Incidence Of Gram-negative Bacteria Research Articles

Microbiological profile of diabetic foot infections in China and worldwide: a 20-year systematic review.

Pathogens causing diabetic foot infections (DFIs) vary by region globally; however, knowledge of the causative organism is essential for effective empirical treatment. We aimed to determine the incidence and antibiotic susceptibility of DFI pathogens worldwide, focusing on Asia and China. Through a comprehensive literature search, we identified published studies on organisms isolated from DFI wounds from January 2000 to December 2020. Based on our inclusion criteria, we analyzed 245 studies that cumulatively reported 38,744 patients and 41,427 isolated microorganisms. DFI pathogens varied according to time and region. Over time, the incidence of Gram-positive and Gram-negative aerobic bacteria have decreased and increased, respectively. America and Asia have the highest (62.74%) and lowest (44.82%) incidence of Gram-negative bacteria, respectively. Africa has the highest incidence (26.90%) of methicillin-resistant Staphylococcus aureus. Asia has the highest incidence (49.36%) of Gram-negative aerobic bacteria with species infection rates as follows: Escherichia coli, 10.77%; Enterobacter spp., 3.95%; and Pseudomonas aeruginosa, 11.08%, with higher local rates in China and Southeast Asia. Linezolid, vancomycin, and teicoplanin were the most active agents against Gram-positive aerobes, while imipenem and cefoperazone-sulbactam were the most active agents against Gram-negative aerobes. This systematic review showed that over 20 years, the pathogens causing DFIs varied considerably over time and region. This data may inform local clinical guidelines on empirical antibiotic therapy for DFI in China and globally. Regular large-scale epidemiological studies are necessary to identify trends in DFI pathogenic bacteria. https://www.crd.york.ac.uk/prospero/, identifier CRD42023447645.

Prevalence of ESBL Producing Bacteria in Community-Acquired UTI from Eastern Part of India

Urinary tract infection (UTI) in the community is a common infection in humans. The causative microorganisms for UTIs may vary in different places and also vary in their antibiotic sensitivity and resistant patterns. This study aimed to find out the incidence of gram-negative bacteria along with their antibiotic sensitivity pattern in community-acquired UTIs and to calculate the existence of Extended-spectrum beta-lactamase (ESBL) positivity among them. A Sum of 515 urine samples was tested and the causative organisms were identified. Antibiotic susceptibility tests were executed where it had shown growth for bacteria by both manual and automated methods. ESBL tests were performed to identify ESBL-producing isolates. From a total of 515 samples, 65 (12.65%) were culture positive for UTIs. The rate of infection was higher in females than in males. The most prevailing bacteria were Escherichia coli and Klebsiella pneumoniae. Out of total culture-positive isolates, only 43.08% were ESBL positives. The study found that the organisms displayed resistance to Ciprofloxacin and Cefixime and sensitivity to Gentamicin, Ertapenem, and Nitrofurantoin. Females have a higher prevalence of UTIs than males. Mostly, females suffer from UTIs in their reproductive years whereas males suffer in their old age. The prevalence of gram-negative bacteria is higher in community-acquired UTIs. These pathogens though present in the community, becoming resistant to commonly used antibiotics like Ciprofloxacin and Cefixime because of overuse and misuse of antibiotics at the community level.

Antibiotic prophylaxis in orthopedic surgery; has the time to reconsider the current practice arrived?

IntroductionThe current practice of antibiotic prophylaxis in orthopedic surgery has existed almost 50 years yet little changes have been made. The incidence of methicillin resistant Staphylococci and multi-drug resistant Gram-negative bacteria is growing. MethodsWe studied the positive cultures after primary hip and knee joint replacement and trauma surgery at our department. ResultsOur investigation substantiates the current reports of an increase in oxacillin resistance of Staphylococci and an increase in incidence of Gram-negative bacteria. Conclusions: The standard use of cephalosporins for prophylaxis does not provide the necessary protection that it used to. We suggest that the recommendations and practice of antibiotic prophylaxis should be reconsidered. Level of EvidenceLevel III – retrospective cohort study.

Bacteriological profile and antibiogram in cases of pneumonia attending to tertiary care hospital

