Wound Swabs Research Articles

Reliability of superficial swab culture results compared with deep wound culture results in Fournier’s gangrene: a retrospective study

ObjectivesTo compare isolates from deep wound and superficial swab cultures to evaluate the detectability of pathogens by each culture in Fournier’s gangrene; and evaluate the association between microorganisms isolated from deep wounds and those isolated from blood or urine. MethodsPatients with Fournier’s gangrene who underwent debridement between October 2006 and January 2023 were retrospectively reviewed. In addition to comparing the isolates from deep wound cultures at initial debridement with those from superficial swab, blood, and urine cultures, the relationship between the traits of the organisms from deep wounds and patient disease severity and prognosis was examined. ResultsAmong 25 patients, deep wound and superficial swab cultures were obtained from 25 and 18 patients, respectively. The frequency of anaerobic isolates was significantly lower in the superficial cultures than in the deep wound cultures (31/76 versus 13/56, p = 0.034). Bacteria not isolated from deep wounds were isolated from superficial cultures in 55.6 % of the patients; the concordance rate between deep and superficial cultures was 27.8 % (5/18). The positive rates of blood and urine cultures were 20.8 % and 35.7 %, respectively; all isolates from the urine and blood cultures reflected the results of the deep wound culture. No significant association was observed between the severity or mortality and the type of causative bacteria. ConclusionsSuperficial swab cultures cannot be substituted for deep wound cultures in Fournier’s gangrene. Although the positivity rates for blood and urine cultures were not high, they were helpful in determining antibiotic de-escalation.

Antibiotic Resistance Profiles of Extended-Spectrum β-Lactamase (ESBL)- and Metallo-β-Lactamase (MBL)-Producing Klebsiella pneumoniae Isolates From Diabetic Foot Ulcers: Implications for Treatment Strategies.

Background Diabetic foot ulcers (DFUs) are prevalent complications of diabetes mellitus, often leading to severe infections and adverse clinical outcomes. Klebsiella pneumoniae, a gram-negative bacterium, has emerged as a significant causative agent in DFU infections, raising concerns due to its increasing antibiotic resistance, particularly in extended-spectrum β-lactamase (ESBL) and metallo-β-lactamase (MBL) production. Aim This study aimed to comprehensively assess the prevalence, antibiotic resistance profiles, and clinical correlates of ESBL- and MBL-producing K. pneumoniae isolates specifically derived from DFUs. Methods A cross-sectional observational study was conducted at Krishna Vishwa Vidyapeeth from January 2023 to June 2023, involving 126 patients diagnosed with DFUs. Clinical and demographic data were collected, and wound swabs underwent microbiological analysis. Phenotypic detection methods were employed to identify ESBL and MBL production, followed by standardized antibiotic susceptibility testing. Results Among the 126 isolates tested, 36 (28.6%) were identified as ESBL-producing and 21 (16.7%) as MBL-producing strains. ESBL-producing isolates exhibited high resistance rates to antibiotics such as ampicillin (92.3%), amoxicillin-acid (84.6%), and cephalosporins, including ceftriaxone (76.9%), and cefepime (73.8%). MBL-producing isolates demonstrated even broader resistance profiles, including resistance to fluoroquinolones (ciprofloxacin, 60.0%; levofloxacin, 57.1%), aminoglycosides (gentamicin, 42.9%), and carbapenems (meropenem, 38.1%; imipenem, 35.7%). Conclusion This study identifies a significant prevalence of ESBL- and MBL-producing K. pneumoniae in DFUs, showcasing high antibiotic resistance rates. Comorbidities correlate significantly with the presence of resistant isolates, necessitating treatment strategies for effective management.

Isolation of Multi-drug Resistant Bacteria from Patients Admitted to Aljala Trauma Hospital in Benghazi, Libya

