Positive Organisms Research Articles

High Mortality Rates and Antimicrobial Resistance in Children with Invasive Bacterial Infections in a Tertiary Care Facility in West Africa

Abstract Background Childhood data on infection mortality and antimicrobial resistance in Sub-Saharan Africa are emerging but remain limited. The University of Maryland Center for Vaccine Development (CVD) and CVD-Mali have been conducting a prospective observational study at L’Hopital Gabriel Toure (HGT), a referral hospital in Bamako, Mali, since 2002 to identify causes of invasive bacterial infections (IBI) in children. These data have been used to initiate vaccination programs to decrease the burden of Haemophilus influenzae type b and Streptococcus pneumoniae. Additional demographic and antimicrobial susceptibility data have been collected since 2021, allowing for more detailed resistance and mortality analyses. Methods All children presenting to HGT are screened. Children ages 0-15 years with temperature of at least 39 degrees Celsius and/or suspicion of IBI are eligible. Eligible children have blood cultures collected with additional site-specific cultures when focal infection is suspected. Cultures are performed using the Bactec system; when positive, Gram staining, sub-culturing, and antimicrobial susceptibility testing (by disk diffusion using standard methods) are performed. Organisms thought to be contaminants are excluded. American type culture collection strains are utilized for quality control. Results Between 1/14/2021 and 9/14/2023, 28703 patients were screened. 2156 patients were included. 212 patients (10%) had 235 pathogens isolated. Gram positive organisms were most frequently isolated (N=112), followed by Gram negative Enterobacterales (N=81), non-Enterobacterales Gram negatives (N=36), and yeast (N=6). Staphylococcus aureus was the most frequently isolated Gram positive organism (59 bloodstream isolates, 2 joint isolates, 2 subcutaneous isolates) followed by S.pneumoniae (10 bloodstream isolates, 17 cerebrospinal fluid isolates, 1 joint isolate) and Enterococcus species (16 bloodstream isolates). Klebsiella pneumoniae (28 bloodstream isolates, 2 cerebrospinal fluid isolates) and Escherichia coli (18 bloodstream isolates, 3 cerebrospinal fluid isolates, 2 subcutaneous isolates) were the most frequently isolated Gram negative Enterobacterales, with Pseudomonas species most common among non-Enterobacterales Gram negative organisms (16 bloodstream isolates, 1 cerebrospinal fluid isolate). Mortality rates in both culture-positive and culture-negative patients were high (52% and 28%, respectively), with greater than 50% of deaths occurring within 48 hours in both groups. 88% of Gram negative Enterobacterales were ceftriaxone resistant or intermediate, with 56% ciprofloxacin resistant or intermediate; 55% of isolates were resistant or intermediate to both. 71% of isolates were gentamicin resistant. Imipenem resistance remained low, with 91% of isolates retaining sensitivity. 24% of S. aureus isolates were oxacillin resistant and 34% of isolates were resistant or intermediate to trimethoprim/sulfamethoxazole. 100% of S. aureus isolates tested (14/60) retained sensitivity to clindamycin. Only 54% of pneumococcal isolates had positive oxacillin screens, implying frequent penicillin resistance, and only 60% of enterococcal species were ampicillin sensitive, although 92% retained vancomycin sensitivity. Conclusion We found higher mortality rates in our study than in similar studies; the contribution of issues such as limited access to advanced supportive care and delay in presentation is an area for further study. The high frequency of multidrug-resistant organisms is alarming, suggesting an urgent need to investigate underlying contributing factors, increase access to affordable broad-spectrum antibiotics, and create robust antimicrobial stewardship programs.

A-277 Viability of multi-drug resistant organisms in a fecal collection and transport system stored at ultra-low temperature

