Non-fermenting Gram Research Articles

Occurrence of bla genes encoding carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii from Intensive Care Unit in a tertiary care hospital.

CONTEXT:ICU shows increasing incidence of infection associated with the use of invasive procedures for the diagnostic purpose as well as the indiscriminate use of antibiotics. Pseudomonas aeruginosa and Acinetobacter species are “very successful” pathogen and the emergence of the Metallo-β-Lactamases (MBL) is becoming a therapeutic challenge.AIMS:To isolate the Nonfermenting Gram negative bacilli from the ICU samples. To identify the metallo betalactamase producers and to detect the bla gene presence among the Pseudomonas aeruginosa and Acinetobacter baumannii.SETTINGS AND DESIGN:The Nonfermenting Gram negative bacilli isolates from the ICU samples were taken over for 5 years (2009-2014) in a tertiary care hospital.METHODS AND MATERIALS:The isolates of Pseudomonas species and Acinetobacter species were confirmed by API analyser and processed according to standard procedures. Detection of the MBL producers were done by E strip method and subjected for bla gene detection by PCR method.RESULTS:In our study a total of 195 isolates of NFGNB were obtained from various ICU. Of these MBL producers, 26 % were Pseudomonas aeruginosa and 25 % were Acinetobacter baumannii. The subtypes of blaVIM MBL producing P.aeruginosa were 26%. The predominant gene coding for MBL activity in A.baumannii were found to be blaOXA gene 11.9%. The gene accession numbers were KF975367, KF975372.CONCLUSIONS:We have to control the development and dissemination of these superbugs among the ICU's.

Disinfectant Susceptibility Testing of Non-Fermenting Gram Negative Bacilli

Context: Non-fermenting Gram negative bacilli (NFGNB) are the major cause of nosocomial infections worldwide. This will be life threatening, if not monitored with proper surveillance and treatment. If disinfectants are diluted, the ineffectiveness of disinfectants leads to microbial resistance. Objective: This study was conducted to identify the disinfectant (both skin and surface disinfectant) susceptibility of NFGNB with three different concentrations. Materials and methods: In this study, 3500 samples were cultured by agar plating technique. Out of which 240 yielded NFGNB which were identified by conventional biochemical tests. Agar cup diffusion method was done for disinfectant susceptibility testing. Results and discussion: Among 240 NFGNB, 100% were sensitive to chlorhexidine gluconate at manufacturer’s concentration. If the concentration was reduced the susceptibility percentage also was reduced. 97% and 39% of isolates were susceptible to hydrogen peroxide and povidone iodine respectively, irrespective to the concentration. Conclusion: Hence, it can be stated that NFGNB has its own susceptibility to individual disinfectant at manufacturer’s concentration. But none showed 100% sensitivity when the concentration was reduced than manufacturer’s concentration. Thus complete surveillance and monitoring of these organisms with disinfectant suceptibility is mandatory to control the hospital acquired infections.

MULTIPLE ANTIBIOTIC RESISTANCE INDEXING OF NON- FERMENTING GRAM NEGATIVE BACILLI

Objective: The multiple antibiotic resistance (MAR) indexing and finding Multidrug resistant (MDR) bacteria will help to indicate the origin from high risk of contamination where the antibiotics are often used. Hence this study was carried out to give the MAR index of non-fermenting Gram negative bacilli in a tertiary care hospital which would help our infection control team also.Methods: Drug resistance was tested by Kirby bauer’s disc diffusion method. MAR index was calculated using the formula, a/b (were a= number of antibiotics to which the organism was resistant and b= total number of antibiotics to which the organism was tested).Results: Out of 240 Gram negative non-fermenters isolated, 117 (49%) strains were greater than 0.2 of MAR index, 95(81%) was from in-patient department. 73(62%) were hospitalized for more than 3 days, 44 (38%) was from surgery department. 49(42%) was wound specimen. Out of 117 multiple antibiotic resistant isolates 99 (85%) were MDR isolates.Conclusion: 51% prevalence of isolates >0.2 MAR index shows that the source of contamination can still be brought up down by proper surveillance and management with proper usage of surface and skin disinfectants especially in surgery ward where the MAR index has indicated more usage of antibiotics