Abstract Background: The high prevalence of multidrug-resistant (MDR) bacteria is a worldwide problem. The overuse and misuse of antimicrobial agents favored the emergence of MDR bacteria and rendered infectious agents difficult to treat. The aim of this study was to isolate bacteria responsible for wound infections in inpatients and outpatients treated at Aljala Trauma Hospital, Benghazi, Libya. Methods: A cross-sectional study was conducted at Al-Jala Trauma Hospital from January to July 2019. Wound swab samples were collected from 230 patients and cultured on different media. An antibiogram of isolates was determined. We were using the disk diffusion technique (Kirby-Bauer technique). Results: Three hundred fifty-five isolates were able to grow on culture media. A single etiological agent was identified in 149 patients and multiple agents were found in 81 patients. The predominant pathogens isolated were Pseudomonas aeruginosa and Staphylococcus aureus (21%), E. coli (15%) Klebsiella (14%), Acinetobacter (7%), CoNS and Enterobacter (6%), while Enterococcus sp. (4%), proteus sp. (3%) and S. pyogens(1%) The overall MDR among Gram-positive and Gram-negative bacterial isolates were (32.7%) and (67.3%) respectively. The percentage of MRSA was 16%, surprisingly the prevalence of MDR among Pseudomonas aeruginosa, Acinetobacter sp., Proteus sp., and S. pyogens were very high (100%) and most of the other bacteria isolated were resistant to most of the antibiotics used. Moreover, Co-negative isolates appeared highly resistant to Oxacillin (89%), Enterococcus sp. (90%), and Staph aureus sp. (79%) Conclusion: The prevalence of multi-drug resistance among Gram-positive and Gram-negative bacteria is high and this is considered a serious problem. It is necessary to follow the bio gram of bacteria causing wound infections in the hospital as this would be beneficial to patients as well as help physicians in the selection of appropriate treatment. Moreover, aseptic techniques, hand hygiene, and wearing personal protective equipment will improve patient outcomes and help reduce the spread of pathogens among patients and in the hospital.

Detection of fim H and UDP virulence-associated genes in patients with MDR Klebsiella pneumoniae isolates from Baghdad hospitals

Klebsiella pneumoniae is a gram-negative, encapsulated, and lactose-fermenting bacterium related to hospital-acquired infections that can cause various diseases. The current study aimed to detect the presence of the virulence-associated genes fim H and UDP among multiple drug-resistant K. pneumoniae isolates obtained from different sources using polymerase chain reaction (PCR) to determine their association with antibiotic resistance. Ninety K. pneumoniae isolates were obtained from 210 different clinical samples collected from various sources (urine, sputum, wound swabs, blood, and burns) from patients of both genders in Baghdad hospitals between March 2022 and July 2022. Bacterial identification was based on selective and differential media, followed by seven biochemical tests, the Vitek-2 system, and molecular identification tests were performed using 16S rRNA. The antibiotic susceptibility of isolates to 13 antibiotics was assessed by the disk diffusion method on Mueller–Hinton agar. The results showed that 100% of the isolates were resistant to vancomycin. Otherwise, colistin had the lowest resistance rate (25.55%). The virulence genes fim H and UDP (uge) were detected by multiplex polymerase chain reaction (PCR) in multidrug-resistant (MDR) isolates. The most prevalent gene was fim H (88%) followed by UDP (80%). The virulence genes were highly prevalent among MDR K. pneumoniae isolates. The resistance rate to colistin was 25.55%, making it the most effective antibiotic used in the current study. Vancomycin, on the other hand, had a high resistance value. Multidrug resistant isolates were found to be associated with the presence of virulence genes.

Prevalence and Antimicrobial Susceptibility Pattern of MRSA amongst Patients from an Indian Tertiary Care Hospital: An Eye Opener

Staphylococcus aureus (S. aureus) is a very common human pathogenic microorganism that can cause a variety of infectious diseases, including skin and soft tissue infections, endocarditis, osteomyelitis, bacteremia, and lethal pneumonia. About one-third of the common population is colonized with S. aureus. MRSA is a formidable pathogen known to cause high mortality & morbidity, that poses a significant threat to public health worldwide. Presence of MRSA strains, resistant to multiple antibiotics especially in hospital stay, has complicated the management of infections caused by this bacterium. The aim of this study was to shed light on the prevalence and antimicrobial sensitivity pattern of MRSA among patients in a tertiary care center located in Faridabad, Haryana. This cross-sectional observational study was conducted in the Department of Microbiology, ESIC Medical College & Hospital, a 510 bedded tertiary care teaching hospital in Faridabad, Haryana, India. All wound samples including pus, exudates, wound swab and tissue samples received for aerobic culture and antimicrobial sensitivity from various clinical departments from January 2019 to July 2019 were included in this study. A total of 747 samples were received from January 2019-July 2019. Mean age of this study population was found to be 50.7 ± 14.8 years. Out of 747 samples, 226 (30.25%) were culture positive. Among the S. aureus isolates, methicillin resistance was seen amongst 39 (58.2%). Antibiotic Susceptibility results of S. aureus showed 100% resistance to Penicillin along with 100% resistance to Fluoroquinolones in both MRSA and MSSA. High prevalence of MRSA amongst patients highlights the importance of continued surveillance and implementation of antimicrobial stewardship program to control the menace of antimicrobial resistance. Strict adherence to Infection Control practices its regular follow up to assess the effectiveness of any hospital infection control measures taken is the key.