Causative bacteria differ in different regions and this knowledge is necessary for formulation of local antibacterial guidelines. Diagnosing the microbial etiology of pneumonia is challenging because the site of infection (lung tissue) is not easily accessible for specimen collection and contamination by upper respiratory tract secretions.This study aimed to determine the bacterial profile of pneumonia cases and its antibiogram. A cross sectional, descriptive study was done at the Department of Microbiology involving 84 patients.Samples collected were sputum, induced sputum in children and endotracheal tube tip in mechanically ventilated patients following standard guidelines.All samples were processed within 2 hours of collection and subjected to Gram staining, incubated on Blood, Chocolate and Mac Conkey agar. Antibiotic susceptibility patterns, Methicillin resistance for Staphylococcus aureus and ESBL production among Gram negative bacteria was confirmed.Out of 84 cases studied, pathogenic growth was seen in 65(77.4%) and commensals were isolated in 19(22.6%) samples. The most common Gram negative bacteria was Klebsiella species(29, 42.7%) followed by Pseudomonas(20, 29.4%). Most common Gram positive bacteria was Staphylococcus aureus(4, 44.4%) and CONS(4, 44.4%). Staphylococcus aureus showed 100% resistance to Methicillin. Out of 20 Pseudomonas isolates, 6 were ESBL producers. Out of the remaining 48 Gram negative bacteria, 7 were ESBL producers.Incidence of pneumonia has increased due to lack of early diagnosis and multidrug resistance. The incidence of Gram negative bacteria has also increased tremendously. According to this study, most of the organisms are resistant to 3rd generation Cephalosporins.

Sepsis in Burn Patients

One hundred blood samples and burn swabs from septicemic burn patients were collected over a period from July 2017 until may 2018 at Burn Center in Baghdad Teaching Hospital. The age of patients was between one year to sixty years and they were suffering from burn wound sepsis ,the highest number of patients was female among age group 20-29 years old. The highest frequent cause of burn was flame 78% and the least was chemical 1%, it was found that flame burn patients were more vulnerable to sepsis. The mortality rate among male 56%, females 48% and the highest mortality rate was 100% in the age group less than one year and more than sixty years, the least rate of mortality was 27% in the age group 10-19 years old. The number of septicemic patients 36 who is total body surface area (BSA) burned 30-39% and the mortality in this group was 16.6%, however the least number of patients was two of BSA 90-99% with mortality rate 100%. The most frequent aetiological agents isolated from the blood of septicemic burn patients was staphylococcus aureus 34(28.1) followed by Pseudomonas aeruginosa 25(20.7), Klebsiella pneumonia 13(10.8), Streptococcal pyogenes 10(8.3), Escherichia coli 8(6.6%) and Serratia marcescense, Acinnetobacter calcoceticus were 5(4.1) equally. The incidence of gram negative bacteria was much higher than gram positive bacteria in the septicemic burn cases, most of septicemic attack occur during the first week of admission and especially on the 7th day of staying in hospital and above, and they were much more likely to result from gram positive organism e.g S.aureus and S.pyogene. After the 1st week the septicemic attack was much more likely to result from gram negative organisms e.g. P.aeruginosa K.pneumonia, E.coli, Serratia mercescense, Acintobacter calcoceticus, P vulgaris and P. rettger.

Predictive value of cytokines and procalcitonin on infection in children with hematological malignancies

Objective: To explore the value of cytokines and procalcitonin (PCT) in predicting the potential pathogen and the severity of infection in children with hematological malignancies. Methods: This was a prospective cohort study. A total of 1 543 children (3 912 episodes) with hematological malignancies admitted to the Department of Hematology/Oncology in Children's Hospital of Zhejiang University School of Medicine from November 2010 to June 2018 were prospectively enrolled in this study. According to the pathogen, the patients were divided into sepsis group with positive blood culture (380 patients/608 episodes), sepsis group with negative blood culture (539/1 484), non-septic infection group (549/1 709), viral infection group (18/21) and fungal infection group (57/90). The patients were also divided into two groups in either shock group (171/187) or non-shock group (1 372/3 725). Meanwhile, 89 children (112 episodes) with matched hematological malignancies without fever were enrolled as the control group. The levels of PCT and cytokines were measured for detecting the potential relationship between these markers and infection severity. Mann-Whitney U test or Kruskal-Wallis H test was used to compare the differences between groups. The Receiver Operator Characteristic curve analysis was used to explore the predictive value. Results: (1) There were significantly higher levels of interleukin (IL) 6 (H=210.002, P<0.01), IL-10 (H=223.045, P<0.01), and PCT (H=76.799, P<0.01) in the infection group, with area under curre (AUC) of 0.67 (95%CI 0.64-0.69), 0.69 (95%CI 0.66-0.71) and 0.59 (95%CI 0.56-0.61), respectively. (2) Among the patients in the shock group, IL-6 (Z=11.460, P<0.01), IL-10 (Z=14.242, P<0.01) and PCT (Z=10.813, P<0.01) were significantly higher than those in the non-shock group, with the AUC of 0.75 (95%CI 0.70-0.79), 0.81 (95%CI 0.77-0.84) and 0.73 (95%CI 0.69-0.77), respectively. (3) In patients with septic shock, the incidence of Gram negative bacteria (GNB) infection (60 episodes) was significantly higher than Gram positive bacteria (GPB) infection (22 episodes) (χ(2)=29.665, P<0.01). The AUC of IL-6, IL-10 and PCT for predicting GNB infection were 0.75 (95%CI 0.72-0.78), 0.82 (95%CI 0.79-0.85) and 0.67 (95%CI 0.63-0.70), respectively. (4) The predictive power of IL-6, IL-10 and PCT combination (AUC=0.994) was superior to IL-10 alone (AUC=0.810) in predicting septic shock (Z=10.211, P<0.01). Conclusions: IL-6 and IL-10 are better predictors of GNB infection than PCT in hematology-oncology children. Furthermore, the combination of these two cytokines and PCT is more valuable in predicting the severity of infection.