Abstract Background Epidemiological studies are constantly investigating new, easier ways to collect and store patient specimens that allow for flexible testing windows and long-term storage as well as accurate quantification of organisms of interest. The FecalSwabTM system (Copan, Brescia, Italy) is intended for the collection and preservation of rectal and fecal specimens. This system includes a preservation medium which serves to maintain the viability of enteric pathogens during transport to a clinical laboratory for up to 72 hours at 4oC. The objective of this study was to assess the continued viability of multi-drug resistant organisms (MDROs) suspended in the FecalSwab sample format when frozen at -80°C and the impact of freeze-thaw cycles. Methods A total of 40 organisms were chosen spanning methicillin-resistant Staphylococcus aureus (MRSA, n=10), carbapenem-resistant Pseudomonas aeruginosa (CRPA, n=5), carbapenem-resistant Enterobacterales (CRE, n=5), vancomycin-resistant Enterobacterales (VRE, n=10) and extended-spectrum beta-lactamase containing Enterobacterales (ESBL, n=10). Each organism was spiked into FecalSwab at standardized concentrations. At each time point, FecalSwab media was plated onto blood agar and colonies were quantified. Each of the 40 organisms were assessed one-week post-freeze and over the course of freeze-thaw cycles at days 3 and 5. The survival of each MDRO was evaluated by calculating a difference between the concentration of organisms recovered (CFU per 10uL media) at each time point and the concentration of organisms confirmed present at the time of inoculation. Percent recovery was calculated from this difference. Results One week after freezing, the percent recovery for MRSA, VRE, ESBL, CRE, and CRPA averaged to 102%, 201%, 17.8%, 7.6%, and 0.8%, respectively (Kruskal Wallis p < 0.001), with significant differences noted between gram positive and gram negative organisms (Kruskal Wallis p <0.001). Conclusions Epidemiological studies interested in MDRO surveillance rely on methodologies that allow for accurate quantification of viable organisms. In this study, we’ve evaluated the viability of several multi-drug resistant organisms when frozen at -80°C in the FecalSwab. The FecalSwab system is intended for the collection of rectal swab and fecal specimens and to preserve the viability of enteric pathogenic bacteria for testing in the clinical laboratory. Although it was not specifically designed to preserve MDROs, it performed well with MRSA and VRE, but less well with CRE, CRPA and ESBL organisms. When using the FecalSwab system, the observed gram-specific differences may inform the suitability of this system depending on the organism(s) of interest.

Microbiological profile and antibiotic susceptibility pattern of chronic dacryocystitis at a tertiary eye care centre in Western India

: Chronic dacryocystitis is a low-grade infection & inflammation of the lacrimal sac. If neglected the infection may extend to surrounding orbit, brain and paranasal sinuses leading to sight and/or life-threatening complications. Thus appropriate, effective and timely antibiotic treatment/ prophylaxis is desirable. The present study was aimed to document the current microbiological profile and antibiotic susceptibility in adult patients of chronic dacryocystitis seen at our tertiary eye care centre in western India.The study was a cross-sectional, prospective, observational study. The study included 60 adult patients of chronic dacryocystitis. In every case two samples from the lacrimal sac collected via the regurgitation technique or by lacrimal passage syringing were sent for microbiological evaluation. Gram staining was used for identification of bacterial pathogen. KOH mount was used for identification of fungi. The second swab was used for performing culture -sensitivity. The Clinical and Laboratory Standard Institute Guidelines were used to know the antimicrobial sensitivity. Kirby-Bauer disk diffusion method was used for this purpose. The statistical analysis was done using descriptive statistics as mean, standard deviation, median and percentages. Microsoft excel worksheet was used. 60 samples were taken. 53/60 (88.3%) samples showed microbial isolates after 24-48 hours of incubation. 78.3% were gram positive organisms and 10% were gram negative organisms. The most common gram-positive organism was (68.3%) and the most common gram-negative organism was (8.3%). Amongst the antibiotics the most sensitive antibiotic was Ampicillin + Sulbactam (92.5%) and the most resistant antibiotic was Ciprofloxacin (3.8%). The antibiotic most sensitive to gram positive organisms was Ampicillin and Sulbactam, Cephalexin, Linezolid, Cloxacillin and Vancomycin. The antibiotic most sensitive to gram negative organisms was Gentamicin, Amikacin, Gatifloxacin, Ceftazidime, Meropenem and Polymixin -B. The current microbiological profile and antibiotic susceptibility of the microorganisms responsible for chronic dacryocystitis is an invaluable tool in the treatment of chronic dacryocystitis with the most appropriate and effective antibiotic.

