic agents in patients with neonatal sepsis, National Children’s Hospital, Ha Noi, Vietnam, 2019–2021

Neonatal sepsis is one of the significant causes of morbidity and mortality in neonates, especially in developing countries. This study investigates the species distribution and antimicrobial susceptibility pattern of agents causing neonatal sepsis in a northern hospital in Vietnam. Materials and methods. All in-term neonates treated at the Neonatal Center, National Children’s Hospital, Vietnam between December 2019, and April 2021 who met the clinical criteria for sepsis and positive blood cultures were enrolled. Species identification and antimicrobial susceptibility testing were performed with Vitek 2 Compact (bioMerieux, France). Results. Eighty-five neonates were included with the majority of cases being early-onset sepsis (61.2%, 95% CI: 50.6–71.8%). Gram-negative, Gram-positive, and fungal isolates constituted 50.6%, 40%, and 9.4%, respectively. The most common agent was Staphylococcus aureus (28.2%) followed by Klebsiella pneumoniae and Escherichia coli (16.5% each). For those with bacteriological sepsis, Gram-negative pathogens were predominant in early-onset sepsis whereas Gram-positive pathogens were predominant in late-onset sepsis (75.0% (33/44) vs 69.7% (23/33), p 0.001). Antibiotic resistance was common among bacterial isolates, but antifungal resistance was not detected among isolates of Candida sp. Vancomycin and fluoroquinolone were very effective against Gram-positive organisms while piperacillin + tazobactam, aztreonam, and ertapenem were potent drugs against Gram-negative organisms. Conclusion. Routine investigation of microbial profiles and antimicrobial susceptibility patterns is essential to guiding strategies for the choices of empirical antimicrobials.

Identification and Speciation of Non-diphtheritic Corynebacteria (NDC) and their Antimicrobial Susceptibility Pattern by Broth Microdilution

Non-diphtheritic Corynebacteria (NDC), originally considered contaminants in clinical samples, have now emerged as nosocomial pathogens, emphasising the importance of their identification and prompt reporting. 120 non-diphtheritic corynebacteria isolated from pus were chosen for examination. A battery of tests identified isolates and minimum inhibitory concentration (MIC) was detected by broth micro-dilution and interpreted as per Clinical &amp; Laboratory Standards Institute (CLSI) and British Society for Antimicrobial Chemotherapy (BSAC) guidelines. C. amycolatum 28 (31%), followed by C. striatum 18 (20.5%) was the predominant isolate. Cephalosporins were least effective followed by Gentamycin. However, all isolates were sensitive to Vancomycin and Linezolid. Our research highlights the necessity of implementing clinical antimicrobial therapy protocols for Corynebacterium spp. Empirical treatment with vancomycin or linezolid is recommended until in vitro susceptibility results become accessible.

Antimicrobial susceptibility patterns of urinary tract infections causing bacterial isolates and associated risk factors among HIV patients in Tigray, Northern Ethiopia

