ABSTRACT
Background: Ventilator-associated pneumonia (VAP) is one of the major hospital-acquired infections and the emergence of bacterial resistance is common among patients in the intensive care units (ICUs). The aim of the study is to identify the common bacterial pathogen isolated from an endotracheal (ET) aspirate and its antibiotic susceptibility pattern. Materials and methods: A prospective analytical study was carried out in a tertiary care hospital for a period of 1 year. All ET aspirate sample sent to the microbiology laboratory was processed and identified by standard biochemical tests and antibiotic sensitivity was by disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Of the total 217 samples studied, 85 (39.17.1%) were culture sterile and 132 (60.82%) showed culture positive. Among 132 isolates, the predominant organism was Acinetobacter baumannii (36.36%) followed by Klebsiella pneumoniae (24.24%) and Pseudomonas aeruginosa (20.45%). We have reported a higher percentage of resistance among the isolated gram-negative bacilli to carbapenems, aminoglycosides, and third-generation cephalosporins, with increased sensitivity to piperacillin-tazobactam and cefoperazone-sulbactam. Conclusion: In our study, A. baumannii was the predominantly isolated gram-negative bacilli followed by K. pneumoniae and P. aeruginosa. One of the rising concerns to hospital-acquired respiratory pathogens is the surge of multidrug resistance patterns. Hence, strict adherence to antibiotic policy and appropriate use according to the guidelines will save the use of drugs in the future in life-threatening conditions.
ABSTRACT
Chryseobacterium species are gaining importance as an emerging opportunistic nosocomial pathogen. Limited availability of clinical data necessitates reporting of such isolates. We report a case of nosocomial urinary tract infection by metallo‑β‑lactamase‑producing Chryseobacterium gleum in an elderly diabetic male with chronic renal disease. Identification and antibiotic sensitivity test performed by conventional methods were confirmed by Matrix‑assisted Laser Desorption Ionization Time‑of‑Flight and VITEK‑2 systems, respectively. The patient responded well to intravenous ciprofloxacin therapy
ABSTRACT
We studied the prevalence of ceftazidime resistance in Pseudomonas aeruginosa and the rates of extended-spectrum β-lactamase (ESBL), AmpC β-lactamase (AmpC) and metallo-β-lactamase (MBL) production among the ceftazidime resistant Pseudomonas aeruginosa. A very high rate of MBL production was observed, which suggested it to be an important contributing factor for ceftazidime resistance among Pseudomonas aeruginosa.
Subject(s)
Humans , Anti-Bacterial Agents/analysis , Anti-Bacterial Agents/isolation & purification , Ceftazidime/analysis , Ceftazidime/isolation & purification , Pseudomonas aeruginosa/enzymology , Pseudomonas aeruginosa/isolation & purification , beta-Lactamases/analysis , beta-Lactamases/isolation & purification , Cross-Sectional Studies , PatientsABSTRACT
BACKGROUND & OBJECTIVE: Shigellae play an important role as a causative organism of acute gastroenteritis, which is a global health problem with significant morbidity and mortality in especially in developing countries. This study was carried out to determine the isolation and pattern of antimicrobial resistance of Shigella in patients with acute gastroenteritis in western Nepal. METHODS: The study included all patients with acute gastroenteritis who visited a tertiary care hospital at Pokhara, Nepal during a 2-year period (2002-2004). The isolates was confirmed as Shigella by biochemical reaction and slide agglutination test using specific antisera. Antibiotic sensitivity test was determined by agar diffusion method and minimum inhibitory concentration (MIC) of the drugs was detected. RESULTS: Of the 770 stool samples, 83 (10.8%) yielded Shigella. Shigella flexneri caused 56 (67.4%) of the total cases of shigellosis followed by S. dysenteriae 12 (14.5%), S. sonnei 10 (12%) and S. boydii 5 (6%). Of the 83 isolates, 67 (80.7%) showed resistance to various drugs and 62 (74.7%) were resistant to two or more drugs. Resistance to cotrimoxazole was 80.7 per cent followed by tetracycline 74.7 per cent, ampicillin 53.0 per cent, nalidixic acid 31.3 per cent and ciprofloxacin 2.4 per cent. The MIC(50) and MIC(90) values of those drugs were also very high. All isolates were sensitive to cefotaxime and ceftriaxone. INTERPRETATION & CONCLUSION: The findings of our study suggested that Shigellae was an important etiological agent for acute gastroenteritis, with a high rate of drug resistance and requires constant monitoring in this region.