Antibiotic Susceptibility Pattern Research Articles

Impact of Covid-19 Pandemic on Antibiotic Susceptibility Patterns of Salmonella Typhi Isolates from Drinking Water of Peshawar

Background: Contamination of drinking water with pathogenic bacteria like Salmonella Typhi is a major public health concern, indicative of poor sanitation and the threat of antibiotic resistance. This study aimed to evaluate the prevalence of S. Typhi in drinking water sources of Peshawar and to assess the impact of the COVID-19 pandemic on the antibiotic susceptibility patterns of these isolates. Objective: To phenotypically detect and identify S. Typhi from drinking water sources in Peshawar, determine antibiotic resistance patterns, and examine changes in these patterns associated with the COVID-19 pandemic. Methods: A cross-sectional survey was conducted, collecting fifty untreated drinking water samples over six months. Standard biochemical tests and the Analytic Profile Index (API) were utilized for bacterial identification, while the Kirby-Bauer disk diffusion method was employed to ascertain antibiotic resistance. Results: Salmonella Typhi was present in 33 of the 50 water samples, yielding a prevalence rate of 66.66%. Antibiotic susceptibility tests revealed a high level of resistance to commonly used antibiotics, with 100% resistance to Azithromycin, 97.5% to Ceftriaxone, and 95% to both Ampicillin and Ciprofloxacin. The comparison of antibiotic resistance patterns before and after the COVID-19 pandemic indicated a significant increase in resistance, with mean resistance rates jumping from 22.85% to 94.68% (p < 0.05). Conclusion: The drinking water of Peshawar is significantly contaminated with S. Typhi, which exhibits a high degree of antibiotic resistance, aggravated post the COVID-19 pandemic. These findings underscore the urgent need for improved water sanitation measures, vigilant antibiotic stewardship, and comprehensive public health strategies to mitigate the risks posed by waterborne pathogens and antibiotic resistance.

Antibiotic Susceptibility and Biofilm Production among Coagulase Negative Staphylococci Isolated from Clinical Samples at Tertiary Care Hospital.

Coagulase Negative Staphylococci have been widely associated with medical device implant treatment and immune-compromised patients. Despite having increasing interest in Coagulase Negative Staphylococci, few studies from Nepal have reported the association of these organisms with urinary tract infections, conjunctivitis, high vaginal swabs, and cerebrospinal fluid. This study was carried out to determine antibiotic susceptibility pattern and biofilm production among Coagulase Negative Staphylococci isolated from clinical samples at tertiary care hospital. This study was a hospital based cross-sectional study in which 3690 clinical samples were included. Isolation and identification of isolates was done following standard microbiological protocol. Coagulase Negative Staphylococci were identified phenotypically on the basis of gram staining, slide and tube coagulase test and by various sugar fermentation tests. Antibiotic susceptibility test was done following Kirby Bauer disk diffusion method (Clinical and Laboratory Standards Institute 2020). Biofilm production was determined by Tissue Culture Plate technique. A total of 113 isolates of Coagulase Negative Staphylococci were detected. Among them S. epidermidis (45.1%), S. saprophyticus (23.9%), S. haemolyticus (16.8%), S. hominis (5.3%), S. capitis (2.7%), -----S. cohini (1.8%), S. lugdunensis (1.8%) and S. sciuri (2.7%) were identified phenotypically. All isolates were found to be resistant against Ampicillin and 111 (98.2%) were sensitive against Linezolid.23.9% of CoNS were strong biofilm producers, 19.5% moderate and 56.6 % were non/weak biofilm producers. It requires susceptibility test for prescribing antibiotics against Coagulase Negative Staphylococci in hospital and the misuse of antibiotics should be prevented.

