Pattern Of Causative Organisms Research Articles

Pattern and Epidemiological Characters of Meningitis Infections, Cairo Egypt. 2016–2019

Background and study aim Egypt is an endemic area with meningitis infections, which is associated with high complications and death rates making it a medical emergency. The World Health Organization (WHO) estimates that there are around 1 million of cases per year worldwide with 135–200,000 fatal cases. The aim of the study is to describe the socio demographic, economic and clinical pattern of meningitis, to determine the outcomes of the disease in term of complications and fatality, to identify the causative organisms, and potential factors associated with either complications or mortality. Patients and Methods All patients presents with symptoms of meningitis according to the standardized case definition of CDC and confirmed with either cerebrospinal fluid analysis or brain imaging were recruited from Ain Shams University Hospitals by retrospective reviewing of medical records along the period from 2016 to the end of 2019. Socioedemographic, clinical and outcome data were also collected (extracted from the records) Results One thousand three hundred twenty-four (1324) patients were enrolled in the current study. males were more infected than females, children were the most vulnerable group. The main cause of septic meningitis was streptococcus meningitis, mainly among children after Haemophilic influenza due to the introducing the HIB vaccine in vaccination program November 2014. Bacterial meningitis was the leading cause of death among studied patient and deafness was the main neurological complication. Conclusion Early clinical suspicion of CNS infection and immediate management are crucial factors in reduction of the still high morbidity and mortality rates. The changes in the pattern of causative organisms must be considered when starting empiric antibiotic.

Pattern of vascular access-related infection in hemodialysis patients

Background Vascular access-related infections (VARI) represent a substantial burden for patients undergoing hemodialysis (HD) that is unfortunately inevitable. The spectrum of causative organisms varies between different regions and centers, so it is necessary for each dialysis unit to have its database. This prospective descriptive multicenter study was conducted over a 6-month duration to delineate the pattern of VARI among patients undergoing HD units of Alexandria University Hospitals, and to determine the possible relationship between VARI, type of vascular access, pattern of causative organisms, and various risk factors. Materials and methods The study enrolled all patients with documented clinical and bacteriological evidence of VARI. Infection incidence-rate event/1000 dialysis session (ds) was calculated. Results During the study period, 877 HD patients were approached. A total of 66 VARI episodes were identified in 62 patients, with 58 bloodstream infection (BSI) episodes and 8 local-access infections, with an overall incidence rate of 4.64/1000 ds. About 64% of isolated organisms were Gram-negative bacilli, 33.3% Gram-positive cocci, and 2.8% fungi. The most frequent isolated pathogens were Klebsiella pneumonia, Escherichia coli, and methicillin-resistant Staphylococcus aureus (MRSA). Conclusion VARI rate was higher in HD patients with temporary central venous catheter compared with permanent tunneled catheters. Gram-negative microorganisms and MRSA were the most frequent identified organisms. Creation of arteriovenous fistula should not be delayed to avoid the use of temporary catheters, which carry high risk of VARI.