Exploring Plasmid-Mediated Quinolone Resistance Gene Diversity among Ciprofloxacin-Resistant Proteus Species in a Tertiary Care Hospital of Bangladesh

Background: Increased resistance to fluoroquinolones has been observed in members of the Enterobacteriaceae, including Proteus species. The extensive use of fluoroquinolones and the presence of plasmid-mediated quinolone resistance (PMQR) genes are believed to contribute significantly to fluoroquinolone resistance. This study highlights the prevalence of ciprofloxacin-resistant Proteus species and the presence of specific PMQR genes among them, emphasizing their potential role in quinolone resistance. Method: The study included 30 ciprofloxacin-resistant Proteus isolates collected from wound swab, pus, urine, and blood samples. Identification of Proteus species was performed using culture and biochemical tests. Antibiotic susceptibility test was conducted using the Kirbey-Bauer disc-diffusion method. The minimum inhibitory concentration (MIC) of ciprofloxacin among ciprofloxacin-resistant Proteus species was determined using the agar dilution method. The study aimed to detect specific PMQR genes, namely aac(6´) lb-cr, qnrA, qnrB, qnrD, and qnrS, using polymerase chain reaction (PCR). Result: A total of 42 Proteus species were isolated from 310 various samples. Among the Proteus isolates, 71.43% were ciprofloxacin resistant. The study found that 30% of ciprofloxacin-resistant isolates were positive for aac(6´) lb-cr gene, 13.33% for qnrA and qnrS respectively and 10% for qnrD gene. In total, 60% of ciprofloxacin-resistant Proteus isolates were positive for at least one PMQR gene. The qnrB gene was not detected among ciprofloxacin-resistant Proteus species. The MIC of ciprofloxacin ranged from 8 μg/ml to 128 μg/ml among ciprofloxacin-resistant Proteus isolates. Conclusion: This study suggests aac(6´) lb-cr, qnrA, qnrS, and qnrD genes are emerging in Proteus species, potentially contributing to the development of quinolone resistance and has implications for clinical management and public health. J MEDICINE 2024; 25: 149-154

Antimicrobial resistance pattern of Klebsiella species isolated from various clinical specimens

Objective: The present study was carried out to identify Klebsiella species and their antimicrobial resistance pattern from various clinical specimens. Methods: This cross study was conducted at a tertiary care hospital, Dhaka, Bangladesh from July2020 to June 2021. Written consent was taken from the concerned authority. A total 6739 clinical samples including urine, wound swab/ pus, sputum, blood and endotracheal aspirates were collected and processed for isolation of bacteria by following standard guidelines from adult patients. All the urine, wound swab, blood and endotracheal aspirates were inoculated in both blood agar and MacConkey agar media, for blood samples blood culture was done in BacT/ALERT 3D 60 aerobic bottles irrespective to antibiotics administration. After incubation at 370C aerobically for 24 hours incubated plates were examined. Phenotypic identification of the organisms were done by observing colony morphology, hemolytic properties, pigment production, Gram staining and biochemical tests (oxidase test, catalase test and biochemical reactions after inoculation in TSI, MIU, citrate agar media). The Kirby - Bauer disk diffusion method was used for antimicrobial susceptibility testing of the isolated organism using Mueller-Hinton agar and commercially available antibiotic discs (Oxoid Ltd, UK). The data were analyzed using SPSS software Version-20 (SPSS Inc., Chicago, IL, USA). Categorical variables were expressed as numbers (n) and percentages (%). Results: A total 6739 samples were included in the present study. Of which, 170 were urine, 162 were wound swabs, 71 were sputum, 52 were endotracheal aspirates and 45 were blood samples. Culture positivity among the samples is shown in table I. Conclusion: Most of the Klebsiella species are highly resistant to commonly used antibiotics. This higher resistance is the major cause morbidity and mortality related with infections in hospitalized patients. So, a regular surveillance of antibiotic susceptibility pattern is needed to prevent indiscriminate use of antibiotics. CME J 2024; 3(2); 12-15

A Four-Year Trend of Ceftriaxone Resistance and Associated Risk Factors Among Different Clinical Samples in Wad Medani, Sudan: A Cross-Sectional Retrospective Study.