Carriage of antimicrobial-resistant Enterobacterales among pregnant women and newborns in Amhara, Ethiopia

ObjectivesInfections are one of the most common causes of neonatal mortality, and maternal colonization has been associated with neonatal infection. In this study, we sought to quantify carriage prevalence of extended-spectrum-beta-lactamase (ESBL) -producing and carbapenem-resistant Enterobacterales (CRE) among pregnant women and their neonates and to characterize risk factors for carriage in rural Amhara, Ethiopia. MethodsWe conducted a prospective cohort study nested in the Birhan field site. We collected rectal and vaginal samples from 211 pregnant women in their third trimester and/or during labor/delivery and perirectal or stool samples from 159 of their neonates in the first week of life. ResultsWe found that carriage of ESBL-producing organisms was fairly common (women: 22.3%, 95% CI: 16.8-28.5; neonates: 24.5%, 95% CI: 18.1-32.0), while carriage of CRE (women: 0.9%, 95% CI: 0.1-3.4; neonates: 2.5%, 95% CI: 0.7-6.3) was rare. Neonates whose mothers tested positive for ESBL-producing organisms were nearly twice as likely to also test positive for ESBL-producing organisms (38.7% vs 21.1%, P-value = 0.06). Carriage of ESBL-producing organisms was also associated with Woreda (district) of sample collection and recent antibiotic use. ConclusionUnderstanding carriage patterns of potential pathogens and antibiotic susceptibility among pregnant women and newborns will inform local, data-driven recommendations to prevent and treat neonatal infections.

Identification of Antibiotics Susceptibility Patterns at Sub-inhibitory Concentrations in Pseudomonas aeruginosa

Pseudomonas aeruginosa is a Gram negative bacterium that has been recognized as an opportunistic pathogen. It is the most common bacterium associated with nosocomial infections and ventilator-associated pneumonia. It exhibits high innate resistance to various ranges of antibiotics thereby causing high morbidity and mortality rate. This research was aimed to identify the antibiotics susceptibility patterns at sub-inhibitory concentration in Pseudomonas aeruginosa. One hundred and fifty (150) clinical swab specimens were collected from urinary catheters; wound and ear infections of patients and the swabs inoculated using standard microbiology method. The isolates were characterized based on the bacteriological methods such as morphology and biochemical tests. The isolates were further confirmed by species specific by PCR amplification of 16S rRNA and the amplicons were analyzed by gel electrophoresis; and further genomic sequencing was done and blast with NCBI database mining. The antimicrobial susceptibility of the isolates was done by disc diffusion methods. The result of the isolation showed 22(59.46%) from wound infections, 12(32.43%) from ear infections and 3(8.11%) from urinary catheter. The isolates were Gram-negative, produced β-hemolysis on blood agar and the morphology is small pigmented circular. The isolates showed positive results to catalase, oxidase, citrate, nitrate and indole tests. The amplification of the 16S rRNA gene region resulted in the band size of 1500bp PCR product and the BLAST analysis gave 99% similarity. The results of susceptibility analysis showed that the isolates from the urinary catheter, wound and ear infection were 82%, 68% and 47% respectively, resistance to Piperacillin tazobactem, Cefoperazon, Ofloxacin, Tetracycline, Amikacin, Gentamycin, Bacitracin, Clarithromycin, Cefalotin, Levofloxacin and Cefpiroma. Antimicrobial susceptibility tests in P. aeruginosa isolates revealedshowed that they were multi-drug resistant. At sub-inhibitory concentrations of antibiotics within the microbial environment, Pseudomonas aeruginosa becomes more resistant. Perhaps, these antimicrobials could have other signaling activities within the environment. Therefore, there is a need for more research work to develop therapeutics combination to combat the recalcitrant nature of Pseudomonas aeruginosa.

Tracking the shift in enteric fever trends and evolving antibiotic sensitivity patterns.