Bacterial flora of combat wounds from eastern Ukraine and time-specified changes of bacterial recovery during treatment in Ukrainian military hospital

BackgroundMicrobiology of modern war wounds is unique for each military conflict. Climatic and geographical features of the theater of war, contemporary warfare as well as wound management affect the microbial flora of wounds. This study was designed to determine time-specific microbial flora of combat wounds of upper and lower extremities obtained during the war in eastern Ukraine.MethodsThe patients enrolled in study had combat wounds of upper or lower extremities which were treated in the Military Medical Clinical Center of Central Region. The wounds were swab-cultured and measured at each surgical debridement. The recovered microorganisms were identified and their antimicrobial resistance profiles were evaluated by disc diffusion method.ResultsForty-nine patients with battle-field wounds were enrolled in the study from July to November 2014; all patients were male with a mean Injury Severity Score and arrival APACHE II scores of 16.2 ± 10.7 and 7.4 ± 4.2 respectively. Among 128 swab cultures, 100 swab cultures were positive. Swab cultures were obtained from 57 wounds of 49 patients. The results of the test showed that 87.7% of all positive swab cultures contained a single-organism while the rest of the swab-culture results showed polymicrobial growth. Among the isolated microorganisms 65% (76 strains) were Gram-negative rods, 22.2% (26 strains) of Gram-positive cocci, followed by Gram-positive rods (12.8%, 15 strains). We found that epidemiology of wound infection changes with the time after injury. The most common bacterial isolates cultured during the first week were Gram-positive microbes with low pathogenicity. The number of Gram-negative rods increased during the wound healing process. The incidence of Gram-positive microorganisms’ growth fell after the first week and increased after third week. During wound healing, bacterial microflora of wounds changes with increasing number of Gram-negative rods with predominance of Acinetobacter species. Predominant microorganisms in positive swab-cultures after first week were nonfermentative Gram-negative bacilli (68% of swab-cultures), which in 53% of the swab-cultures belonged to the genus Acinetobacter, and in 15% to the genus Pseudomonas. The incidence of polymicrobial wound cultures increased from first week to second post-injury week. The most frequent microbial mixture were Acinetobacter baumannii with Enterobacteriaceae or other nonfermentative Gram negative rods with Enterococcus spp. We observed bacteria recovery from wounds during proliferation phase. These wounds had no pure inflammation signs and were free of devitalized tissues.ConclusionsAny wound is at some risk of becoming infected. In the event of infection, a wound fails to heal, treatment costs rise, and general wound management practices become more resource demanding. Determining the microorganisms which colonize battle wounds and cause wound infection is paramount. This information can help to treat battle wound infections or even changes infection control strategies. The fact of shifting in wound microbiology in the favor of bacteria responsible for healthcare-associated infections support to the proposition that these changes are nosocomially related [4, 14]. For Ukrainian military medicine this study is the first time-specified assessment of battle wound colonization from the World War II.

Antimicrobial resistance of <i>Stenotrophomonas maltophilia</i> isolated from various clinical specimens