Introduction In sub-Saharan Africa, including Sudan, there is commonly no local data on the bacterial profile or antibiotic resistance pattern. Therefore, to bridge these gaps, this study aimed to evaluate ceftriaxone resistance patterns and associated risk factors among different clinical samples. Methods This study was a laboratory-based, retrospective,cross-sectional study. All clinical specimens were obtained from patients at Wad Medani and examined at the Pathology Center for Diagnosis and Research, Faculty of Medicine, University of Gezira, Sudan, from January 2020 to October 2023. Results Overall, 1784 specimens exhibited bacterial growth over four years. Of these, 1260 (70.6%) were females. Approximately one-third of the 588 (33%) studied patients were aged 30 to 44 years. Of the studied samples, 1108 (62.1%) were urine, and 465 (26.1%) were wound swabs. Staphylococcus aureus(697, 39.1%) and Escherichia coli(656, 36.8%) were the most frequently encountered bacteria. Generally, ceftriaxone resistance has been evaluated in 150 positive culture samples. The overall ceftriaxone resistance rate was 106 (70.7%). The greatest proportion of ceftriaxone resistance was observed in 4/4 (100%) of Klebsiella spp. and 66/82 (80.5%)of E. coli strains. The type of isolate (95% Cl, p-value; 0.006) and type of bacterial stain (95% Cl, p-value0.013) have been significantly associated with ceftriaxone resistance, in which Gram-negative bacteria had a greater resistance rate of 98/132 (74.2%)than Gram-positive bacteria 8/18 (44.4%). Conclusions This study revealed a high rate of ceftriaxone resistance. The most resistant bacteria were Klebsiella spp. and E. coli. The type of isolate and bacterial stain were significantly associated with ceftriaxone resistance. Therefore, hospitals should immediately and significantly modify their antibiotic prescription policy to give doctors a consistent strategy for the rational, safe, and effective administration of antibiotics.

Virulence Determinants of Acinetobacter baumannii Isolated from Different Infections in Baghdad Hospitals

Acinetobacter baumannii is an essential pathogenic bacteria cause nosocomial infections worldwide. The current work aimed to characterize several virulence factors in Acintobacter baumannii isolated from diverse clinical specimens in Baghdad. Clinical samples including sputum, blood, urine, CSF and wound swabs were collected from patients who were admitted to hospitals in Baghdad. Identification of Acinetobacter baumannii isolates was performed using Vitek 2 system. Phospholipase (plcN) and elastase (lasB) genes were identified using Polymerase chain reaction (PCR) technique. Other virulence factors such as motility, biofilm formation,hemolysin production were screened. Sixty-nine isolates were identified as Acinetobacter baumannii. The isolates were screened for Phospholipase (plcN) and elastase (lasB) production.The results of amplification revealed that out of the total isolates, 18 (26.6%) isolates included both (plcN) and (lasB) genes, 18(26.6%) isolates included only (plcN) and 23(33.3%) isolates have only (lasB). Sixty (86.9%) isolates were positive for biofilm formation, 8 (11.6%) isolates indicated intermediate biofilm producers and 52(75.4%) isolates were weak biofilm producers. Sixty six A.baumannii isolates were motile on Nutrient agar (0.3%). Sixteen isolates were intermediate motile and 50 were highly motile. Positive association was found between the biofilm formation capacity and surface associated motility. Fifty-seven isolates showed hemolysis on Blood agar on the second day of the incubation. Of these, 48 (69.56%) isolates show β –hemolysis and 9 (13.04%) isolates show α-hemolysis,

When less is more: the art of communicating clinical microbiology results.