This study aims to examine the frequency of Salmonella Paratyphi found in blood cultures and evaluate the antibiotic susceptibility pattern of Salmonella isolates to different antibiotics. Additionally, the study aims to assess the paradigm shift in the trend of enteric fever caused by Salmonella Typhi (S. Typhi) to Salmonella Paratyphi(S. Paratyphi) . Retrospective study. The study enrolled patients aged 12 years and above diagnosed with enteric fever (positive blood culture) and admitted to Peelamedu Samanaidu Govindasamy Naidu (PSG) Hospital. The study analyzed demographic and antibiotic susceptibility profiles of Salmonella isolates collected from 106 enteric fever patients in the hospital between 2010 and 2022. The susceptibility profiles of Salmonella isolates to multiple antibiotics were assessed. There were 106 participants, and 95 (89.62%) of them had enteric fever linked to Salmonella Typhi, while only 11 (10.38%) had enteric fever linked to Salmonella Paratyphi A. From 2010 to 2022, the study discovered a general decline in the prevalence of enteric fever caused by Salmonella species. But between 2014 and 2022, the incidence of enteric fever linked to S. Typhi rapidly increased. Azithromycin (100% , n = 106) and ceftriaxone (99% , n = 105) were highly effective against the Salmonella isolates, whereas nalidixic acid was resisted by 3 isolates (4.72%, n = 3). The study observed a higher incidence of Salmonella Typhi in comparison to Paratyphi A and a greater susceptibility of males to enteric fever. None declared.

Investigation of Uropathological Bacterial Profile and Antibiotic Susceptibility Patterns Among Pregnant Women in Rawalpindi and Islamabad: A Comprehensive Analysis

Background: Urinary tract infections (UTIs) represent a significant health concern for pregnant women, potentially leading to adverse outcomes for both mother and child. The anatomical and physiological changes during pregnancy increase the risk of UTIs, making the study of their bacteriological profile and antibiotic susceptibility patterns especially pertinent. Objective: This study aimed to assess the bacteriological profile and antibiotic susceptibility patterns of UTIs among pregnant women in Rawalpindi and Islamabad, to identify the most prevalent pathogens and their resistance to commonly used antibiotics. Methods: A cross-sectional study was conducted on 165 early morning mid-stream urine samples collected from pregnant women attending the Railway General Hospital, Rawalpindi, over four months. Samples were analyzed for UTI-causing organisms using Cysteine Lactose Electrolyte Deficient (CLED) medium, MacConkey agar, and blood agar plates. Gram staining and biochemical tests were utilized for bacterial identification, while the Kirby-Bauer disk diffusion method determined antibiotic susceptibility. Statistical analysis was performed using SPSS version 25. Results: The study population predominantly consisted of residents from Rawalpindi (94.5%). The highest incidence of UTIs was observed in the age group of 31-36 years (34.5%). Staphylococcus aureus (28%) and Pseudomonas aeruginosa (30%) were the most prevalent pathogens. High resistance rates were noted against ampicillin and azithromycin among gram-positive isolates, whereas gram-negative bacteria showed considerable resistance to ciprofloxacin. However, gentamicin displayed relative effectiveness across various pathogens. Conclusion: The study highlights a significant prevalence of antibiotic-resistant UTIs among pregnant women in the studied regions, with Staphylococcus aureus and Pseudomonas aeruginosa being the dominant pathogens. The findings call for an urgent need to implement effective antibiotic stewardship and screening programs during pregnancy to mitigate the risk of UTIs and their associated complications.