Aim: Stenotrophomonas maltophilia (S. maltophilia) is a multi-drug resistant non-fermentative Gram negative bacilli that causes opportunistic infections especially in hospitalized patients. S. maltophilia strains show a high level of resistance to routinely tested antibiotics such as penicillins, cephalosporins, aminoglycosides, quinolones and carbapenems therefore the treatment of this strains is quite difficult. The aim of this study to determine the resistance patterns of S. maltophilia strains isolated from various clinical specimens during a six year period. Materials and methods: The antimicrobial resistance patterns and distribution of 202 S. maltophilia strains isolated from services and outpatients during a period of six years (2010-2015) were analyzed retrospectively. Identification and antimicrobial susceptibilities of the isolates were determined by conventional methods and BD Phoenix 100 (Becton-Dickinson, USA) automated systems. Antibiotic susceptibilities were established by disk diffusion and were evaluated according to the CLSI criteria in 2011-2014 and EUCAST criteria in 2015. Results: A total of 202 strains were isolated from services (62.4%), intensive care units (28.7%) and outpatient clinics (8.9%). 122 patients (60.4%) were male and 80 (39.6%) of them were female. Respiratory tract specimens (n=69) were the most common specimens that S. maltophilia strains were isolated. These strains were found most resistant to meropenem (92.8%) and most sensitive to trimethoprim-sulfamethoxazole (1%). Conclusion: Our resistance rates in S. maltophilia strains were found lower for trimethoprim-sulfamethoxazole, relatively higher for levofloxacin and ciprofloxacin and similar to the other antibiotics compared with the rate in our country. Antimicrobial resistance rates of S. maltophilia strains vary among centers. We believe that it is important to determine their resistance rate of each center for deciding empirical antibiotherapy.

“ISOLATION AND CHARACTERIZATION OF LACTOSE AND NON- LACTOSE FERMENTING BACTERIA FROM TERTIARY CARE HOSPITAL AND THEIR ANTIMICROBIAL SUSCEPTIBILITY TEST”

Objective: The purpose of the present study was to identify the fermenting and non-fermenting gram negative bacteria from the tertiary care hospital.Methods: The conventional method of identification by biochemical analysis and antibiotic susceptibility test was performed by Kirby-Bauer disc diffusion method. Furthermore, analysis of microbes was done by Vitek-2.Results: 424strains of lactose fermenting and non-lactose fermenting gram negative bacilli were isolated from 3097 clinical samples. From the total lactose fermenting bacteria Escherichia coli was the predominant isolate accounting for 50.94% specimens, followed by Klebsiella pneumonia 27.59% and Enterobacter 0.47%. From the total non-lactose fermenting gram negative bacilli Acinetobacter baumannii was the predominant isolate accounting for 12.73% specimens followed by Pseudomonas aeroginosa 6.13%, other isolates were Stenotrophomonas maltophilia 1.17% , Burkholderia cepacia 0.94%. In the present study male were more infected than female. The study also showed that lactose fermenting bacteria were more infectious than non lactose-fermenting bacteria and isolates were from urine samples.Conclusion: Both Non-Lactose Fermenting Gram Negative Bacilli and Lactose Fermenting Gram Negative Bacilli were found to be major contaminants, and are important pathogenic bacteria causing wide range of infections in the tertiary care hospital.Keywords: Lactose fermenting gram negative bacteria, Vitek-2, Tertiary Care Hospital, Kirby-Bauer Disc Diffusion, Lactose non-fermenting gram negative bacteria

Prevalence of Carbapenem Resistant Non-Fermenting Gram Negative Bacterial Infection and Identification of Carbapenemase Producing NFGNB Isolates by Simple Phenotypic Tests.