BackgroundUrinary tract infections, a prevalent global infectious disease, are clinical issues not well studied in HIV-positive individuals. UTIs have become a global drug resistance issue, but the prevalence and antibiotic susceptibility patterns of UTI-causing bacteria among HIV patients in Tigray, Ethiopia, are poorly understood. This study aims to identify the prevalence of UTI-causing bacteria, their antibiotic susceptibility patterns, and associated risk factors in HIV patients attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia.MethodClean-catch midstream urine samples (10–15 mL) were collected from HIV patients who are attending ART clinics at Mekelle General Hospital and Ayder Comprehensive Specialized Hospital. Samples were analyzed based on standard microbiological protocols using cysteine-lactose electrolyte deficient (CLED) agar. Pure colonies of bacterial isolates were obtained by sub-culturing into Mac-Conkey, Manitol Salt agar and blood agar plates. The bacterial isolates were then identified using macroscopic, microscopic, biochemical, and Gram staining methods. Gram-negative bacteria were identified using biochemical tests like triple sugar iron agar, Simon’s citrate agar, lysine iron agar, urea, motility test, and indol test, whereas Gram-positive isolates were identified using catalase and coagulase tests. The Kirby-Bauer disk diffusion technique was used to analyze the antimicrobial susceptibility pattern of bacterial isolates. Data was analyzed using SPSS version 25.0.ResultsAmong the 224 patients, 28 (12.5%) of them had been infected by UTIs-causing bacteria. E. coli was the dominant bacterium (16 (57%)) followed by K. pneumoniae (4 (14%)), and S. aureus (3 (11%)). Of the total bacterial isolates, 22 (78.6%) of them developed multi-drug resistance. All Gram-positive (100%) and 75% of Gram-negative bacterial isolates were found to be resistant to two or more drugs. Patients with a history of UTIs, and with CD4 count < 200 cells/ mm3, were more likely to have significant bacteriuria. Compared to male patients, female patients were more affected by the UTIs-causing bacteria. More than 93% of the UTIs-causing bacterial isolates were susceptible to nitrofurantoin, ceftriaxone, ciprofloxacin, and gentamycin; whereas they are highly resistant to ampicillin (96%), cotrimoxazole (82%) and tetracycline (71%).ConclusionsMost of the bacterial isolates were highly resistant to ampicillin, cotrimoxazole, and tetracycline. Female patients were more affected by the UTIs causing bacteria. The highest prevalence (12.5%) of UTIs in HIV patients needs special attention for better management and monitoring. Previous UTI history and immune suppression are predictors of UTIs, highlighting the need for intervention measures involving molecular studies to identify resistant bacteria genes and promote patient immune reconstitution.

Antimicrobial susceptibility patterns of aerobic bacteria isolated from canine urinary samples in South East Queensland, 2013 to 2018.

Urinary tract infections are a common diagnosis in dogs presenting to veterinary practice. Veterinarians often treat suspected infections empirically, either in the absence of culture and susceptibility testing results or whilst waiting for them. This study aimed to identify the bacteria most frequently isolated from canine urinary samples and their antimicrobial susceptibility patterns in South East Queensland (SEQ) to help guide responsible empirical antimicrobial prescription by the veterinary community in this geographical location. Cumulative antibiograms were generated from the results of 1284 culture-positive urinary samples in SEQ, obtained from a commercial veterinary laboratory over a 5-year period. Escherichia coli was the most commonly isolated bacterial species (43%), followed by Staphylococcus spp. (23%), Proteus spp. (21%) and Enterococcus spp. (10%). Of the six most common isolates, 97% had susceptibility to at least one low-importance antimicrobial. Susceptibility to the low-importance and first-line antimicrobial recommendation, amoxicillin, was 81% for E. coli and 24% for Staphylococcus spp. Susceptibility of both E. coli and Staphylococcus spp. to medium-importance and commonly recommended empirical antimicrobials, trimethoprim sulphonamides and amoxicillin-clavulanic acid was ≥85% and >92% for high-importance antimicrobials enrofloxacin and ceftiofur. Of the E. coli and Staphylococcus spp. isolates, 8.8% and 4%, respectively, were considered multidrug resistant. There was no increase in resistance to antimicrobials detected over the study period. Susceptibilities suggest low- and medium-importance antimicrobials remain acceptable first-line empirical treatments. However, this should be continually assessed and updated using local surveillance data.

Interactions between Aeromonas caviae and Yersinia enterocolitica isolated from a case of diarrhea: evaluation of antimicrobial susceptibility and immune response of infected macrophages.