STUDY OF ACUTE BACTERIAL MENINGITIS IN CHILDREN BY GRAM STAIN, CULTURE AND ANTIGEN DETECTION

Objective: Acute Bacterial Meningitis (ABM) is associated with a high mortality rate and morbidity in paediatric population despite recent advances in diagnostic methods, antimicrobial and supportive treatments and monitoring. This study is therefore undertaken to aid in rapid diagnosis of ABM by latex agglutination test (LAT) and to comparatively evaluate Gram stain, Culture and LAT in the diagnosis of ABM along with antibiotic susceptibility pattern of the isolates. We undertake this study in children with symptoms of meningitis to isolate and identify the pathogens in CSF and blood and to determine their antibiotic susceptibility pattern. We will compare and evaluate the three methods Gram stain, culture and Antigen detection.
 Methods: A hospital-based prospective study conducted at Government General Hospital, Kakinada during December 2018–August 2020. A total of 50 clinically suspected cases of bacterial meningitis in the paediatric age group were taken. The CSF sample was collected and subjected to Gram stain, culture and antigen detection tests using PASTOREX TMMENINGITIS kit.
 Results: Out of 50 samples collected, 15 cases were declared as laboratory confirmed cases as per WHO criteria. Gram stain was positive in 6 cases. CSF culture could identify 8 cases of ABM. CSF LAT was positive in 12 cases. Group B Streptococcus was the most common etiological agent in neonates, while S. pneumoniae in children. The isolates were 100% sensitive to cefoperazone, cefuroxime, cefepime and gentamicin.
 Conclusion: Although Gram stain is simple and CSF culture is the gold standard, LAT has an advantage over Gram stain in terms of species identification. It was found to be more sensitive, rapid, easy to perform and could identify fastidious organisms like S. pneumoniae, N. meningitidis and Group B Streptococcus.

STUDY OF MULTIDRUG-RESISTANT GRAM-NEGATIVE BACILLI IN URINARY TRACT INFECTIONS AND THEIR ANTIBIOGRAM AT A TERTIARY CARE HOSPITAL

Objective: To study the frequency of multidrug-resistant Gram-negative bacilli in urinary tract infections and antibiotic susceptibility pattern of multidrug-resistant Gram-negative bacilli in urinary tract infections.
 Methods: This study was conducted on urine samples received at the Department of Microbiology, Andhra Medical College, for a period of six months from August 2022 to January 2023. During the study period, a total of 3361 urine samples were processed and conventional microbiological techniques were used to isolate uropathogens. Antibiotic susceptibility was tested by the Kirby-Bauer Disc diffusion method and interpreted according to Central Laboratory Standard Institute (CLSI) guidelines 2022. Multidrug-resistant bacilli in this study were defined as Gram-negative bacilli that were resistant to at least one agent in three or more antibiotic classes.
 Results: Out of 3361 urine samples received from outpatient and inpatient departments of our hospital, 858 samples were culture positive-839 were Gram-negative isolates and 19 were Gram-positive isolates. Mean age was 40-60 y. Urinary tract infections were more common in females than males. Among Gram-negative bacilli isolated, Escherichia coli was the most common organism isolated-435(50.69%), followed by Klebsiella species-232(27.03%), Acinetobacter species-105(12.25%), Pseudomonas species-55(6.41%), Proteus species-10(1.16%), Citrobacter species-2(0.23%). Among Gram-positive cocci, Staphylococci-17(1.98%) and Enterococci-2(0.23%) were isolated. Out of 858 isolates, 177 (20.62%) were identified as multidrug-resistant bacilli and all were resistant to the drug groups Cephalosporins, Carbapenems and Quinolones. Most of the Multidrug-resistant gram-negative bacilli were sensitive to Fosfomycin and Nitrofurantoin.
 Conclusion: Multidrug-resistant Gram-negative bacilli in urinary tract infections have become a major health problem. Assessment of Risk factors, Surveillance of Resistance patterns and policies for proper use of antibiotics are urgently needed.

Antimicrobial susceptibility of bacterial clinical specimens isolated from Al-Sader Teaching Hospital in Basra-Iraq