The clinical microbiology laboratory is capable of identifying microorganisms in clinical specimens faster and more accurately than ever before. At face value, this should enable patient care providers to make better-informed decisions and target antimicrobial therapies to deliver individualized care. Ironically, more complete and specific reporting of microorganisms isolated from specimens may result in overtreatment based on the presence of a pathogen, even in the absence of clear signs of clinical infection. This conundrum calls into question the role of the laboratory in contributing to care through selective or "exception" reporting whereby some results are selectively withheld when there is a low probability that laboratory findings correlate with the clinical infection. In a recent article published in the Journal of Clinical Microbiology, Bloomfield et al. (J Clin Microbiol 62:e00342-24, 2024, https://doi.org/10.1128/jcm.00342-24) examine the impact and safety of an exception reporting strategy applied to wound swab specimens. Canonical pathogens associated with skin and soft tissue infections including S. aureus and beta-hemolytic streptococci are withheld from the laboratory report if certain patient criteria are met that would put them at low risk of adverse outcomes if untreated, or if treated with guideline-recommended empiric therapy. Their central finding was an approximately 50% reduction in post-laboratory report antibiotic initiation without adverse events or increased 30-day admission rate (indicative of infection-related complications, e.g., disseminated disease). While effectively achieving their goal, the premise of exception reporting and other modified reporting strategies raises questions about the potential risk of underreporting and how to ensure that the message is being interpreted, and acted upon, by care providers as was intended by the laboratory.

Molecular characterization of Pseudomonas aeruginosa from diabetic foot infections in Tunisia.

Background. Pseudomonas aeruginosa is an invasive organism that frequently causes severe tissue damage in diabetic foot ulcers.Gap statement. The characterisation of P. aeruginosa strains isolated from diabetic foot infections has not been carried out in Tunisia.Purpose. The aim was to determine the prevalence of P. aeruginosa isolated from patients with diabetic foot infections (DFIs) in Tunisia and to characterize their resistance, virulence and molecular typing.Methods. Patients with DFIs admitted to the diabetes department of the International Hospital Centre of Tunisia, from September 2019 to April 2021, were included in this prospective study. P. aeruginosa were obtained from the wound swabs, aspiration and soft tissue biopsies during routine clinical care and were confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing, serotyping, integron and OprD characterization, virulence, biofilm production, pigment quantification, elastase activity and molecular typing were analysed in all recovered P. aeruginosa isolates by phenotypic tests, specific PCRs, sequencing, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing.Results. Sixteen P. aeruginosa isolates (16.3 %) were recovered from 98 samples of 78 diabetic patients and were classified into 6 serotypes (O:11 the most frequent), 11 different PFGE patterns and 10 sequence types (three of them new ones). The high-risk clone ST235 was found in two isolates. The highest resistance percentages were observed to netilmicin (69 %) and cefepime (43.8 %). Four multidrug-resistant (MDR) isolates (25 %) were detected, three of them being carbapenem-resistant. The ST235-MDR strain harboured the In51 class 1 integron (intI1 +aadA6+orfD+qacED1-sul1). According to the detection of 14 genes involved in virulence or quorum sensing, 5 virulotypes were observed, including 5 exoU-positive, 9 exoS-positive and 2 exoU/exoS-positive strains. The lasR gene was truncated by ISPpu21 insertion sequence in one isolate, and a deletion of 64 bp in the rhlR gene was detected in the ST235-MDR strain. Low biofilm, pyoverdine and elastase production were detected in all P. aeruginosa; however, the lasR-truncated strain showed a chronic infection phenotype characterized by loss of serotype-specific antigenicity, high production of phenazines and high biofilm formation.Conclusions. Our study demonstrated for the first time the prevalence and the molecular characterization of P. aeruginosa strains from DFIs in Tunisia, showing a high genetic diversity, moderate antimicrobial resistance, but a high number of virulence-related traits, highlighting their pathological importance.

Prevalence of Chronic Wounds Microbial Contaminations and their Susceptibility Pattern to Current Antibiotics in Mbingo and Nkwen Baptist Hospitals