Aeromonas species cause a wide spectrum of human diseases, primarily gastroenteritis, septicemia, and wound infections. Several studies have shown that about 40% of these cases involve mixed or polymicrobial infections between Aeromonas spp. and bacteria from other genera. However, the immune response of macrophages in front of the bacteria present in the mixed infections, as well as their impact on antimicrobial therapy, have not been investigated. This study evaluated the cell damage and immune response of the mouse macrophage BALB/c cell line (J774A.1) after performing a single and a mixed infection with a strain of Aeromonas caviae and Yersinia enterocolitica, both recovered from the same fecal sample from a patient with diarrhea. Macrophage cell damage was measured by the release of lactate dehydrogenase (LDH) while the immune response was evaluated studying the expression by RT-qPCR of six relevant immune-related genes. Additionally, the antimicrobial susceptibility pattern of the single and mixed strains in front of seventeen antibiotics was evaluated to determine the potential impact on the infection treatment. Macrophages infected with the mixture of the two strains showed a higher cell damage in comparison with the single infections and the immune-related genes, i.e., cytokines and chemokines genes (TNF-α, CCL20), and apoptotic and pyroptotic genes (TP53 and IL-1β) were overexpressed. After infection with the mixed cultures, an increase in the antimicrobial resistance was observed for ciprofloxacin, trimethoprim, chloramphenicol, gentamicin and ertapenem. This study increased the knowledge about the synergetic effect of the bacteria involved in mixed infection and on their potential impact on the treatment and evolution of the infection.

Phenotypic and molecular characterization of β-lactamase-producing Klebsiella species among children discharged from hospital in Western Kenya

BackgroundThe emergence and spread of β-lactamase-producing Klebsiella spp. has been associated with a substantial healthcare burden resulting in therapeutic failures. We sought to describe the proportion of phenotypic resistance to commonly used antibiotics, characterize β-lactamase genes among isolates with antimicrobial resistance (AMR), and assess the correlates of phenotypic AMR in Klebsiella spp. isolated from stool or rectal swab samples collected from children being discharged from hospital.MethodsWe conducted a cross-sectional study involving 245 children aged 1–59 months who were being discharged from hospitals in western Kenya between June 2016 and November 2019. Whole stool or rectal swab samples were collected and Klebsiella spp. isolated by standard microbiological culture. β-lactamase genes were detected by PCR whilst phenotypic antimicrobial susceptibility was determined using the disc diffusion technique following standard microbiology protocols. Descriptive analyses were used to characterize phenotypic AMR and carriage of β-lactamase-producing genes. The modified Poisson regression models were used to assess correlates of phenotypic beta-lactam resistance.ResultsThe prevalence of β-lactamase carriage among Klebsiella spp. isolates at hospital discharge was 62.9% (154/245). Antibiotic use during hospitalization (adjusted prevalence ratio [aPR] = 4.51; 95%CI: 1.79–11.4, p < 0.001), longer duration of hospitalization (aPR = 1.42; 95%CI: 1.14–1.77, p < 0.002), and access to treated water (aPR = 1.38; 95%CI: 1.12–1.71, p < 0.003), were significant predictors of phenotypically determined β-lactamase. All the 154 β-lactamase-producing Klebsiella spp. isolates had at least one genetic marker of β-lactam/third-generation cephalosporin resistance. The most prevalent genes were blaCTX-M 142/154 (92.2%,) and blaSHV 142/154 (92.2%,) followed by blaTEM 88/154 (57.1%,) and blaOXA 48/154 (31.2%,) respectively.ConclusionCarriage of β-lactamase producing Klebsiella spp. in stool is common among children discharged from hospital in western Kenya and is associated with longer duration of hospitalization, antibiotic use, and access to treated water. The findings emphasize the need for continued monitoring of antimicrobial susceptibility patterns to inform the development and implementation of appropriate treatment guidelines. In addition, we recommend measures beyond antimicrobial stewardship and infection control within hospitals, improved sanitation, and access to safe drinking water to mitigate the spread of β-lactamase-producing Klebsiella pathogens in these and similar settings.

The prevelance of multidrug resistance in uropathogens of patients admitted in the intensive care unit of a tertiary care hospital.