Anti-quorum Sensing Activity and Bioactive Components of Marine-derived Bacteria

Understanding and harnessing quorum sensing activity and identifying bioactive substances produced by marine-derived bacteria are essential for exploring their potential applications in various fields, including biotechnology, pharmaceuticals, and environmental management. This research aims to investigate the quorum-sensing activities employed by these bacteria and to characterize the bioactive compounds they produce, to unlock their therapeutic, industrial, and ecological potentials. This study focuses on screening, isolation and characterization of marine bacteria from Thoothukudi Harbour Beach, India, and potential antibacterial and anti-quorum sensing activities of their respective spent media against biofilm forming pathogens. Three soil samples were collected and processed for bacterial isolation. Seventeen different bacterial isolates were obtained and identified after prior culture. Antibacterial activity was evaluated against four pathogenic bacteria, with some isolates demonstrating significant inhibition. Additionally, biofilm inhibition assays were conducted, revealing the ability of certain isolates to inhibit the formation of biofilms. The secondary metabolites present in the ethyl acetate fraction of I.B 6 isolate exhibiting relatively high antibacterial and antibiofilm properties were identified by GC-MS. Anti-quorum sensing activity was also investigated using swarming assay and the MIC was determined accordingly for the ethyl acetate fraction. Hence, these marine bacteria hold for producing bioactive compounds with potential pharmaceutical and industrial applications. Finally, the positive organism is subjected to 16S rRNA sequencing for identification and was found to be Bacillus thuringiensis.

Clinical, Microbiological Profile, and Treatment Response to Intraventricular Antibiotics in the Management of Postneurosurgical Meningitis: A Single-Center Experience.

Postneurosurgical meningitis (PNM) is a serious medical condition with high mortality and morbidity caused by Gram positive organisms like Staphylococcus aureus and Gram-negative organisms like Acinetobacter baumannii. Optimum concentration of antibiotics in the cerebrospinal fluid (CSF) to treat these infections is difficult to achieve. Intraventricular antibiotic administration bypasses the blood-brain barrier and can achieve high CSF concentration without causing systemic toxicity. Retrospective review of all patient records were done to identify patients who developed postneurosurgical meningitis and received intraventricular antibiotic therapy during the period of July 2017 to December 2022. Demographic and clinical data along with the type of antibiotic, route, dose, and duration of administration were collected. CSF parameters before and after intraventricular antibiotic administration were collected and analyzed. Twenty-six patients with postneurosurgical meningitis received intraventricular antibiotic therapy. Intracranial tumors were the most common underlying pathology followed by aneurysms. In all, 17/26 patients had received vancomycin and 9/26 patients had received colistin. External ventricular drain was used in 17/26 cases and Ommaya reservoir was used in 9/26 cases. Six patients showed growth of organism in CSF before starting intraventricular antibiotics, while one patient remained culture positive despite treatment. Of the 26 patients, 3 died despite treatment. There were significant changes in the CSF parameters after intraventricular antibiotic therapy. Intraventricular administration of antibiotic provides an alternative therapeutic option in the management of patients who are not responding or poorly responding to systemic antibiotics.

Bacteriological profile of bloodstream infections in pediatric age group in a tertiary care centre, Solapur

Bloodstream infections (BSI) due to multidrug-resistant organisms from paediatric setup have become increasingly common. BSI can be transient and be rapidly cleared out by the host defence mechanism or be associated with high morbidity and mortality if it becomes persistent.Blood samples were collected from 1112 children within a 1-year study period (July 2022 to June 2023) which included all children admitted with complaint of fever and suspected of having sepsis in Paediatric department of Shri Chhatrapati Shivaji Maharaj Sarvopchar Rugnalaya (SCSMSR), Solapur. Blood volume was collected depending upon age and body weight of the patient with aseptic precautions and inoculated in Brain Heart Infusion broth (BHI) which was incubated at 37°C for 7 days. Subcultures were made on blood agar and MacConkey agar plates. Organisms were identified by biochemical reactions and antibiotic susceptibility test of the isolates were performed by disk diffusion. Out of 1112 suspected cases, 175 (15.74%) were culture positive. (27.43%) was the most common isolate followed by (16.57%) Most common Gram positive isolate was (11.43%) followed by (6.86%). Total Multidrug resistant (MDR) isolates in Gram negative and Gram positive were 50.35% and 31.25% respectively.High rates of antibiotic resistance are observed in both gram positive and gram negative organisms. Thus, there is an urgent need for proper implementation of antibiotic stewardship programme and infection prevention and control measures.

Frequency of Multi Drug Resistant E.coli Urinary Tract Infection Presenting to a Tertiary Care Hospital.