Abstract BACKGROUND: Antimicrobial resistance among pathogens causing chronic wound infections is a growing concern, particularly in low-income countries. Understanding the microbial profile and antibiotic susceptibility patterns in chronic wounds is crucial for guiding effective treatment strategies. This study aimed to investigate the prevalence of microbial contamination and antibiotic susceptibility patterns in chronic wounds among patients treated at Mbingo Baptist Hospital and Nkwen Baptist Hospital in Northwest Cameroon. METHODS: A cross-sectional, hospital-based study was conducted from March to June 2022. Wound samples were collected from patients with chronic wounds, and microbiological analyses were performed to identify the isolates and assess their antimicrobial susceptibility. RESULTS: A total of 54 chronic wounds were examined, with venous ulcers being the most common type (42.6%). Bacterial and fungal growth was detected in 89% of the wound swabs. Gram-negative bacteria, including Salmonella spp. (14.8%) and Pseudomonas aeruginosa (7.4%), were frequently isolated, along with Gram-positive organisms such as Staphylococcus aureus (18.5%) and Staphylococcus spp. (11.1%). Polymicrobial infections were observed in 11.2% of the cases. The isolates exhibited high-resistance rates to commonly used antibiotics, such as sulfamethoxazole/trimethoprim (83%), amoxicillin (80.9%), ceftriaxone (74.5%), azithromycin (66%), and doxycycline (61.7%). Diphtheria spp. and S. aureus showed resistance to nearly all the tested antibiotics. CONCLUSION: This study highlights the significant burden of antimicrobial-resistant bacteria in chronic wound infections in the studied health-care facilities in Cameroon. These findings underscore the urgent need for improved antimicrobial stewardship and the development of novel treatment strategies to address the growing challenge of drug-resistant pathogens in chronic wound management.

The Effect of pH Variation on Antibiotic Susceptibility of MDR <i>Klebsiella pneumoniae</i> Isolates

Background: Klebsiella pneumoniae is a significant opportunistic pathogen responsible for various nosocomial infections in humans. The emergence of multi-drug resistant strains poses a significant challenge in clinical settings, necessitating a deeper understanding of factors influencing antimicrobial resistance. Objective: This research aimed to investigate the impact of pH variation on the resistance patterns of multi-resistant K. pneumoniae isolated from Iraqi patients with urinary tract infections and wound infections against different antibiotics. Methods: Forty K. pneumoniae isolates were obtained from urine samples and wound swabs, and their identification was confirmed using the VITEK ® 2 compact system and molecular identification of the rpoB housekeeping gene. Antibiotic susceptibility testing was performed using the Kirby Bauer’s disk diffusion method under varying pH conditions (pH 5, 7, 9, and 11) at 37°C for 18 to 24 hours. Results: The study findings indicated that K. pneumoniae isolates exhibited differential susceptibility to antibiotics based on pH conditions. Cefotaxime demonstrated increased efficacy under alkaline pH, while tetracycline showed optimal efficacy under acidic conditions. However, ciprofloxacin displayed resistant phenotypes at acidic pH 5 and either resistant or intermediate phenotypes at alkaline pH 9. Conclusions: The results suggest a potential influence of pH on the antibiotic susceptibility profiles of K. pneumoniae isolates. Understanding the role of pH in antimicrobial resistance can inform strategies for better managing infections caused by multi-resistant pathogens. Further research is warranted to elucidate the underlying mechanisms and implications for clinical practice.

Classification of a novel Serratia species, isolated from a wound swab in North Rhine-Westphalia: Proposal of Serratia sarumanii sp. nov

Novel, white-pigmented, Gram-negative bacterial strains (K-M0706T, K-M0228, K-M0252, K-M0260) were isolated from clinical samples. With a similarity of up to 69.7 % to Serratia nevei S15T and up to 63.8 % to Serratia marcescens ATCC 13880T, as determined by digital DNA-DNA hybridization, the strains were assigned as novel species of the genus Serratia. The species can easily be differentiated from the red colored Serratia marcescens sensu stricto by its white phenotype. Discrimination between this strain and Serratia nevei is possible due to alpha-glucosidase activity and O/129-resistance, as shown for strain K-M0706T. The major fatty acids were determined as myristate, palmitate, cis–9,10-methylenehexadecanoate, linoleate, and (all cis-9,10)-methyleneoctadecanoate. These phenotypical and genomic data support the assignment of a novel species within the genus Serratia, named S. sarumanii due to its pathogenicity and white phenotype, with strain K-M0706T as the type strain.

Staphylococcus aureus Is the Predominant Pathogen in Hospitalised Patients with Diabetes-Related Foot Infections: An Australian Perspective.