Pattern of bacterial and fungal pathogen in patients with high risk for invasive fungal disease in an indonesian tertiary care hospital: an observational study.

IntroductionIn critically ill patients, there is a defect in host defense mechanism resulting in increased susceptibility to bacterial and fungal infection. The pattern of organisms causing infections varies between different countries and hospitals; therefore it is important that every hospital generates antibiograms to guide healthcare professionals during treatment with optimal choice of antibiotics. Our study aimed to described the pattern of fungal and bacterial pathogen in patients with high risk for invasive fungal disease (IFD).MethodsAn observational study was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, within March-September 2015. Specimens were taken from blood, sputum, endotracheal aspiration, bronchoalveolar lavage (BAL), urine, pus and drainage fluid/surgical tissue specimen on 5th-7th day of hospitalization. Samples were cultured onto suitable culture media and bacterial isolates were identified using standard biochemical methods.ResultsBacteria and Candida sp. were isolated from 153 patients. C. tropicalis (44.31%) was the commonest fungal isolated. Incidence of gram-negative bacteria was higher than gram-positive bacteria. Klebsiella pneumonia was the most common gram-negative bacteria isolated, where as Enterococcus faecalis for gram-positive bacteria.ConclusionCritically ill patients were vulnerable to contracted fungal and bacterial pathogen. Candida non-albicans and Gram-negative bacteria were the most common pathogen detected among critically ill patients with high risk for IFD.

Polymyxin B Consumption and Incidence of Gram-Negative Bacteria Intrinsically Resistant to Polymyxins

Polymyxin B Consumption and Incidence of Gram-Negative Bacteria Intrinsically Resistant to Polymyxins

Hazards with cracked eggs and their relationship to egg shell strength

BACKGROUND: This study examined the relationship between egg shell strength and the prevalence of cracked shells, plus the relationship between egg shell cracks and the presence of bacteria in the albumen of retail eggs. A total of 500 eggs was sampled from five supermarket stores. Each egg was assessed for shell cracks using a candling method. The strength of the shells was assessed using a penetrometer. Bacteria from the egg albumen were recovered on blood agar. RESULTS: The proportion of eggs that were cracked was on average 9%, and at one of the stores it was 17%. Albumen from eggs with gross cracks produced more abundant bacterial growth on blood agar compared to non-cracked eggs, and contained a higher incidence of Gram negative bacteria. Campylobacter spp. were not recovered from any eggs. The shells in cracked eggs had lower Shore D durometer values indicating that they were physically weaker than non-cracked eggs. CONCLUSIONS: Weaker shells were more prone to developing cracks, and cracked eggs were more likely to contain bacteria. There were substantial differences between supermarkets in the prevalence of eggs with cracked shells. (c) 2008 Society of Chemical Industry

Efficacy and tolerability of prophylactic treatment with intravenous piperacillin/tazobactam in patients undergoing hematopoietic stem cell transplantation.

Infections remain a major cause of morbidity and mortality in patients undergoing autologous or allogeneic hematopoietic stem cell transplantation (HSCT). About 80% of patients experience fever during aplasia and early engraftment despite oral antibacterial chemoprophylaxis. In a pilot study, 50 patients undergoing autologous or allogeneic HSCT received a prophylactic antibacterial treatment with intravenous piperacillin/tazobactam beginning on day of stem cell or bone marrow transfusion. They were analyzed retrospectively for frequencies of fever of unknown origin (FUO), documented infection, bacteremia and death because of infection. Furthermore, data from microbiological monitoring and tolerability were evaluated. Among 28 autologous transplanted patients, 10 (36%) developed fever more than 38.5 degrees C; 9/10 FUO, 1/28 pulmonary infiltrates. Eighteen patients (64%) remained without any symptom of infection. In the allogeneic group (n = 22), there were eight patients (36%) with FUO, and five patients (23%) with documented infections (pneumonia 2, enteritis 1, pyelonephritis 1, Escherichia coli bacteremia 1). In nine patients (41%), escalation of antimicrobial treatment was not necessary. The majority of detected microbes in cultures of throat and nose secretions, blood, urine and stool were gram-positive bacteria (77.8%), among them Staphylococcus epidermidis (23.5%), streptococci (group A, B, C; 21.0%) and enterococci (10.6%). Incidence of gram-negative bacteria and fungi was similar with 11.8% and 10.4%, respectively. The most frequent gram-negative strains were Escherichia coli (6.5%) and Pseudomonas aeruginosa (1.7%). There was no severe toxicity or hypersensitivity. Compared to oral decontamination and chemoprophylaxis, an intravenous prophylactic regimen as described above could be an effective and well-tolerated approach in prevention of bacterial infections and related complications, with a higher acceptance in recipients of bone marrow or stems cell grafts. Further evaluation in comparison with fluoroquinolone prophylaxis regarding efficacy, development of resistances as well as cost-benefit analyses is warranted.