Background: Urinary tract infections (UTIs) are a severe public health problem and are caused by a range of pathogens, but most commonly by gram negative and gram positive organisms. High recurrence rates greatly increase the economic burden. This study was conducted to determine the frequency of multidrug resistant Escherichia Coli in patients with urinary tract infections. Methods: Descriptive cross sectional study was conducted over 6 months among 146 patients presenting with E.Coli UTI. Urine culture and sensitivity was performed from the same laboratory and reported by a consultant microbiologist. Results: Among the 146 patients, 65 (44.5 %) were male patients while 81 (55.5 %) were female patients. Mean age of our study cases was 46.87 ± 8.70 years. Of these 146 study cases, 90 (61.6 %) belonged to rural areas and 56 (38.4 %) belonged to urban areas. Diabetes was present in 31 (21.2 %), hypertension was present in 54 (37.0 %) and 27 (18.5 %) had chronic kidney disease. Mean body mass index was 26.23 ± 1.99 kg/m2 and obesity was present in 27 (18.5 %). Mean disease duration was 3.43 ± 1.57 days and 90 (61.6 %) had duration of illness up to 3 days. Multi - drug resistant E. coli was noted in 69 (47.3%). Conclusion; Almost half of our patients had MDR E.coli UTI and was significantly associated with increasing age, residential status, diabetes, hypertension, disease duration and obesity. Urine cultures are recommended to identify MDR in our community.

Cutibacterium species: An Underestimated Pathogen in Chronic Infections

Cutibacterium speciesis a member of the skin micro biota, found predominantly in regions rich in sebaceous glands, involved in various chronic infections that led to its emergence as an opportunistic pathogen. The present study is a retrospective study to determine the prevalence and antibiotic sensitivity pattern of Cutibacterium species recovered from chronic infections over a period of 4.5 years. The identification of the colonies grew on the Robertson’s Cooked Meat media plate was done using VITEK 2. The antibiotic sensitivity tests were put by pour plate method using Epsilometer strips (E-strip).Out of 400, 17.75% (n=71) were confirmed as anaerobic bacteria by VITEK 2. Out of 71 positive anaerobic organisms, 21% (n=15/71) were confirmed as Cutibacteriumspecies.Cutibacterium species recorded prevalenceof 3.75% (15/400) among clinical specimens. High sensitivity was observed with beta lactam group of drugs whereas metronidazole drug was found ineffective against Cutibacteriumspecies. Due to prolonged culture time for anaerobic bacteria there is a high need in new diagnostic methods. In the recent times Cutibacterium species has been reported from various clinical samples which depicts shift of Cutibacterium species as a potential pathogen in the upcoming time.

Synthesis, Chemical Characterization and Antibacterial Activity of Some Novel Triazole Substituted 5-Oxo-Imidazoline Derivatives

5-oxo-imidazoline rings have been reported to possess various biological activities such as antibacterial, anticancer, antifungal, and anthelmintic activities. These activities also include anticonvulsant, and anthelmintic. These observations and findings prompted to synthesize the novel triazolo substituted 5-oxo-imidazoline derivatives. In the present investigation, a series of 10 new 1-trazolyl-5-oxo-imidazolinones were synthesized in good yield by using appropriate synthetic methods and have been established on the basis of their M.P., TLC, FT-IR, 1H-NMR, 13C-NMR data. Also, all the compounds were evaluated for the possible antibacterial activity by cup-plate agar diffusion method by measuring % zone of inhibition. Streptomycin at the concentration of 50?g/ml was used as standard drug. Of all the tested compounds, A6 exhibited significantly high potency against the various gram positive and gram negative organisms used in the investigation.

Microbiology of acute bacterial dacryocystitis: a tertiary institutional experience in South Australia

PurposeTo provide a comprehensive microbiological profile of bacterial dacryocystitis in South Australia. By identifying the specific microorganism and antibiotic susceptibility, this study intends to aid ophthalmologists in choosing appropriate empirical antibiotic therapies and development of evidence-based clinical guidelines.MethodA retrospective study was conducted at the Royal Adelaide Hospital (RAH) over five years (2018–2023) of patients with acute dacryocystitis. The study included 43 patients, and data encompassed demographic information, clinical presentation, microbiological analysis, management, and outcomes. Patients with chronic dacryocystitis were excluded.ResultsAmong the 43 patients included in the study (female 28 (65%), mean age: 64 years old), the most common clinical features were pain (74%) and swelling (70%). Organisms were identified in 49% of patients, with the predominant bacteria being Staphylococcus aureus (42%), Streptococcus species (19%), and Escherichia coli (8%). Aggregatibacter species (8%), Morganella morganii (4%), Enterobacter cloaceae (4%), Hafnia alvei (4%), mixed anaerobes (4%), E coliforms (4%) and Pseudomonas aeruginosa (4%) were also identified. The most frequently prescribed empirical antibiotics were amoxicillin-clavulanic acid (50%), flucloxacillin (33%) and cefalexin (18%).ConclusionThe microbiological trends of acute dacryocystitis have largely remained consistent, with a predominance of Gram positive organisms. This is the most recent profile analysis of acute dacryocystitis in South Australia and will help form evidence-based clinical guidelines.