Diabetes prevalence continues to increase worldwide, which has led to a rising incidence of diabetes-related foot infections (DFIs). There is significant local variation in the microbiology of DFIs, and Pseudomonas spp. is suggested to be more prevalent in subtropical climates. The aim of this study was to investigate the local microbiological findings in patients admitted to the hospital with DFIs. This retrospective study analysed data from all adult patients diagnosed with diabetes and admitted to the hospital for the treatment of a DFI between 1 January 2021 and 31 December 2022. Both superficial wound swabs and tissue cultures were included. The Infectious Diseases Society of America classification system was used to categorise the severity of the DFI. Patient characteristics and demographics were analysed using descriptive statistics. One hundred fifty-one episodes of care were included. Most of the DFIs were classified as moderate infections 101/151 (67%). The most commonly isolated microorganism was Staphylococcus aureus (33%) followed by normal skin flora (11%) and β-haemolytic streptococci (7%). P. aeruginosa was isolated more commonly in those with chronic DFIs (10%) compared to those with acute DFIs (2%). Despite the frequent identification of S. aureus, 83% of patients received an antipseudomonal antibiotic. The introduction of multidisciplinary DFI rounds should be considered.

Detection of Metallo β-Lactamase in Acinetobacter Species Using Phenotypic Methods with their Antibiotic Resistance Profile in Tertiary Care Hospital

Background: Acinetobacter species are commonly found in nature, in water, and in soil, and also, and they have been isolated from humans and animals. In the hospital setting, Acinetobacter species has emerged as a major opportunistic pathogen, being able to colonize and develop infections in patients. In Acinetobacter species, β-lactamases and outer membrane alterations are likely to function together to impart resistance. Understanding the epidemiology, and resistance mechanism, and for infection management and preventing a potential global health crisis, techniques for identifying Carbapenem-Resistant-Acinetobacter species are essential. Aim: To detect Metallo β-Lactamase (MBL) in Acinetobacter species with their antimicrobial susceptibility pattern. Material and Methods: 100 Acinetobacter species isolates from various clinical samples such as blood, cerebrospinal fluid, sputum, bronchoalveolar lavage, pus, urine, wound swab, and body fluids were included in the study. Phenotypic tests such as, Disc Potentiation test & Modified Hodge test were used to detect the presence of Metallo β-lactamase in imipenem & meropenem-resistant isolates. Results: The highest prevalence of Acinetobacter was found in blood (37%), followed by sputum (31%) and others [pus, urine, ascitic fluid, cerebrospinal fluid (CSF), bronchoalveolar Lavage (BAL), and pleural fluid]. A maximum number of Acinetobacter were isolated from MICU followed by medicine and surgery. The Modified Hodge test yielded the largest percentage of MBL-positive Acinetobacter isolates (67.26%) when compared to the Disc Potentiation test method (50.45%). Conclusion: Early detection of Metallo β-lactamase production is essential for planning appropriate treatment according to the resistance mechanisms of the multi-drug resistant strains, as well as for efficient infection control procedures to prevent the spread of infection.

Microbiological challenges in the treatment of war injuries

The treatment of war injuries represents a continuing and recurrent challenge in modern reconstructive surgery. Previously, tumor resections and sepsis-related resections were mainly responsible for lengthy bone defects in Germany. In recent years another picture has increasingly emerged, particularly caused by the medical support of Ukraine. Aspects of military surgery are also becoming more important in civil hospitals, especially in the treatment of gunshot and explosion injuries. In Germany, war injuries are currently secondarily treated, as the distribution of patients is carried out according to the cloverleaf principle, weeks or months after the occurrence of the primary injury. In addition to complex bone and soft tissue defects of the extremities following such injuries, which often affect neural and vascular structures, reconstruction is often complicated by an increasing spectrum of multidrug-resistant pathogens. The definition of microbiological terms, such as contamination, colonization, critical colonization, local and systemic infections are important in the clinical routine in order to initiate a targeted treatment, especially in treatment with antibiotics. Wound swabs for determination of the spectrum of pathogens and the optimal testing of resistance are important for selecting the appropriate antibiotic agents. The concept of antibiotic stewardship (ABS) is established in many hospitals to improve the quality of antibiotic treatment and to minimize the formation of resistance. The selection of the method of reconstruction depends on the condition of the patient, the overall clinical constellation and the function to be expected after completion of treatment. The treatment of injuries due to violence and terrorism necessitates clear concepts and an interdisciplinary approach, especially with respect to microbiological challenges and increasing resistance situations.