Pattern of Keratitis: A Study of 500 Cases in Tertiary Hospital of Bangladesh

Background: Keratitis is a potentially serious corneal infection and a major cause of visual impairment worldwide. Most common form of which is infectious variety; pathogens may be bacteria, viruses, fungi and parasites which varies with age and predisposing factors. Topical antimicrobials and cycloplegic agents are the mainstay of treatment. Pattern of causative organisms and drug sensitivity changes from time to time and differs from one to another geographic location.
 Objective: To assess and evaluate the pattern of diagnosed patient of keratitis presented in a tertiary hospital.
 Material and methods: This cross-sectional study was conducted on 500 diagnosed patients of keratitis in the department of cornea of National Institute of Ophthalmology & Hospital, a well-known tertiary care hospital with 500 beds for a period of 6 months. Patients were selected based on specific selection criteria. Detail history was taken, and thorough ocular examination was done in every patient. Corneal scrapings were taken for Gram’s stain and 10% potassium hydroxide wet mount preparation. All the relevant data was recorded in a predesigned data collection sheet.
 Results: The mean age of the study subjects was 38.49 years. Male (43.2%) and female (56.8%) ratio was almost equal. The prevalence was highest among lower economic class (56.8%) as usual, and lowest among affluent class (3.8%) but not sparing them. In terms of regional distribution, majority (42.6%) of the patients came from rural area, whereas 37% from urban non-slum area and 20.8% from urban slum area. The problem was mostly observed among day-laborers (24.8%) with gradually declining trend among students (20.6%), housewives (20%), service holders (14.2%), businessmen (3.2%) and unemployed (2.2%), surprisingly! Presentation of the cases were mostly in between 2nd-3rdweek (55%), while 30% patients were presented within 1st week & 15% after 4 weeks of diagnosis. Among the cases, it was found that 28.8% patients had corneal injury, which were caused by vegetative trauma in 16% cases, 4% dust or sand trauma, 2.8% animal injury, 2.2% stick injury, 1% nail injury and 2.8% patients had history of other injury like stone, wooden materials, flying insects, dirty wire etc. Ocular diseases predispose to corneal ulcer were present in 9% patients. These were chronic dacriocistitis, entropion and trichiasis. 1.2% patients were diabetic, and 1% patients had history of inadvertent use of steroids. On the contrary, there were no specific predisposing factors in 71.2% cases. Among the cases, 96.6% experienced photophobia, 90% had foreign body sensation, 88.4% had reduced vision, 85.4% had eye pain, 78.8% suffered from watering, 73.6% had discharge, 48.8% had burning sensation, 12.2% had decreased corneal sensation and 11.2% patients noticed white spot in cornea in first stage. Slit lamp bio-microscopic examination of the patients shows 90% patients had conjunctival injection, 70% had epithelial defect, 28.6% patients had stromal infiltration, 18.4% patients had hypopyon, 14% patients had feathery pattern, 8.8% patients had suppuration, anterior chamber reaction was present in 4.4% cases and 2.2% patients had satellite lesion. The evaluation of etiology on the basis of clinical appearance reveals 61.4% of cases were presented with viral keratitis, 23.0% fungal corneal ulcer, 11.4% with bacterial corneal ulcer, 2.2% with marginal keratitis, 0.8% with exposure keratitis, 0.8% with filamentary keratitis and 0.4% cases with Acanthamoebic keratitis at the time of presentation. While assessing the depth of keratitis of the study subjects, 73.2% found superficial while 26.8% found deep. Assessment of area of corneal involvement in terms of punctate epithelial defect showed that in 46.8 % cases less than 3mm of cornea was involved, 3 to 6 mm of the cornea involved in 19.6 % cases and in 11.8 % corneal involvement was found in more than 6 mm area. Corneal scraping done in 118 (23.6%) out of 500 patients. Among them, Fungi were found in 11.2% cases, mixed organism in 4%, Bacteria in 5.6% and Acanthamoeba found in o.4% cases while 2.4% remains unidentified.
 Conclusion: Analysis of the study findings shows diversity in the pattern, presentation, predisposing factors of different form of keratitis which may be helpful as basis of further study on this problem.

Epidemiological and Bacteriological Profile of Urinary Tract Infection and the Antibiotic Sensitivity Pattern of Causative Organisms in National Medical College and Teaching Hospital - A Retrospective Cross-Sectional Study