Non-Fermenting Gram negative bacilli (NFGNB) are emerging multi-drug resistant pathogens causing nosocomial infections. In recent years, carbapenem resistance in NFGNB has increased due to a variety of drug resistance mechanisms, the most common being production of carbapenemases. To detect carbapenemase and metallo-β-lactamase (MBL) production in NFGNBs by four phenotypic tests and to compare the various phenotypic methods for detection of carbapenemase and MBL production in nosocomial NFGNB isolates. It is a cross sectional study carried out in the department of Microbiology, Chennai Medical College Hospital and Research Center, Irungalur, Trichy between January 2015 and December 2015. Out of the 598 NFGNB isolated from all the 5402 heterogenous clinical samples that were processed, 52 (8.7%) NFGNB showed resistance or intermediate sensitivity to meropenem as tested by disc diffusion assay. All the 52 isolates were subjected to four different phenotypic tests for carbapenemase and MBL detection, which included Modified Hodge Test (MHT), Meropenem-EDTA Disc Synergy (EDS) test, Meropenem-EDTA Combined Disc Test (CDT) and Growth on CHROMagar KPC. Among the 52 isolates, 29 (55.77%) were MHT positive and 49 (94.23%) were positive for growth on CHROMEagar KPC which were identified as carbapenemase producers. 44 (84.61%) were EDS positive and 46 (88.46%) were CDT positive which were identified as metallo-β-lactamase producers. The presence of these resistant bugs strongly suggests the need to prevent their further spread by implementation of strict infection control measures and regular surveillance to check their outcome. Growth on CHROMagar KPC is the test that has picked up more number of carbapenem resistant isolates as carbapenemase and metallo-β-lactamase producers among the four tests. It is also cheap and easy to perform, making it the most reliable test for routine screening of carbapenemase and MBL producers in clinical laboratories.

Matrix-Assisted Laser Desorption-Ionization Time-of-Flight Mass Spectrometry (MALDI- TOF MS) for Early Identification of Septic Patients.

Matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a powerful technique for the rapid identification of bacteria from growing colonies in routine cultures. In this study, we evaluated the feasibility of a 5-hour incubation on solid medium after sub-cultivation of positive blood culture broth without any preparation steps in order to speed up the identification of bacteria. In addition to standard laboratory protocols, a Columbia agar plate with 5% sheep blood was inoculated with 1 drop from the blood culture broth. After a 5-hour incubation period, a colony from the culture plate was submitted to MALDI-TOF MS. A total of 1351 positive blood cultures (1299 monomicrobial and 51 polymicrobial) were analyzed. When compared to routine identification procedure results for positive blood cultures, 79.3% of isolates were correctly identified to the species level. When manufacturer-recommended score values were taken into account, MALDITOF MS correctly identified 98.4% of the isolates to the species level with a score of > 2.0, 89.1% with a score between 1.7 and 2.0, and 75.4% with a score of < 1.7. ln our evaluation, a large majority of the S. aureus (91.5%) and Enterobacteriaceae (87.6%) were correctly identified at the species level. A 5-hour incubation period was found to be associated with moderate identification results for CoNS, Enterococcus spp., and nonfermentative gram negative bacilli, with failure being mostly observed with Streptococcus spp., Candida spp., and other gram positive bacteria. We believe that the performance of MALDI-TOF MS identification after short-term culture is directly related to the sufficient growth of microorganisms at 5 hours.

Comparison of Normal Resident Flora on the Face of Medical Students who use and who do not use Cosmetics

Introduction: Normal flora of the skin plays a beneficial role in preventing the pathogenic organisms from colonizing the skin and causing infection. It is possible that the facial cosmetics may cause a change in the normal flora disrupting its protective function. Aim: To find out the effect of cosmetics, those that are applied on to the face on resident normal flora of the face. Materials and Methods: This was a cross-sectional study involving medical students aged 19 to 25 years, of whom 42 were regular cosmetic users and another 42 were non cosmetic users. Swabs were taken from the face of the subjects after a face wash with soap and water and eluted in 1 ml sterile peptone water. Tenfold dilutions of the sample were made and 100 μl of the diluted sample was spread over the surface of Trypticase soy agar, Mac Conkey’s agar and blood agar. The colonies were counted and also identified. Statistical evaluation was done by Chi square test using SPSS version 16. R esults: We isolated Coagulase Negative Staphylococci (CoNS), Micrococcus spp. and methicillin sensitive S.aureus, non-fermenting oxidase negative gram negative bacilli and diphtheroids from both the groups. We found that most of the students who were regular cosmetic users 22 (52.38%) yielded negligent growth in comparison with non-cosmetic users (16, 38%). CoNS was less frequently isolated from regular cosmetic users 10 (23.8%) in comparison with those who do not use cosmetics 17 (40.47%). Conclusion: It is possible that regular use of cosmetics does reduce the normal flora but further studies with larger sample size are required to prove and confirm this finding.

