ABSTRACT
Objective: To determine the in vitro susceptibility of MRSA clinical isolates to ceftaroline, using interpretation of zones of inhibition by disk diffusion method. Study Design: Descriptive cross sectional. Place and Duration of Study: The study was carried out at the Department of Microbiology, Combined Military Hospital Peshawar, from Jan to Dec 2014
Material and Methods: To carry out this descriptive cross sectional study, clinical specimens were obtained from indoor and outdoor patients of Combined Military Hospital Peshawar. All the isolates of MRSA cultured with CLSI guidelines and identified with standard microbiological procedures, from clinical specimens of pus, body fluid, urine, tissue and blood were included in the study. The antimicrobial susceptibility pattern of ceftaroline was determined according to CLSI guidelines. The data was analyzed in SPSS [version 19] software
Results: Out of a total 190 MRSA isolates, 183 [96.3%] were susceptible to ceftaroline in vitro, whereas 5 [2.6%] were resistant and 2 [1.1%] were intermediate in their response to ceftaroline
Conclusion: Ceftaroline can be used effectively against infections caused by MRSA as it has shown very high in vitro activity against MRSA strains of clinical origin
ABSTRACT
Objective: To evaluate the pathogen burden and antibiotic-resistance trends of Pseudomonas aeruginosa among hospitalised patients at a tertiary care hospital. Study Design: Retrospective, hospital record-based, cross-sectional study. Place and Duration of Study: Microbiology Laboratory, Allama Iqbal Medical College/Jinnah Hospital, Lahore, from January 2014 to December 2016
Methodology: A total of 5,960 samples were collected from clinically suspected cases of bacterial infections, admitted to the hospital. Microbial identification and antibiotic susceptibility pattern were carried out and analysed
Results: Out of a total of 5,960 samples, Pseudomonas aeruginosa was isolated from 1,268 [21.2%] specimens. Department-wise isolation rate was n=600 [42.9%], n=268 [15.4%], n=201 [12.6%], and n=199 [16.0%] from intensive care unit [ICU], surgical units, medical units, and Gynae wards, respectively [p<0.0001]. Sample-wise isolation rate was, wound swabs n=448 [35%], urine n=356 [28%], sputum n=187 [14 %], tracheal aspirate n=127 [10%], blood n=99 [7%], and broncho-alveolar lavage n=51 [4%] [p<0.0001]. Drug-resistance pattern showed low rates for carbapenems [meropenem n=440 [35%], Imipenem n=436 [34%] and beta-lactam + beta-lactamase inhibitor combination [piperacillin+ tazobactam n=437 [34%] while alarming rates were observed for cephalosporins [ceftazidime n=716 [56%], fluoroquinolones [ciprofloxacin n=690 [54%], cefoperazone+sulbactam n=685 [54%], aminoglycosides [gentamicin, n=669 [53%], amikacin n=608 [48%], and monobactams [aztreonam n=666 [52%]. Decreasing trend was observed only for amikacin 63% to 37%, aztreonam showed similar pattern throughout, while there was an increasing trend of drug resistance in all groups of antibiotics
Conclusion: Emerging drug-resistant strains of Pseudomonas aeruginosa are probably linked to the injudicious use of antibiotics, leading to ineffective empirical therapy. Therefore, we suggest that culture and antimicrobial susceptibility testing should be done for targeted antimicrobial therapy against Pseudomonas aeruginosa
ABSTRACT
Background: Bacterial infections are the major cause of morbidity and mortality among neutropenic patients. Prompt administration of empiric antimicrobial therapy for febrile neutropenic patients is considered vital. Before putting neutropenic patients on empiric antimicrobial regimens, it is essential to be aware of the spectrum of locally prevalent pathogens and their susceptibility pattern
Methods: We studied the bacterial spectrum and antimicrobial susceptibility pattern of organisms causing bloodstream infections in febrile neutropenic patients in Armed Forces Bone Marrow Transplant Centre, Rawalpindi and the Department of Oncology, Combined Military Hospital, Rawalpindi over a period of nine months from January to September 2002
Results: Blood specimens for culture and susceptibility testing were collected from 158 febrile patients with neutropenia. Eighty-three organisms were isolated from 60 patients. Thirty-six [43%] isolates were Gram-positive cocci and forty-seven [57%] were Gram-negative rods. Among the Gram-positive cocci, coagulase negative staphylococci [CoNS] were the predominant pathogens [26%], followed by Staphylococcus aureus [8%]. Among Gram-negative rods, Escherichia coli was the predominant isolate [13%] followed by Klebsiella pneumonia [10%], Acinetobacter johnsonii [10%] and Pseudomonas aeruginosa [7%]. Nine specimens yielded polymicrobial growth. Forty percent of Staphylococcus aureus and 55% of CoNS were resistant to methicillin. All the Gram-positive isolates were susceptible to vancomycin and teicoplanin. Among the Gram-negative rods, there was 100% resistance to ampicillin, 65% to gentamicin, 47% to amikacin and 66% to third generation cephalosporins. All the gram-negative isolates were susceptible to imipenem
Conclusion: The spectrum of isolates among febrile neutropenic patients in our population appears to be shifting towards Gram-positive microorganisms. Due to increasing levels of drug resistance among the isolates, a glycopeptide in combination with a carbapenem would be a prudent choice as empiric therapy in high-risk cases