Background: Urinary tract infections (UTIs) are one of the most common infectious conditions seeking treatment. There are varieties of microorganisms associated. The bacteriological investigations are incomplete without antibiotic sensitivity test of the isolate. Our aim is to determine age and sex distribution of UTI, bacteriological profile, and antibiotic sensitivity pattern of the organisms.
 Materials and Methods: A retrospective cross-sectional observational study of records of patients with clinically suspected UTI from Kartik 2076 to Magh 2076 was conducted at National Medical College and Teaching Hospital (NMCTH). It included both inpatient and OPD visit patients who submitted their clean-catch midstream urine sample for culture and antibiotic sensitivity at Microbiology lab of NMCTH.
 Result: Out of 385 patients, 103 (26.75%) showed bacterial growth. Escherichia coli (47.58 %) was the most common organism followed by Staphylococcus sps. (18.45%) and Klebsiella sps.(17.47%) respectively. There was female dominance (62.13%) but male were predominantly affected in children and older population. The most common age group for UTI was 21-30 years (mean age 25 years) and females were more affected than males. The most common pathogen was Escherichia coli, followed by Staphylococcal sps. and Klebsiella. All the organisms showed best sensitivity to tigecycline (100%).
 Conclusion: This study highlights the common pathogens causing UTI and their antibiotic sensitivity patterns which could help clinicians in starting rational empirical antibiotic therapy for such patients while awaiting urine culture reports.

Outcome of Late-onset Neonatal Sepsis at a Tertiary Hospital in Oman.

ObjectivesWe sought to determine the prevalence, pattern of causative organisms, and mortality of newborns with culture-proven late-onset sepsis (LOS) and to determine and compare the risk factors linked to late-onset gram-positive and late-onset gram-negative sepsis in Sultan Qaboos University Hospital (SQUH).MethodsWe conducted a cross-sectional retrospective study of data obtained between 1 January 2007 and 31 December 2014 (eight years) from infants in the neonatal intensive care unit (NICU) at SQUH. Infants born in SQUH (inborn) and other institutions (outborn) with positive blood cultures were included in the study.ResultsThe total number of live births and admissions during the study period were 26 289 and 3559, respectively. The total number of infants identified with LOS were 125 of whom 69 (55.2%) were gram-positive, 52 (41.6%) were gram-negative, and four (3.2%) were due to Candida species (spp.). The majority of infants (n = 113, 90.4%) were inborn; 69 (55.2%) were males and 56 (44.8%) were females. The prevalence of LOS among inborn admissions was 4.3 per 1000 live births. Most infections occurred in very low birth weight infants (n = 81, 64.8%). Eleven (8.8%) infants died due to gram-negative sepsis. Klebsiella pneumoniae followed by Pseudomonas aeruginosa were the leading cause of death. Maternal intrapartum antibiotics were the only independent risk factor correlating with gram-negative organisms in multivariate analysis (p = 0.003).ConclusionsLOS poses a burden in the NICU, which could be due to the increasing survival of premature babies. The main contributing organisms to LOS are gram-positive bacteria. Klebsiella spp. is a major cause of mortality in LOS. The use of intrapartum antibiotic prophylaxis in mothers might explain the positive correlation of maternal antibiotics as a risk factor with gram-negative infections.

Pattern and Outcome of Central Nervous System Infections in Suez Governorate

Background and study aim: Egypt is an endemic area with Central nervous system (CNS) infections, which associated with high complications and death rates so it is considered a medical emergency. In spite of emerging of new potent antibiotics and availability of specific vaccination accompanied with improving of medical care, morbidity rates accompanied with CNS infection remains unacceptably high. There is dramatic change in the epidemiology of CNS infection that leads to incomplete understanding of its pathogenesis which interferes with the initiation of effective empirical antimicrobial treatment. There is a growing need for more researches to uncover these changes.The aim of the study is to assess the pattern of CNS infections, identify the causative organisms, course and outcome of the CNS infections to implement standard management approaches and improve outcome. Patients and Methods: One hundred twenty-four patients, recruited from Suez Fever and General Hospitals with suspected CNS infection, were enrolled in this study. CNS infection was confirmed by cerebrospinal fluid results supported by clinical diagnosis and in some patients brain imaging was performed. Results: In our study streptococcus pneumonia was the main cause of septic meningitis; males infected more than females, children were the most vulnerable group; among children Haemophilus influenzae was the commonest cause of septic meningitis. Mycobacterium meningitis was the leading cause of death among studied patient and deafness was the main neurological complication. Conclusion: Early clinical suspicion of CNS infection and immediate management are crucial factors in reduction of the still high morbidity and mortality rates. The changes in the pattern of causative organisms must be considered when starting empiric antibiotic.