Infections in patients with hematological diseases: recent advances in serological diagnosis and empiric therapy.

Recent advances in the diagnosis and therapy of infections in patients with hematological diseases are reviewed. In general, 40-60% of febrile episodes lack clinical or microbiological evidence of infection and are thus treated empirically. Among the cases of microbiologically documented bacteremia treated in our department, the incidence of Gram-negative bacteria was high (47.1%) and the incidence of Gram-positive bacteremia is increasing. To improve the diagnostic rate of Gram-negative sepsis, the measurement of plasma endotoxin was performed. Of 147 febrile neutropenic episodes, endotoxemia was observed in 58 (39.5%) and the causative microorganisms of these infections were deemed Gram-negative bacteria. The measurement of plasma (1-->3)-beta-D-glucan, a ubiquitous component of fungi, was also performed for making early diagnosis of deep mycosis; the sensitivity of this assay was 90% and the specificity was 100%. The detection of (1-->3)-beta-D-glucan appears to be useful as a screening test of deep mycosis. The effects of the concomitant use of granulocyte-colony stimulating factor (G-CSF) and empiric antibiotic therapy for febrile neutropenia were studied in a randomized fashion. G-CSF did not affect the rate of the response to the empiric antibiotic therapy, although a significant effect of G-CSF on neutrophil recovery was observed. Guidelines for empiric antibiotic and antifungal therapy combined with serological diagnosis are proposed.

Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers.

To determine (a) the influence of HIV in developing osteoarticular infections in intravenous drug abusers (IVDAs) and (b) the differences between the clinical features of osteoarticular infections in IVDAs and a control group of non-IVDAs. A comparative study of the clinical features of osteoarticular infections in all HIV positive and HIV negative IVDAs admitted to the departments of rheumatology and internal medicine during a 10 year period was carried out. The joint infections of all IVDAs, irrespective of HIV status, were compared with those of a control group of non-IVDAs lacking risk factors for HIV infection. A total of 482 HIV positive and 85 HIV negative IVDAs was studied, in whom 25 (5%) and six (7%) osteoarticular infections were found respectively. There were no differences in age, sex, joints affected, and causative agents between these two groups. A comparison of the 31 (5.5%) osteoarticular infections in all IVDAs with 21 infections in 616 (3.4%) non-IVDAs showed significant differences in the mean age (27.5 v 54), the frequency of affection of the axial joints (hip, sacroiliac, and sternocostal joints) (64.5% v 16.6%), and in the incidence of Candida albicans (19% v 0%). (1) HIV may not predispose to osteoarticular infections in IVDAs. (2) The hip, sacroiliac, and sternocostal joints (axial joints) were most commonly affected in IVDAs. (3) In Spain, unlike other countries, Gram positive bacteria and C albicans seem to be predominant agents in osteoarticular infections in IVDAs, with a low incidence of Gram negative bacteria.

Properties of Human Anti‐Lipopolysaccharide Gamma Globulin: Specificity and Protective Effects

Blood donated to the Natal Blood Transfusion Service was screened by an enzyme-linked immunosorbent assay (ELISA) for anti-lipopolysaccharide (anti-LPS) antibodies. Plasma units with high concentrations (greater than 40 micrograms/ml) of anti-LPS IgG were pooled and fractionated to obtain a gamma globulin (lot LG-1). The binding of LG-1 antibodies to LPS prepared from 14 bacterial species and strains was found to be the highest to LPS from Shigella flexneri, Salmonella abortus equi and Salmonella typhimurium and intermediate with Klebsiella pneumoniae, Pseudomonas aeruginosa, Salmonella enteritidis and Escherichia coli 026:B6. Differential absorption experiments showed that LG-1 contained a mixture of specific and cross-reacting antibodies. A large proportion of antibodies binding to Sh. flexneri LPS were mainly specific, while those binding to S. typhimurium and the other Salmonella species tested were largely cross-reactive. There was little correlation between the spectrum of activity of the LG-1 antibodies and the incidence of gram-negative bacteria in blood cultures taken from hospital patients in an area covered by the Transfusion Service. Mice treated with LG-1 prior to inoculation with P. aeruginosa were significantly protected against morbidity and mortality compared to controls.