Urinary tract infections (UTIs) are among the most common bacterial infections, posing significant public health challenges due to increasing antimicrobial resistance (AMR). This study aims to assess the prevalence, demographic characteristics, microbial profile, and antimicrobial resistance patterns in Indian patients with UTIs admitted to intensive care unit. A total of 154 patients with positive UTIs were included in this cross-sectional study. The prevalence data including demographics, microbial isolates, and antimicrobial susceptibility patterns were collected. Additionally, risk factors for multidrug resistance uropathogens were assessed using multivariate analyses. The patient cohort had diverse demographic, with a slight male predominance of 52.6% (n = 81). The most common comorbidities were hypertension 59.1% (n = 91) and diabetes mellitus 54.5% (n = 84). The microbial profile was dominated by gram-negative bacteria, particularly Escherichia coli 26.62% (n = 41) and Klebsiella pneumoniae 17.53% (n = 27). The predominant gram-positive and fungal isolate was Enterococcus faecium 7.14% (n = 11) and Candida spp. 18.83% (n = 29), respectively. Substantial resistance was noted against common antimicrobials, with variations across different pathogens. Gram-negative bacteria, particularly Escherichia coli and Klebsiella pneumoniae, exhibited high MDR rates, emphasizing the challenge of antimicrobial resistance. Multivariate logistic regression identified age groups 50-65 and over 65, and prolonged catheterization as significant risk factors for MDR infections. A significantly high resistance rate among pathogens emphasizes the need for judicious antimicrobial use. Our findings emphasize the necessity of ongoing surveillance and tailored interventions based on local pathogen prevalence and antibiogram data to effectively address the threat of AMR threat for better management of UTI management in ICU settings.

Detection of multidrug-resistant organisms of concern including Stenotrophomonas maltophilia and Burkholderia cepacia at a referral hospital in Kenya.

Regular monitoring of bacterial susceptibility to antibiotics in clinical settings is key for ascertaining the current trends as well as re-establish empirical therapy. This study aimed to determine bacterial contaminants and their antimicrobial susceptibility patterns from medical equipment, inanimate surfaces and clinical samples obtained from Thika Level V Hospital (TLVH), Thika, in Central Kenya. Three hundred and five samples were collected between the period of March 2021 to November 2021 and comprised urine, pus swabs, catheter swabs, stool, and environmental samples. Bacterial identification and antimicrobial susceptibility were performed using VITEK 2 and disc diffusion respectively. We observed that Coagulase-negative Staphylococci (28 /160, 17.5%) were the most commonly isolated species from clinical samples followed by E. coli (22 /160 13.8%) and S. aureus (22/160, 13.8%). The bed rails were the mostly contaminated surface with S. aureus accounting for 14.2% (6/42). Among the clinical samples, pus swabs yielded the highest number of pathogens was pus (92/160). Trauma patients had the highest proportion of isolates (67/160, 41.8%). High level of antimicrobial resistance to key antimicrobials, particularly among Enterobacterales was observed. Extended Spectrum Beta Lactamase (ESBL) phenotype was noted in 65.9% (29/44) of enteric isolates. While further ESBL genetic confirmatory studies are needed, this study highlights the urgent need for actions that mitigate the spread of antibiotic-resistant bacteria.

Identification of common bacterial etiologic agents, antimicrobial susceptibility pattern &amp; associated risk factors of Otitis media among pediatric patients of ENT Center of Orotta National Referral Hospital

Identification of common bacterial etiologic agents, antimicrobial susceptibility pattern &amp; associated risk factors of Otitis media among pediatric patients of ENT Center of Orotta National Referral Hospital

Microbial profile and antimicrobial susceptibility pattern in paediatric intensive care unit of a tertiary care hospital, North East India

Microbial profile and antimicrobial susceptibility pattern in paediatric intensive care unit of a tertiary care hospital, North East India