Prevalence of Methicillin Resistant Staphylococcus aureus, Extended Spectrum of Lactamase Producing Escherichia coli and Klebsiella Spps Isolates from ICU Patients at Tertiary Care Hospital, Aurangabad

Background and Objectives The microbial surveillance of intensive care units (ICUs) for multidrug resistant bugs is required for management of ICU patients. The objectives of the study were to find out the prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) and extended spectrum of beta lactamase (ESBLs) producing Escherichia coli and Klebsiella isolates in clinical samples from ICU patients. Methods A total of 464 clinical samples were received in the department of microbiology for culture and sensitivity from ICU patients and were processed as per standard protocol. Detection of MRSA and ESBLs was carried out by using CLSI guidelines. Results A total of 164 were positive for culture. A total of 196 isolates were isolated, among that 57 were S. aureus and 34 were E. coli, 51 were Klebsiella spp. and remaining 54 isolates were other gram negative and gram positive organisms. Out of 57 S. aureus, 23 (42.6%) were detected as MRSA. 41.2% of E. coli and 45.1% of Klebsiella spp. were ESBL producers. The antibiotic sensitivity rates were found higher in MRSA than MSSA and also same in non-ESBL-producing and ESBL-producing strains which were statistically significant (p-value). Conclusion The maximum ESBL producing isolates were Klebsiella. spp than E. coli. Vancomycin and linezolid remains a drug of choice for MRSA. For ESBL-producing E. coli and Klebsiella, carbapenems remain the drug of choice. Institutional antimicrobial surveillance and proper infection control practices are essential to prevent and control multidrug resistant bugs in ICUs and hospital.

Comparison of Urine Culture and Urine Dipstick Nitrite Test in Diagnosis of Urinary Tract Infection

UTI is one of the most frequent bacterial diseases in all group of the age. The most widespread reference method for UTI is conventional urine culture. Dipsticks nitrite test is commonly used in primary care to predict the subsequent diagnosis of urinary tract infection also it helps in early detection of UTI by avoiding the complication of UTI in causing other diseases. The current study was carried out to determine the sensitivity; specificity of Nitrite (NIT) testing in relation to urine culture. A total of 1043 mid stream urine samples from patients who attend KFH; Kigali; at the microbiology service for bacteriological analysis of urine from January 2014 to March 2014 were included in the study. Urine culture and dipstick tests were carried out on urine samples of all patients. Urinalysis and nitrite were performed in fresh and uncentrifuged urine by using urine dip stick. The urine culture was considered as gold standard. Urine cultures were positive in 165 (15.8) patients. Dipstick tests of urine were positive in 61(5.8) patients. Sensitivity; specificity; positive predictive value (PPV) and negative predictive value (NPV) of Dipstick test were 36.6; 99.9 and 87.8 respectively. The results suggest that any method of urine screening shouldn't be substituted for a urine culture in patient with suspicion of UTI

Antibiotic sensitivity patterns of enterobacteriaceae isolated at King Faisal Hospital; Kigali - a three years study

Introduction: A great concern exists about the emergence of antibiotic resistant organisms. The goal of this study is to delineate antibiotic sensitivity patterns at King Faisal Hospital. Methods: A three years study; from Jan 2009 to Dec 2011 was conducted in the Microbiology unit; department of Laboratory; King Faisal hospital; Rwanda. All the specimens and antibiotic sensitivity were processed according to the standard guidelines. Microorganisms and their sensitivity data were reviewed and compiled by using hospital information system. Results: Over the 3-year period; several Enterobacteriaceae pathogens declined in susceptibility to various antimicrobial agents. A total of 2153 Enterobacteriaceae were isolated. Most common isolate was Escherichia coli check for this species in other resources (1413) followed by Klebsiella check for this species in other resources species (550); Enterobacter check for this species in other resources species (110); Proteus check for this species in other resources species (165); Citrobacter check for this species in other resources Species (79); Shigella check for this species in other resources species (110) and other species. Most notable were the decreased sensitivities to cefuroxime: E. coli (84 to 72); Klebsiella (78 to 33); Enterobacter (50 to 41) Proteus(67 to 59) and Shigella to ciprofloxacin (100 to 96). And also decreased sensitivities to Imipenem: E. coli (100 to 98) and Klebsiella species (100 to 94). Conclusion: These decreased antibiotic sensitivities reflect increased bacterial selection pressure as a result of widespread antibiotic use. A combined approach involving infection-control specialists; infectious disease physicians; and hospital administrators is necessary to address this increasingly difficult problem