Species of non-fermentative Gram–negative bacilli other than Pseudomonas aeruginosa isolated from surgical wards in Regional Institute of Gastroenterology and Hepatology Cluj Napoca, Romania

Species of non-fermentative Gram–negative bacilli other than Pseudomonas aeruginosa isolated from surgical wards in Regional Institute of Gastroenterology and Hepatology Cluj Napoca, Romania

Emerging Issues Regarding Management of MDR Non-Fermenting Gram Negative Ventilator Associated Pneumonia in A Rural Catering Tertiary Care Hospital

Introduction: Nosocomial infections due to Non-fermenting gram negative bacilli (NFGNB), especially multidrug resistant, are emerging as a great concern to the clinicians worldwide. NFGNB, normally a saprophyte cause serious infections in patients who are immune compromised or are hospitalized especially in ICU. The changing pattern of their susceptibility towards commonly used antibiotics specially carbapenems has necessitate to investigate the prevalent NFGNB circulating in a particular setting and their susceptibility in order to implicate appropriate empirical treatment. In this study we determined the antibiotic sensitivity pattern of the NFGNBs isolated from respiratory secretions of the patients in our ICU. Design: Observatinal cross-sectional study. Setting: Intensive care unit of a rural catering tertiary care hospital. Material and Methods: A total of 523 respiratory tract samples were obtained from patients admitted to ICU during a period of 6 months from September 2015 to March 2016.The samples were processed as per CLSI guidelines on blood agar and macconkey agar. Bacterial growth was identified up to species level and antimicrobial susceptibility testing was determined by Vitek 2 compact (BioMerieux, France). Result: Out of 150 patients with Ventilator associated pneumonia due to non-fermenting gram negative bacilli 63% were male and maximum age effected is 45-75 yrs with medical disease and multiple comorbidities. Acinetobacter baumanii was most common isolate (54.66 %) followed by Pseudomonas aeruginosa(28.66%), Elizabethkingia meningoseptica(8.66%) and Strenotrophomonas maltophilia(8%). Antibiotic resistance among non-fermenting gram negative bacilli appears to be high. Conclusion: Surveillance of nonfermenting gram negative bacilli infections in ICU appears to be important as organism causing infection and their sensitivity profile changes from hospital to hospital and over the period of time.

Occurrence of unusual non-fermentative gram negative bacilli in intensive care units of a university hospital, Egypt

Non-fermentative Gram-negative bacilli (NFGNB) other than Pseudomonas and Acinetobacter species have emerged as nosocomial pathogens. No much data is currently available concerning the occurrence of these types of bacteria in Zagazig University Hospitals (ZUHs). In this study, the occurrence as well as the antimicrobial susceptibility pattern of unusual NFGNB obtained from clinical samples collected from intensive care units (ICUs) of ZUHs was assessed. Additionally, the genetic relatedness among the most prevalent unusual NFGNB species was studied.Results: Out of 516 non-repeated clinical sample, 97 NFGNB (18.7%) were isolated. Among them, 17 unusual NFGNB were identified by API 20NE, accounting for 17.5% of NFGNB and 3.3% of all tested samples. Within the unusual NFGNB, Burkholderiacepaciacomplex (Bcc) was the most prevalent species accounting for 94.1% of NFGNB and 3.1% of total samples. This was followed by Burkholderia pseudomallei (B. pseudomallei) which accounted for 5.9% of NFGNB and 0.2% of all obtained specimens. Tigecycline antibiotic was the most effective antibiotic against Bcc isolates (68.8% susceptibility) in disc diffusion method. After random amplified polymorphic DNA (RAPD) testing, the obtained Bcc isolates were found to be genetically diverse. This highlights Bcc as an emerging nosocomial pathogen in ICUs of ZUHs. Continuous monitoring of the occurrence of Bcc in ICU as well as in other hospital wards is warranted.Keywords: ʺUnusualʺ, ʺNon-fermentativeʺ, ʺgram-negative bacilliʺ, ʺintensive care unitʺ