Time to positivity of blood cultures in a level IV NICU varies based on organism category and population subgroups: is a 36-hour rule out safe?

Time to positivity (TTP) of blood cultures and organism characteristics may be different in a Level IV NICU population. Retrospective study of 309 Level IV NICU positive blood cultures between January 2012 to December 2018 describing TTP and organism characteristics. Median TTP [IQR] was 21.1 [14.3, 25.2] hours, with 91.2% positive at 36 h, and 96.1% positive at 48 h. Gram negative definite pathogens had the shortest TTP (13.0 [11.4, 15.4] hours) compared to gram positive definite pathogens (16.3 [13.0, 22.4] hours). TTP for treated gram positive commensal organisms (22.3 [20.1, 30.4] hours) and those considered contaminants (23.6 [21.4, 26.0] hours), was significantly longer than both gram positive and negative definite pathogens. When antimicrobials are initiated due to concern for bacteremia and blood cultures have not identified a causative pathogen at 36 h, antimicrobials may be safely discontinued in the majority of Level IV NICU patients.

Changing Patterns of Organisms Causing Neonatal Sepsis and Their Antimicrobial Sensitivity Profile in a Tertiary Center - A Prospective Study.

To identify the profile of organisms causing neonatal sepsis and their antibiotic susceptibility pattern in recent years. In this prospective study, authors included neonates with blood culture proven sepsis. Antibiotic resistance patterns that were identified were extended spectrum β-lactamase, AmpC β-lactamase and possible carbapenamase producer. Xpert CARBA-R test was performed to identify genes causing carbapenem resistance. There were 210 neonates with 216 episodes of blood culture proven sepsis. Klebsiella pneumoniae (n = 85) and Escherichia coli (n = 19) were the most common gram-negative organisms. Coagulase negative Staphylococcus (n = 11) and Staphylococcus aureus (n = 7) were the mostcommon gram positive organisms. There were 17 episodes of fungal sepsis with Candida albicans (n = 6) being the most common. Sixty-five out of 216 (30%) organisms were multidrug resistant. Among the Klebsiella isolates, 32/85 (37.6%) were possible carbapenamase producers. Xpert CARBA-R performed for 13 infants showed that all were positive for New Delhi metallo-β-lactamase. Among the 19 Escherichia coli, 10/19 (37.6%) were multidrug resistant and 1/19 (5.3%) was a possible carbapenamase producer. The authors found a significant increase in New Delhi metallo-β-lactamase positive Klebsiella pneumoniae causing neonatal sepsis in last three years. Regular monitoring of resistance patterns and prudent use of antimicrobials are imperative in regulating the shadow pandemic of multi-drug resistant neonatal sepsis.

Orthopedic postoperative infection profile and antibiotic sensitivity of 2038 patients across 24 countries – Call for region and institution specific surgical antimicrobial prophylaxis

PurposeImproper utilization of surgical antimicrobial prophylaxis frequently leads to increased risks of morbidity and mortality.This study aims to understand the common causative organism of postoperative orthopedic infection and document the surgical antimicrobial prophylaxis protocol across various institutions in to order to strengthen surgical antimicrobial prophylaxis practice and provide higher-quality surgical care. MethodsThis multicentric multinational retrospective study, includes 24 countries from five different regions (Asia Pacific, South Eastern Africa, Western Africa, Latin America, and Middle East). Patients who developed orthopedic surgical site infection between January 2021 and December 2022 were included. Demographic details, bacterial profile of surgical site infection, and antibiotic sensitivity pattern were documented. Results2038 patients from 24 countries were included. Among them 69.7 % were male patients and 64.1 % were between 20 and 60 years. 70.3 % patients underwent trauma surgery and instrumentation was used in 93.5 %. Ceftriaxone was the most common preferred in 53.4 %. Early SSI was seen in 55.2 % and deep SSI in 59.7 %. Western Africa (76 %) and Asia-Pacific (52.8 %) reported a higher number of gram-negative infections whereas gram-positive organisms were predominant in other regions. Most common gram positive organism was Staphylococcus aureus (35 %) and gram-negative was Klebsiella (17.2 %). Majority of the organisms showed variable sensitivity to broad-spectrum antibiotics. ConclusionOur study strongly proves that every institution has to analyse their surgical site infection microbiological profile and antibiotic sensitivity of the organisms and plan their surgical antimicrobial prophylaxis accordingly. This will help to decrease the rate of surgical site infection, prevent the emergence of multidrug resistance and reduce the economic burden of treatment.