Clinical and Laboratory Profile of Urinary Tract Infections in Type 2 Diabetics Aged over 60 Years.

Urinary tract infections are frequently encountered among diabetic patients and the incidence rate increases with age. There have been growing research to identify the clinical profile of urinary tract infections in diabetic patients. However, such studies on elderly patients are rare. To determine the risk factors, clinical/laboratory profiles, causative organisms and antimicrobial susceptibilities in type 2 diabetics aged over 60 years. This prospective single centre study was conducted at NRI Medical College and General Hospital, Guntur, India, between November 2012 and November 2014. A total of 100 consecutive patients with type 2 diabetes mellitus, aged over 60 years, with symptoms suggestive of urinary tract infection were examined. Subsequently, the demographic characteristics, detailed medical history, signs/symptoms of urinary tract infections, laboratory investigations for blood and urine samples, ultrasound abdomen findings were compared between bacteriuric and non bacteriuric patients. In addition, the organisms in urine cultures and antibiotic sensitivity patterns were investigated for bacteriuric patients. Two groups were compared using the Mann-Whitney test for continuous variables and the Chi-square or the Fisher's exact test for categorical respectively. Bacteriuria was found in 43% of type 2 diabetic patients aged over 60 years. Comparative analysis revealed that bacteriuria was more common among patients with female gender (p=0.028), diabetes duration of >15 years (p=0.011) and diabetes complications such as neuropathy (p=0.027) and diabetic foot (p=0.003). Age and uncontrolled fasting blood sugar or HbA1c levels did show an increased propensity for developing urinary tract infections. Increased frequency (76.7%), and urgency (67.4%), dysuria (65.1%) were significantly more common among bacteriuric patients than that in nonbacteriuric patients (p<0.05). Urine culture analysis revealed that E. coli (69.8%) was the most common causative organism, followed by Klebsiella (16.3%). Majority of isolated organisms were sensitive to antimicrobial agents like nitrofurantoin and imipenem. Bacteriuria was very common in elderly patients with diabetes. The observed trends in risk factors, clinical profile, laboratory profile, causative organism patterns, and antimicrobial susceptibilities will help to add the growing literature on this topic.

Present scenario of microbiological pattern in chronic suppurative otitis media and its management guidelines

AIMS: Chronic suppurative otitis media (CSOM) is a common infectious chronic ear disease in India resulting in serious complications, especially hearing impairment. Irrational use of antibiotics for its management has led to the emergence of multidrug-resistant bacterial strains. Considering this, this study was conducted to know the pattern of causative organisms associated with CSOM and their antimicrobial sensitivity. Materials and Methods: Ear discharge from 200 clinically diagnosed cases of CSOM was collected by suction using sterile techniques in a sterilised test tube on wash bottle principle consisting of a glass tube made air tight with the help of a cork with an inlet and outlet facility. All samples were processed in the department of microbiology for the identification of bacterial and fungal isolates and their antimicrobial sensitivity testing. Results: Among the 200 samples of ear discharge, 127 were from ear having tubotympanic (mucosal or safe) type of CSOM while 73 were from ear with attico-antral (squamosal or unsafe) CSOM. Among aerobic isolates, Pseudomonas aeruginosa (35%) was most common followed by Staphylococcus aureus. Other aerobes isolated were Klebsiella spp., coagulase-negative Staphylococcus, Proteus spp. and Escherichia coli. Fungus was isolated in tubotympanic (9.45%) CSOM only. Among anaerobic isolates, Peptostreptococcus (1%) was most common. Conclusion: Monomicrobial isolates, especially P. aeruginosa and Staphylococcus species, were found to be most common in our study. Therefore, evaluation of microbiological pattern and their antibiotic sensitivity pattern in local area becomes helpful in prescribing empirical antibiotics for successful treatment of CSOM.