Prevalence and antibiogram of pseudomonas aeruginosa and acinetobacter baumannii in the clinical samples from tertiary care hospital

Introduction: The present study was undertaken to determine the prevalence of non-fermenting gram negative bacilli and antibiogram of Pseudomonas aeruginosa and Acinetobacter baumannii. Materials and Methods: Conventional bacteriological methods were used for identification non fermenting gram negative bacilli and susceptibility testing was performed with the help of the Kirby-Bauer disc diffusion method. Results: A total 195 non fermenting gram negative bacilli were isolated during the study period. Pseudomonas aeruginosa and Acinetobacter baumannii isolates represent 89.23% of all isolated bacteria. Therefore, antibiotic resistance rates were performed specifically against these two bacteria. P. aerurginosa showed good sensitivity to imipenem(94.29%) followed by amikacin(86.67%) and piperacillin/tazobactum(68.57%). A. baumannii showed good sensitivity to imipenem(82.61%) followed by amikacin(76.81%). Conclusion: P. aeruginosa and A. baumannii were the most common NFGNB isolated in our study. Both showed good susceptibility towards imipenem and amikacin. Alarming resistance rate was found towards commonly used antibiotics. Control measures which include the judicious use of antibiotics, antibiotic cycling, the implementation of appropriate infection control measures and the formulation of an antibiotic policy must be done, to prevent the spread of these strains. Keywords: Pseudomonas aeruginosa, Acinetobacter baumannii, Antibiogram

Investigation of Antimicrobial Susceptibility of Nonfermentative Gram Negative Bacteria Isolated from Intensive Care Units

Investigation of Antimicrobial Susceptibility of Nonfermentative Gram Negative Bacteria Isolated from Intensive Care Units

Emergence of Hospital Acquired Carbapenem Resistant Non-Fermenters in Teaching Institute.

Non-Fermenting Gram Negative Bacilli (NFGNB) are emerging now-a-days because of their tendency to colonize various surfaces and inherent resistance to commonly used disinfectants. They are responsible for multi-drug resistant hospital acquired infections. Detection of carbapenem resistance mechanisms is essential for treatment and infection control purpose as can spread to other organisms causing hospital outbreaks. To characterize non-fermenters from various clinical samples and to detect different carbapenem resistance mechanisms in meropenem resistant isolates. The prospective study was conducted at Sri Aurobindo Medical College and Post Graduate Institute, Indore over a period of one and half year from December 2014 to May 2016. A total of 1310 samples were collected from Ventilator Associated Pneumonia (VAP), Surgical Site Infection (SSI), Urinary Tract Infection (UTI), septicaemia, Lower Respiratory Tract Infection (LRTI) and middle ear infected patients. Non-fermenters were identified by standard microbiological tests. Meropenem resistance was determined by Kirby-Bauer disk diffusion method and resistant isolates were further tested by Modified Hodge test, Combined disc test and AmpC disc test. Isolation rate of non-fermenters was 13.82% (181/1310). Colistin, amikacin and imipenem were the antibiotics with maximum sensitivity. Overall meropenem resistance was found to be 44.2% (80/181). Metallo-β-lactamase and AmpC-β-lactamase were produced by 56.82% (25/44) and 72.22% (26/36) of meropenem resistant Pseudomonas and Acinetobacter species respectively. Detection of carbapenem resistance mechanisms and implementation of antibiotic policy are needed to prevent the emergence of non-fermenter infections.

Bloodstream infection outbreak caused by burkholderia cepacia complex: the role of genetic sequencing in the investigation

Burkholderia cepacia complex is a group of at least 15 species of non-fermentative Gram negative bacteria, common in the environment. These agents are often associated with infections in Cystic fibrosis and immunosuppressed patients, as well with healthcare associated infection outbreaks.