Antibiotic resistance is a global health concern that requires multiple efforts to establish proper preventive and curative programs. This study aimed to assess the antibiotic susceptibility profiles of commonly isolated bacteria at Al-Sader Teaching Hospital, Basra-Iraq. A total of 234 clinical specimens were collected from urine, skin infections, and blood. The bacterial isolates were initially identified using standard microbiological methods, and the identification of the four most common isolates was confirmed by PCR technique using species-specific primers (malB for Escherichia coli, rpoB for Klebsiella pneumonia, OprL for Pseudomonas aeruginosa, and mecA for methicillin resistant Staphylococcus aureus). The identified bacteria were subjected to disc diffusion and VITEK2 system to test the antibiotic susceptibility. E. coli was the most prevalent in urine (51.25%), followed by S. aureus (15%), while S. aureus (31.25%) and P. aeruginosa (30.20%) were more prevalent in skin infections. S. aureus (31.57%) and E. coli (26.31%) were predominant in the blood samples. The Antibiotic susceptibility pattern of Gram-negative isolates revealed high resistance to Cefoxitin (90%), Aztreonam (87%), Ceftriaxone (87%), Piperacillin/tazobactam (85%), and Amoxicillin/clavulanic acid (85%). S. aureus showed high resistance to Cefoxitin (93%), Oxacillin (89.58), and Methicillin (91%), whereas, the highest sensitivity was recorded for Colistin (100%), Rifampin (93%), Amikacin (87%), and Meropenem (76%). A high level of multidrug-resistance strains was detected among Gram negative bacteria (76%) and S. aureus (56%). The current study provides valuable insights into the distribution of pathogenic bacteria and their antibiotic resistance patterns in different clinical samples, contributing to improved treatment strategies and infection control measures.

Analysis of the Frequency, Antibiotic Susceptibility, and Related Genes among Foodborne Pathogenic Bacteria Isolated from Hospital Refrigerators in Tehran, Iran.

Hospital refrigerators as essential food storage can be important source of food contamination. We aimed to investigate the frequency and antibiotic susceptibility of the pathogenic bacteria in three hospital refrigerators in Tehran. This study was performed on 254 samples, collected from 60 refrigerators of the various wards of three hospitals, A, B, and C, in Tehran, Iran from 2020 to 2021. Following isolation and identification of isolates, the antibiotic susceptibility pattern was determined. PCR-based assays were used to screen the presence of antibiotic resistance genes of resistant isolates. From 254 collected samples, 236 samples (92.9%) were contaminated. Most strains were isolated from refrigerators with poorly cleaned, temperatures above 8 °C in non-critical wards. Most bacteria belonging to Enterobacteriaceae (68.8%), followed by Staphylococcus (11.9%), and Enterococcus (10.6%), while the frequency of non-Enterobacteriaceae isolates was 8.9%. The highest antibiotic resistant bacteria were in extended spectrum beta-lactamase (ESBL) 9.7%, vancomycin-resistant enterococci (VRE) 5.3%, methicillin-resistant S. epidermidis (MRSE) 0.4%, and methicillin-resistant S. aureus (MRSA) 0.4%, respectively. The bla OXA-48, bla CTX, and bcla TEM genes were found only in 10% of Enterobacteriaceae isolates. The bla OXA-51 gene was found in all non-Enterobacteriaceae isolates. The vanA and mecA genes were detected in antibiotic-resistant Enterococcus and Staphylococcus. Our findings suggests major concern about cross-contamination and the emergence of antibiotic-resistant isolates as a potential health threat with hospital refrigerators origin. More attention to hospital refrigerators cleaning is necessary to prevent foodborne diseases and nosocomial infections.

Molecular typing of clinical multidrug-resistant Klebsiella pneumoniae isolates.

Klebsiella pneumoniae is an opportunistic pathogen which is an important cause of hospital-acquired and antibiotic resistance infections. Therefore, this study aimed to determine the frequency of resistance to antibiotics, as well as the molecular typing of the associated isolates, and compare multiple-locus VNTR analysis (MLVA) and Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction (ERIC-PCR) methods to specify the degree to which distinctions can be separated from each other. One hundred K. pneumoniae isolates were obtained from different sources of infections from patients admitted to hospitals. Antibiotic susceptibility testing was then performed by applying the Kirby-Bauer disk diffusion method. Typing of K. pneumoniae was done by utilizing MLVA and ERIC-PCR methods. Eighty-six multidrug-resistant (MDR) K. pneumoniae isolates were identified, which resistance to ampicillin, trimethoprim/sulfamethoxazole, and ceftriaxone was the most frequent in the considered isolates (100, 93, and 93%, respectively). A total of 50 different antibiotic susceptibility patterns were observed among the MDR K. pneumonia, with the most frequent pattern being resistance to all antibiotics (12.79%) and resistance to all antibiotics except amikacin (10.47%). The isolates were then divided into 37 different MLVA types and seven clonal complexes were obtained from the minimum spanning tree analysis. Finally, the isolates were assigned to 38 different ERIC types. The discriminatory power of MLVA and ERIC methods also showed a value of 0.958, and 0.974. Both PCR-typing methods with phenotypic patterns can be useful for the epidemiological typing of K. pneumoniae isolates with the highest performance in discriminating isolates.