Role of Panchakarma in management of Urinary Tract Infection - Review Article

All ages of urinary tract infections (UTI) are associated with substantial morbidity and long-term problems. Since using antibiotics helps treat urinary tract infections, it is highly concerning from a therapeutic standpoint when harmful germs become resistant to them. Ayurvedic medications are said to include particularly significant ingredients that are used to treat a variety of illnesses. The review study included a variety of scientific and clinical data that support the effectiveness of Ayurvedic medications in treating urinary tract infections. In the current paper, an evaluation of the effectiveness of Ayurvedic medications for treating clinical conditions such as UTIs was conducted. Good antibacterial qualities were demonstrated by ayurvedic drugs against gramme positive and negative microscopic organisms that cause urinary tract infections. Other aspects are highlighted likewise mitigating, diuretic, cell reinforcement, nephroprotective and antiurolithiatic properties helpful in the administration of UTI and all medications are protected even in high dosages subsequently can be adequately utilized for UTI conditions. In this paper an attempt is made to highlight the research work of role of Panchkarma in UTI, which would be effective in the treatment of UTI.

An uncommon encounter in an unusual location – A case report on acute emphysematous suppurative thyroid abscess

Acute emphysematous suppurative thyroid abscess is a potentially life threatening uncommon disease caused most commonly by gram positive organisms. It usually occurs in immunocompromised individuals with pre-existing multinodular goiter secondary to hematogenous spread of infection. The most characteristic feature of this disease is the presence of gas within the thyroid swelling seen on imaging, even though crepitus may be absent on examination. Surgical debridement and thyroidectomy are the procedure of choice in such cases and can lead to effective cure. We present an unusual and rare case of an acute emphysematous suppurative thyroid abscess caused by a gram negative (non-clostridial) organism in an immunocompromised patient after a fine needle aspiration cytology intervention.

Study of bacteriological profile and antibiotic susceptibility pattern of pus isolates in tertiary care hospital

Surgical wound causes invasion of pathogens causing surgical site infections which are commonly polymicrobial in nature. This pus forming infection causes delayed wound healing, wound dehiscence and wound breakdown contributing to important healthcare associated infections (HAI) Multidrug resistance has emerged among organisms isolated in pus sample due to failure of appropriate use of antibiotics.: 1. To study the bacteriological profile of pus samples 2. To determine the antibiotic susceptibility pattern of isolated pathogens from pus samples.The study was conducted in department of microbiology, Shimoga institute of medical sciences, Shimoga from January 2018 to June 2018.All pus samples were processed on blood agar, MacConkey agar and incubated at 37°c under aerobic conditions for 24 hours. The organisms were identified as per standard conventional methods. The antimicrobial susceptibility tests were done by Kirby–Bauer’s Disk Diffusion method on Mueller–Hinton Agar and interpreted as per clinical laboratory standard institution guidelines (CLSI). Out of 350 samples 250 were culture positive 100 were culture negative. Among culture positive most common organism isolated was followed by 86(34.45%), 72(28.8%), 55(22%), 20(8%), 9(3.6%), 2(0.8%), 3(1.2%) 3(1.2%), 3(1.2%). Gram positive organisms were most sensitive for linezolid, vancomycin and least sensitive to cefoxitin, erythromycin. Gram Negative Organisms Were Most Sensitive for Imipenam, Piperacillin tazobactam and least Sensitive for Ampicillin-sulbactam, Ciprofloxacin is most common etiology of pus forming infection most importantly surgical site infections (SSI). MRSA prevalence in hospital set up indicates the failure of proper infection control practices implementation in the hospitals causing healthcare associated infections (HAI). Emergence of multidrug resistance among the pus isolates is because of non-judicious use of antibiotics.