104 Antimicrobial susceptibility of Pseudomonas aeruginosa (PA) and Staphylococcus aureus (SA) isolated from CF patients over 13 years

Objectives Aim of this study was to determine the frequency and pattern of antimicrobial susceptibility of isolated microorganisms. Method Clinical materials (sputum, deep throat swab and BAL) were obtained from 155 pts (age range 0.5–21 yrs; 82 F/73 M), observed from 2002 to 2014. Isolation, identification and susceptibility testing were performed by standard methods. 2324 specimens were analyzed. Results In 1949 isolates collected over 13 yrs the most frequent microorganism was SA, 53%, followed by PA, 17.5%, HI, 17.3%, and non-fermenting Gram(–) bacilli other than PA, 3.7%. SA was identified in 80% pts, 12% of whom were colonized with MRSA strains. The prevalence of small colony variants in SA-positive pts was 9%. SA strains were susceptible to gentamicin (97%) and sulfamethoxazole (96%), ciprofloxacin (93%), macrolides (64%). All strains were susceptible to glycopeptides and linezolid. PA was isolated from 34% pts; in this group 52% were colonized chronically, 42% presented mucoid phenotype and 25% were infected with multi-drug-resistant strains. PA strains were susceptible to colistin 97%, imipenem 86%, ceftazidime 86%, tobramicin 84%, ciprofloxacin 83%, piperacillin 79%, gentamicin 71%. Over 13 yrs, PA resistance to antibiotics increased substantially: carbapenems from 0% to 10%, ciprofloxacin from 0% to 13%, third generation cephalosporins from 0% to 15%, aminoglycosides from 9% to 45%; SA resistance to ciprofloxacin from 2% to 11%. Conclusion SA and PA are still the most commonly isolated microorganisms in CF pts. PA increasing resistance gives a serious cause for concern.

A two-hour antibiotic susceptibility test by ATP-bioluminescence

The antibiotic susceptibility test (AST) in Clinical Microbiology laboratories is still time-consuming, and most procedures take 24h to yield results. In this study, a rapid antimicrobial susceptibility test using ATP-bioluminescence has been developed. The design of method was performed using five ATCC collection strains of known susceptibility. This procedure was then validated against standard commercial methods on 10 strains of enterococci, 10 staphylococci, 10 non-fermenting gram negative bacilli, and 13 Enterobacteriaceae from patients. The agreement obtained in the sensitivity between the ATP-bioluminescence method and commercial methods (E-test, MicroScan and VITEK2) was 100%. In summary, the preliminary results obtained in this work show that the ATP-bioluminescence method could provide a fast and reliable AST in two hours.

Superbugs causing ventilator associated pneumonia in a tertiary care hospital and the return of pre-antibiotic era!

The rise in super bugs causing Ventilator-Associated Pneumonia (VAP) is a major cause of mortality and morbidity despite recent advances in management owing to the looming 'antibiotic apocalypse'. The aetiology and susceptibility pattern of the VAP isolates varies with patient population, type of intensive care unit (ICU) and is an urgent diagnostic challenge. The present study carried out for a period of one year in a tertiary care hospital, enrolled patients on mechanical ventilation (MV) for ≥48 hrs. Endotracheal aspirates (ETA) from suspected VAP patients were processed by semi quantitative method. Staphylococus aureus, members of Enterobacteriaceae were more common in early onset VAP (EOVAP), while Nonfermenting Gram negative bacilli (NFGNB) were significantly associated with late onset VAP (LOVAP). Most of the isolates were multi drug resistant (MDR) super bugs. With limited treatment options left for this crisis situation like the pre-antibiotic era; it is an alarm for rational antibiotic therapy usage and intensive education programs.

Investigation of Metallo-Beta-Lactamase Activity by Various Phenotypic Methods in Non-Fermentative Gram Negative Bacteria

Investigation of Metallo-Beta-Lactamase Activity by Various Phenotypic Methods in Non-Fermentative Gram Negative Bacteria