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

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

Retraction: Molecular Characterization and Antibiotic Susceptibility Pattern of Bacterial Strains Isolated From Wound of Patients With Diabetes.

[This retracts the article DOI: 10.7759/cureus.47681.].

Assessing bacterial prevalence and resistance in paediatric meningitis: safeguarding the central nervous system.

Paediatric bacterial meningitis (PBM) represents a major contributor to childhood morbidity and mortality globally, with heightened susceptibility in low- and middle-income nations where antimicrobial resistance (AMR) is highly prevalent. Pakistan exemplifies this setting, with widespread antibiotic overuse driving AMR expansion. Thus, expediting PBM diagnosis and targeted antibiotic therapy is imperative yet challenged by the dynamic local epidemiology. This study aimed to delineate the recent bacterial etiologies and AMR profiles of PBM from a major Pakistani diagnostics laboratory to inform empirical treatment. This prospective observational investigation evaluated PBM epidemiology in patients under 18 years old admitted to the study hospital. Standard cerebrospinal fluid analysis identified bacterial pathogens and antibiotic susceptibility patterns. Among 171 PBM cases, 152 (88.9%) had bacterial isolates confirmed via culture. The cohort was 42.7% male with a mean age of 3 months. The most prevalent pathogens among infants younger than 3 months were Escherichia coli, Enterococcus faecium, and Staphylococcus epidermidis, contrasting with S. epidermidis, Streptococcus pneumoniae, and Staphylococcus hominis predominating in older children. Staphylococcal isolates exhibited considerable penicillin and erythromycin resistance but maintained vancomycin and linezolid susceptibility. Other resistance patterns varied. These findings highlight the pressing threat of paediatric AMR in Pakistan, underscoring the need for vigilant AMR surveillance and judicious antimicrobial use. This study provides a reference to current PBM epidemiology to guide context-specific empirical therapy.

A Study on the Magnitude of Non-Fermenter Gram-Negative Bacilli and their Antibiotic Susceptibility Pattern in Clinical Samples from a Tertiary Care Hospital, Kolkata

Background: Non-fermenting Gram-negative bacilli (NFGNB) were initially considered non-pathogenic contaminants but now have emerged as major pathogens because of increased isolation from clinical samples and emerging resistance to common antibacterial agents. Objectives: The study aims to determine the magnitude of NFGNB in clinical samples received at the Department of Microbiology, Nil Ratan Sircar Medical College, Kolkata, for a period of one year. Material and Methods: The samples were processed according to standard procedures; for identification and antibiotic susceptibility test, Vitek 2 Compact (Biomerieux©) was used. Results: Out of 725 bacterial isolates, 169 (23.31%) NFGNB were identified during the entire study period. Pseudomonas spp. (n = 84) was isolated most frequently, followed by Acinetobacter spp. (n = 73), Burkholderia cepacia (n = 7), and Stenotrophomonas maltophilia (n = 5). Both Pseudomonas spp. and Acinetobacter spp. showed greater susceptibility to piperacillin-tazobactam and poor susceptibility against cefepime. Conclusion: It is necessary to identify these drug resistant pathogens in healthcare setup. The antibiotic susceptibility pattern of these pathogens needs to be monitored to guide clinicians in better patient care and management by initiating proper antibiotic therapy.