Comparison of Microbial Pattern Causing Urinary Tract Infection in Female Out and Hospitalized Patients in Jakarta

Urinary Tract Infection (UTI) is an infection in any part of the urinary system. Women are 3 times more likely to have UTI than men. The UTI accounts for 15% infection cases in outpatients and 24% cases in hospitalized patients. Although the most common cause of UTI is certain bacteria, but it was not easy to choose the appropriate antimicrobial therapy. Strategy for choosing empiric antimicrobial treatments for UTI in female out- and hospitalized patients should be based on the pattern of the causative organisms. The aim of this study was to understand the microbial pattern causing UTI in female out- and hospitalized patients in Jakarta. The UTI -1 causative microorganisms were obtained from urine culture containing 100,000 cfu/mL . Twenty nine microorganisms were found as the causative agents of UTI in 317 pregnant women who came to six Community Health Centres (Puskesmas) in Jakarta: Makassar; Pulogadung, Cakung, Pasar Rebo, Duren Sawit, and Kramat Jati for antenatal care. Twenty nine microorganisms were isolated from 114 urine samples of female hospitalized patients who were diagnosed of UTI. The samples were obtained from the Microbiology Laboratory Clinic of FKUI-RSCM. The most common microorganisms causing UTI in female out- and hospitalized patients were Gram negative bacteria. In female outpatients, Klebsiella sp was the most common causative bacteria (31%), followed by Escherichia coli (24.1%). In female hospitalized patients, Escherichia coli was the most common causative bacteria (30%), followed by Candida sp (24.1%) and Klebsiella pneumonia (6.8%). There was more variation in the pattern of UTI causative organisms in hospitalized female patients in comparison to that of the outpatients. Candida sp. was only found in hospitalized UTI patients but not in outpatients.

Patterns of colonising and pneumonic organisms in intubated ICU patients - a prospective analysis

The incidence and nature of upper respiratory tract colonisation and pneumonia were prospectively studied in 102 sequential patients admitted to a general intensive care unit (ICU) requiring tracheal intubation for longer than 48 hours. Endotracheal sampling for quantitative cultures was performed upon all patients twice weekly. Twenty-three patients (22%) developed pneumonia of whom seven (30%) died. Colonisation occurred in 28 patients, showing exclusively a Gram-negative pattern. Colonisation proved a poor predictor of pneumonia with a sensitivity of 35%, specificity of 75% and a positive predictive value of 29%. There was no significant difference in the incidence of pneumonia between patients who were colonised and those who were not colonised (p>0.4). The pattern of causative organisms for pneumonia were Gram-negative bacilli (60%), Gram-positive organisms (30%), polymicrobial (26%) and culture negative (8%). Of the eight patients who were colonised and developed pneumonia, six (75%) were infecte...

Continuous Ambulatory Peritoneal Dialysis in Children in Saudi Arabia

Over a period of 5 years, 26 children with end-stage renal disease were started on maintenance continuous ambulatory peritoneal dialysis (CAPD) program in King Khalid University Hospital, Riyadh. A...

Choice of antibiotics in management of acute osteomyelitis and acute septic arthritis in children.

A survey of 158 children with acute haematogenous osteomyelitis, and of 94 children with acute septic arthritis over an 8-year period was made to determine which bacteria cause these infections. In the osteomyelitis group the organism most frequently detected was Staphylococcus aureus (74% of cases). In 16% of cases streptococci were found. Staph. aureus was also the most frequently grown organism in cases of acute septic arthritis (55% of cases), but Haemophilus influenzae accounted for 24% of positive cultures. On the basis of the survey it is the current practice of the author to use a combination of methicillin or cloxacillin and penicillin for acute haematogenous osteomyelitis, and methicilline or cloxacillin and ampicillin for acute septic arthritis. The choice of antibiotics is vitally important as treatment must start before the results of culture are known. Repeated evaluation of trends in the pattern of causative organisms is strongly recommended, in order to be aware of changing sensitivity of organisms to antibiotics.