Bacteriological profile in patients with cesarean infection at Ruhengeri level two teaching Hospital

Background: A cesarean infection is a referral hospital acquired bacterial infection that occurs after deliver by cesarean section which could be emergency or elective. As highlighted by the various researchers that the infections following a cesarean delivery, which some people call a C-section, are common. The wound coming into contact with bacteria or other harmful microbes is a common cause of these infections. The main objective of this study was the assessment of bacteria isolated from cesarean infection patients attending Ruhengeri level two teaching hospital. Methodology: A cross-sectional study was conducted and total of 30 wound swabs of cesarean were collected from inpatient of Ruhengeri level two teaching hospital.Data were analyzed using SPSS statistical software (version 20). Results: The results showed that the most predominant bacteria isolated from patients with cesarean infection was S. aureus (28.1%) followed by S. pyogenes (18.8%), K. pneumoniae (18.8%), P. aeruginosa (12.5%), S.epidermidis (9.4%), E. coli (6.3%) and P. mirabilis(6.3%). Antibiotics sensitivity test was performed, so this study showed the predominant antibiotic which were sensitively to different bacteria were Chloramphenicol, Gentamycin and Norfloxacin and most bacteria were resistance to Rifampicin and Vancomycin. Conclusion: This study has shown that there are many bacteria that may be isolated in cesarean infection. It has also shown that some of the isolated bacteria were sensitive and other were resistant to Rifampicin and Vancomycin. The study recommends that Rwandan government should create more clinical microbiological laboratory, in Rwanda, in order to minimize the antibiotic resistance and also on the side of health care providers, especially at Ruhengeri level two teaching hospital, they should use the experienced workers in order to minimise the risks of getting caesarean infection and also to recommend the patients taking care their wound. Keywords: Cesarean infection, Bacteria, Antibiotics, Bacteriological profile

Influence of patient characteristics on microbial composition in surgical-site infections: insights from national surveillance study.

Although the impact of surgery- and patient-dependent factors on surgical-site infections (SSIs) have been studied extensively, their influence on the microbial composition of SSI remains unexplored. The aim of this study was to identify patient-dependent predictors of the microbial composition of SSIs across different types of surgery. This retrospective cohort study included 538 893 patients from the Swiss national infection surveillance programme. Multilabel classification methods, adaptive boosting and Gaussian Naive Bayes were employed to identify predictors of the microbial composition of SSIs using 20 features, including sex, age, BMI, duration of surgery, type of surgery, and surgical antimicrobial prophylaxis. Overall, SSIs were recorded in 18 642 patients (3.8%) and, of these, 10 632 had microbiological wound swabs available. The most common pathogens identified in SSIs were Enterobacterales (57%), Staphylococcus spp. (31%), and Enterococcus spp. (28%). Age (mean feature importance 0.260, 95% c.i. 0.209 to 0.309), BMI (0.224, 0.177 to 0.271), and duration of surgery (0.221, 0.180 to 0.269) were strong and independent predictors of the microbial composition of SSIs. Increasing age and duration of surgical procedure as well as decreasing BMI were associated with a shift from Staphylococcus spp. to Enterobacterales and Enterococcus spp. An online application of the machine learning model is available for validation in other healthcare systems. Age, BMI, and duration of surgery were key predictors of the microbial composition of SSI, irrespective of the type of surgery, demonstrating the relevance of patient-dependent factors to the pathogenesis of SSIs.

Clinico Microbiological Study of Infection In Burn Patients at BPKIHS Teaching Hospital

Background: Each year around 2,00,000 peoples globally are injured by burn and 1,00,000 of these seek medical attention out of which 10,000 lose their lives. prevention is better in burns. The exact data about burns patient in Nepal is not known. Methods: Prospective observational study carried out at surgical ward of BPKIHS Teaching Hospital between 15 May 2001 to 14 May, 2002 i.e. one year altogether. Results: There were total 95 cases of burn patients admitted and managed by BPKIHS Teaching Hospital during that periods. Males were 40% (38) and Females were 60% (57). Accidental burns injury was 90.55% (86) and flame burns were 83% (79). Mixed infection in 36%, Acinobacter in 32% and pseudomonas in 14.4% found in wound swab cultures. Ofloxacin was found sensitive in 91.6%. 27% (26) patients expired in our study. Conclusion: Mortality is high in our study because of Major burn patients came late in our Teaching Hospital for treatment.