Assessment of Resistance and Susceptibility Pattern of Antibiotics in Tertiary Care Teaching Hospital in Eastern Gujarat

Assessment of Resistance and Susceptibility Pattern of Antibiotics in Tertiary Care Teaching Hospital in Eastern Gujarat

BACTERIAL PROFILE AND ANTIBIOTIC SUSCEPTIBILITY TEST AMONG DIABETES MELLITUS PATIENTS WITH GANGRENE IN SURABAYA

Background: Gangrene is a severe complication of damaged tissue that can occur in people with Diabetes Mellitus (DM), putting them at risk for bacterial infection. A pus culture can show diabetic gangrene patients' infecting bacteria. Purpose: Determine the prevalence of infection-causing bacteria and antibiotic sensitivity tests in diabetic gangrene patients at Haji Regional General Hospital, East Java Province, for January-December 2021. Method: The method used in this study is observational analytical cross-sectional, which is based on secondary data and is analyzed using the percentage formula and Chi-Square test. Result: The data obtained from 39 patients revealed 29 (74.4%) positive patients for bacterial infection. The Gram-negative bacteria was found to cause infection more frequently (72.41%) than the Gram-positive bacteria (27.59%). The prevalence of Gram-negative bacteria species most frequently from Escherichia coli (ESBL) 13.79% (4/29), Klebsiella pneumoniae 10.35% (3/29), Proteus mirabilis 10.35% (3/29). While the dominant Gram-positive bacteria a Methicillin-Resistant Staphylococcus aureus (MRSA) 10.35% (3/29). The antibiotic sensitivity test showed that Gram-negative group were susceptible to ertapenem, meropenem, amikacin, gentamicin, and piperacillin tazobactam while resistant to ampicillin and cefazolin. The antibiotic sensitivity tests showed that the Gram-positive group was susceptible to linezolid, vancomycin, and tigecycline while resistant to tetracycline and ciprofloxacin. Conclusion: It is important to screen the bacterial profile causing gangrene and their antibiotic susceptibility pattern in DM patients in order to give proper treatment to DM patients.

Antibiotic susceptibility patterns at the Médecins Sans Frontières (MSF) Acute Trauma Hospital in Aden, Yemen: a retrospective study from January 2018 to June 2021.

Antimicrobial resistance (AMR) is an urgent global health concern, especially in countries facing instability or conflicts, with compromised healthcare systems. Médecins Sans Frontières (MSF) established an acute trauma hospital in Aden, Yemen, treating mainly war-wounded civilians, and implemented an antimicrobial stewardship (AMS) programme. This study aimed to describe clinical characteristics and identify antibiotic susceptibility patterns representative of patients treated with antibiotics. Retrospective cross-sectional study using routinely collected data from all patients treated with antibiotics in the MSF-Aden Acute Trauma hospital between January 2018 and June 2021. Routine clinical data from patients' files was entered into an AMS electronic database and microbiological data were entered into WHONET. Both databases were imported and merged in REDCap and analysed using RStudio. Three hundred and sixty-three of 481 (75%) included patients were injured by violence-related trauma. Most were men aged 19-45 years (n = 331; 68.8%). In total, 598 infections were diagnosed and treated. MDR organisms were identified in 362 (60.5%) infections in 311 (65%) patients. Skin and soft-tissue infections (SSTIs) (n = 143; 24%) were the most common, followed by osteomyelitis (n = 125; 21%) and intra-abdominal-infections (IAIs) (n = 116; 19%), and 111 (19%) secondary bloodstream infections were identified. Escherichia coli was the most frequently identified pathogen, causing IAI (n = 87; 28%) and SSTI (n = 43; 16%), while Staphylococcus aureus caused mainly osteomyelitis (n = 84; 19%). Most Gram-negatives were ESBL producers, including E. coli (n = 193; 81.4%), Klebsiella pneumoniae (n = 72; 77.4%) and Enterobacter cloacae (n = 39; 50%) while most S. aureus were methicillin resistant (n = 93; 72.6%). High rates of MDR were found. This information will facilitate a comprehensive review of the empirical antibiotic treatment guidelines.