Prevalence of bacterial isolates and change in their antibiotic susceptibility patterns in urinary tract infections- A five year retrospective study

Urinary Tract Infection (UTI) continues to be one of the commonly occurring infections in medical practice despite the widespread availability of antibiotics. Presence of risk factors like elderly age, diabetes, immune-suppression, and other comorbidity pose a challenge in its treatment. Over the years, the etiology and antibiotic resistance of the uropathogens has been inconsistent. Therefore, it is important to determine the causative agents of UTI and their resistance patterns locally, in each region, so that appropriate empiric therapy can be started before the culture and antibiotic sensitivity results are available. This study aims to highlight the prevalence of uropathogens and determine the antibiotic sensitivity pattern over the period of five years.The urine samples from patients with suspected urinary tract infections (UTI) received in the laboratory at Nanavati Max Super speciality hospital were processed by standard protocol from January 2018 to December 2022. Antibiotic susceptibility test for the bacterial isolates was carried out by the VITEK2 automated system and interpreted as per CLSI guidelines. The data collected over the study period of five years was interpreted by using the WHO Net Antibiotic Susceptibility Surveillance Software in February 2023. From a total of 8068 urine samples received over five years, uropathogens were isolated in 4209 (52.16%) samples. E.coli was the most common isolate causing UTI, with prevalence of 380(46.7%) in 2018 and 480(50.6%) in 2022 of total samples. Amongst gram positive organisms, a rise in Enterococcus species was seen from 41(5%) in 2018 to 87(9%) in 2022, with significantly fewer Staphylococcus species isolated, from 32(4%) in 2018 to 7(0.7%) in 2022. The Enterobacteriaceae showed high sensitivity to Amikacin, Tigecycline and Meropenem all throughout the study. However, rise in resistance to Nitrofurantoin and Fosfomycin, antibiotics commonly used for UTIs, was observed. Also the prevalence of Extended Spectrum of Beta lactamase (ESBL) producers decreased from 213(36%) to 127(17%) with a rise in Carbapenemase producing Enterobacteriaceae from 48(8%) to 298(40%) over the five years study period.Amongst Lactose Nonfermenting gram negative bacilli only 32 % were sensitive to Carbapenems and 37% sensitive to Aminoglycosides.By 2022, Enterococcus species showed an increase in sensitivity to Nitrofurantoin (27%), High level Aminoglycosides (37%), Fluoroquinolones (25%) and Ampicillin (37%).The change in antibiotic sensitivity patterns over time and rise in resistance to antibiotics commonly used in empirical treatment of UTIs warrants the need for regular surveillance, so the physicians can be updated regarding the most prevalent organism and its susceptibility and the empirical treatment for UTIs can be modified accordingly. This can help curb indiscriminate use of antibiotics and development of antibiotic resistance.

To Check Efficacy of Different Disinfectants by Kelsey Sykes Method

The incidence of hospital and community acquired infections has globally increased worldwide. The concentration of the disinfectants is important to give its higher efficacy against pathogens or microorganisms. Microorganisms are part of or environment cause major or severe diseases to reduce the risk of these diseases we generally clean surrounding by using cleaning agents like soaps, antiseptics or disinfectants. So to check weather these disinfectants are performs there work against specific bacteria or microorganism we performed this test to check the effectiveness of disinfectants against specific microorganism and fungus. Five bacterial types that are frequently acquired in hospitals from which two are gram positive organism, two are gram negative organism and single strain of fungus ‘(Pseudomonas aeruginossa, Klebsiella pneumoniae, Staphylococcus aureus (MRSA), Acinetobacter baumannii, Candida tropicalis) (clinical isolates) were examined for their susceptibility against 3 commonly used disinfectants hospitals Chlorine releasing agent, Quaternary ammonium compound and Aldehyde free disinfectant). The turbidity in the nutrient broth and the growth in culture media showed that all three disinfectants had lowered the microbial growth of every clinical strain. In general, the reference strains have lower growth and turbidity than the clinical strains. When combined, our results demonstrated that every product we examined had a high disinfection killing rate against microorganisms from various sources, indicating the excellent caliber of these goods. In response to rising disinfectant usage, hand sanitizer production has expanded to keep up with demand. Normal flora or microorganisms are part of our body in everyday life in which some are necessary some are unnecessary and can cause major or severe diseases to avoid from these diseases we generally clean our self and surrounding by using cleaning agents like soaps, antiseptics or disinfectants. So, to check weather these sterilizing agents are performed their work against specific bacteria or microorganism we performed this test to check the effectiveness of disinfectants against specific microorganism and fungus.