Antimicrobial resistance patterns, virulence genes, and biofilm formation in enterococci strains collected from different sources

BackgroundCurrently, antibiotic-resistant strains of Enterococcus are considered to be one of the critical health challenges globally. This study aimed to investigate the antibiotic susceptibility pattern, biofilm formation capacity, and virulence genes of enterococci isolated from different sources.MethodsIn this cross-sectional study, environmental and fecal samples were collected from the hospital environment, volunteers, and hospital staff from October 2018 to August 2019. The isolates were identified by morphological and biochemical tests (gram staining, catalase, bile resistance, esculin hydrolysis, carbohydrate fermentation, growth in 6.5% NaCl, Pyrrolidonyl arylamidase, arginine dehydrolase), and PCR for ddl gene. An antimicrobial susceptibility test was performed by the standard disk agar diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Quantitative microplate assays were used to assess biofilm production. The bacterial DNAs were extracted by alkaline lysis method and polymerase chain reaction technique was used detect the esp, ace, and efaA virulence genes.ResultsOut of 145 isolates, 84 (57.9%) were identified as E. faecalis and 61 (42.1%) as E. faecium. Resistance to kanamycin and quinupristin-dalfopristin was 82.1% (69/84) and 85.7% (72/84), respectively, in E. faecalis isolates. Out of 61 E. faecalis isolates, 38 (62.4%) were resistant to kanamycin. Among the E. faecalis isolates, esp was the most dominant virulence gene (73.80%), followed by efaA, and ace, which were detected in 60.71%, and 30.95% isolates, respectively. In total, 68.27% of the strains were biofilm producers. Further, esp and efaA genes were more frequently found among E. faecalis strains with moderate and strong biofilm biomass.ConclusionsAccording to the findings of our study, enterococci strains isolated from different samples possess distinctive patterns of virulence genes. The esp, ace, and efaA genes were more prevalent among E. faecalis than E. faecium. Besides, the high level antibiotic resistance of normal flora and environmental enterococci strains is alarming the researchers.

Pattern of antibiotic resistance in surgical site infections in a tertiary care hospital of Nepal

Background: Surgical site infection (SSI) is the second most common hospital-acquired infection. The identification of bacterial pathogens and their antibiotic susceptibility pattern is required for the successful treatment of SSI and curb antimicrobial resistance, which is a major threat globally. This study aimed to assess the microbial profile of the organisms causing SSI and their antibiogram in a tertiary care hospital. Methods: This cross-sectional study was conducted at Microbiology Laboratory of tertiary care hospital, from March 2023 to August 2023. Swab or aspirate specimens were collected aseptically from the surgical site and processed for bacterial isolation following standard bacteriological techniques. Gram’s staining and biochemical tests were performed to identify the organisms at the species level. Antimicrobial susceptibility tests were done following Kirby–Bauer’s disc diffusion method. Statistical analysis was performed using SPSS software version16.0. Results: Out of 405 samples, 92 (22.7%) yielded bacterial growth. Eighty-three culture positive cases (90.2%) were monomicrobial while nine (15.7%) had mixed growth of at least two different bacteria. Out of 108 isolates, 43 (39.8%) were gram-positive and 65 (60.2%) were gram-negative bacteria. Escherichia coli (39.8%) was the most commonly isolated organism. All gram-negative isolates were resistant to ceftriaxone followed by amoxicillin-clavulanic acid (94.0%), amoxicillin (94.0%), cefixime (90.7%), and cefepime (89.8%). Similarly, none of the gram-positive isolates were susceptible to ampicillin, amoxicillin, and ampicillin/sulbactam. The most effective drugs against E. coli were imipenem (100%), followed by tigecycline (96%), meropenem (95.1%), chloramphenicol (84%), amikacin (81.5%), and gentamicin (81.5%). Overall prevalence of MDR was 59.3%. Conclusion: Our study demonstrates increased resistance of both gram-positive and gram-negative organisms to commonly used drugs like cephalosporins and even quinolones. Continued surveillance of antimicrobial susceptibility results at local level, dissemination of data, and prescribing the antibiotics accordingly based on culture and sensitivity results are necessary to ameliorate antimicrobial resistance.