Antimicrobial Activity of African Walnut (<em>Tetracarpidium conophorum</em>) Oil against Bacterial and Fungal Species Causing Food Spoilage and Food Poisoning Diseases

This study evaluated the antibacterial and antifungal activity of African walnut (Tetracarpidium conophorum) oil against species causing food poisoning and food spoilage. African walnut oil was extracted using the solvent extraction method. The fatty acid profile of the oil was determined using gas chromatography mass spectrometry (GC-MS). The agar disc diffusion method was used to determine the antibacterial activity of the oil before using it for further tests. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were also determined using the disc diffusion assay. The result indicates that palmitic (1.53%), linoleic (13.5%), linolenic 80.59%, stearic (4.41%), and eicosenoic acid (0.42%) were present in the oil with higher polyunsaturated fatty acid values. African walnut oil showed remarkable activity against all the Gram positive organisms (Bacillus cereus ATCC 33018, Staphylococcus aureus ATCC 25923, Clostridium perfringes NCTC 8799, and Listeria monocytogenes ATCC 13932) with the inhibition zones ranging from 21.6 ± 0.27 mm to 26.3 ± 0.23 while the Gram negative organisms (Pseudomonas fluorescens ATCC 13883, Pseudomonas fragi ATCC 4973, Escherichia coli ATCC 12806, Salmonella enterica subsp. enterica serovar Typhimurium strain ATCC 14028) were less sensitive and resistant to the oil chromatography-mass with inhibition zones ranging from 6.3 ± 0.31 to 9.9 ± 0.21 mm. Out of the tested oil concentrations from 100 – 0.39 mg/mL, MIC obtained for the Gram positive organisms was 1.56 mg/mL while it was 3.13 mg/mL for Gram negative bacteria (except L. monocytogenes). The antifungal test reveals the MIC range of 100 - 0.78 mg/mL in all the fungal isolates tested. African walnut oil has proved to be potentially active against the Gram positive bacterial and fungal species tested indicating that it can be used as a natural alternative to control food spoilage and food poisoning diseases.

Risk factors for surgical site infection following cardiac surgery in a region endemic for multidrug resistant organisms

ObjectivesTo identify risk factors for surgical site infections following cardiosurgery in an area endemic for multidrug resistant organisms. DesignSingle-center, historical cohort study including patients who underwent cardiosurgery during a 6-year period (2014–2020). SettingJoint Commission International accredited, multiorgan transplant center in Palermo, Italy. Main outcome measuresSurgical site infection was the main outcome. ResultsOn a total of 3609 cardiosurgery patients, 184 developed surgical site infection (5.1 %). Intestinal colonization with multidrug resistant organisms was more frequent in patients with surgical site infections (69.6 % vs. 33.3 %; p < 0.001). About half of surgical site infections were caused by Gram-negative bacteria (n = 97; 52.7 %). Fifty surgical site infections were caused by multidrug resistant organisms (27.1 %), with extended-spectrum Beta-lactamase-producing Enterobacterales (n = 16; 8.7 %) and carbapenem-resistant Enterobacterales (n = 26; 14.1 %) being the predominant resistance problem. However, in only 24 of surgical site infections caused by multidrug resistant organisms (48 %), mostly carbapenem-resistant Enterobacterales (n = 22), a pathogen match between the rectal surveillance culture and surgical site infections clinical culture was demonstrated. Nevertheless, multivariate logistic regression analysis identified a rectal swab culture positive for multidrug resistant organisms as an independent risk factor for SSI (odds ratio 3.95, 95 % confidence interval 2.79–5.60). Other independent risk factors were female sex, chronic dialysis, diabetes mellitus, previous cardiosurgery, previous myocardial infarction, being overweight/obese, and longer intubation time. ConclusionIn an area endemic for carbapenem-resistant Enterobacterales, intestinal colonization with multidrug resistant organisms was recognized as independent risk factor for surgical site infections. Implications for clinical practiceNo causal relationship between colonization with resistant pathogens and subsequent infection could be demonstrated. However, from a broader epidemiological perspective, having a positive multidrug resistant organisms colonization status appeared a risk factor for surgical site infections. Therefore, strict infection control measures to prevent cross-transmission remain pivotal (e.g., nasal decolonization, hand hygiene, and skin antisepsis).