Bacterial Isolates Of The Respiratory Tract Infection And Their Current Sensitivity Pattern Among Patients Admitted In Tertiary Care Hospital.

Background & Objectives: This study was aimed to observe the susceptibility pattern of bacterial isolates from respiratory tract infection (RTI). Respiratory tract infection is considered as one of the major public health problems and a leading cause of morbidity and mortality in many developing countries. Respiratory tract is the part of the human system that plays a vital role in breathing processes. In human, the respiratory system can be subdivided into an Upper respiratory tract and a Lower respiratory tract based on anatomical features. The respiratory tract is constantly exposed to microbes due to the extensive surface area. The present study was conducted retrospectively for a periodMethods: of one year November 2021 to October 2022. All respiratory specimens included Sputum, BAL, throat swab; endotracheal aspirate specimens were collected aseptically from patients and cultured on the appropriate bacteriological media (Blood agar, MacConkey agar & Chocolate Agar). Bacterial isolates were identified by biochemical tests and antimicrobial susceptibility performed by standard methods as per CLSI 2022. 152Results: (72.3%) of total 210 samples were positive for bacterial culture. 126 (82.8%) were gram negative bacilli (GNB) and 26 (17.1%) were gram positive cocci (GPC). The predominant pathogen isolated was K. pneumoniae 46 (30.2%) followed by Escherichia coli 28 (18.4%).The overall susceptibility of GNB was highest towards Imipenem, Meropenem followed by Piperacillin tazobactam and Amikacin. Gram positive organisms exhibited highest susceptibility towards Vancomycin and Linezolid. Imipenem is the most sensitive antibiotic followed by Piperacillin tazobactamConclusion: and Amikacin which can be used for empirical therapy for respiratory tract infections (RTI). The antibiotic therapy should be modified as per the culture and sensitivity report. Regular determinations of the type of bacterial pathogens and updation of antibiogram must be followed in every institution to aid in better patient management by helping the clinician in the judicious use of antibiotics.

A clinical study of commonly isolated organism and its antibiotic sensitivity in diabetic foot ulcers in Sri Manakula Vinayagar Medical College and Hospital, Pondicherry

Background: Diabetic foot ulcer is one of the major surgical problem leading to hospital admission. Diabetic foot ulcer patients with uncontrolled diabetes may end up in forefoot amputation. Early aggressive debridement, control of blood sugar and empirical antibiotic therapy would reduce the morbidities in patients with diabetic foot ulcer. Further the knowledge of commonly isolated microbes and their antibiotic sensitivity pattern would be helpful to start empirical therapy. The purpose of this study was to determine the microbiological profile of diabetic foot infections (DFIs) and assess the antibiotic susceptibility of the causative agents.Methods: This cross-sectional study was conducted in 115 patients admitted with diabetic foot ulcer over a period of 9 months from October 2015 to June 2016 at the department of general surgery, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry. Tissue scrapping samples were collected and processed as per standard guidelines.Results: 167 organisms were isolated from 115 patients. 52% of culture showed polymicrobial growth. There was increased prevalence of gram-negative organisms 53% compared to gram positive organisms 47%. When comes to individual isolate, Staphylococcus aureus was the most common organism isolated 24.6% followed by Pseudomonas aeruginosa 21%. All gram-positive aerobes were sensitive to vancomycin and gram-negative isolates were sensitive to amikacin, piperacillin-tazobactum, gentamycin and cefotaxime.Conclusions: Staphylococcus aureus and Pseudomonas were the common pathogens isolated. This study recommends use of vancomycin along with piperacillin-tazobactum as an empirical therapy along with adequate blood sugar control and early debridement of devitalized tissues in patients with diabetic foot infections.

Prevalence and antimicrobial sensitivity pattern of Staphylococcus aureus isolated from clinical and subclinical mastitis in small ruminant in Besut and Setiu, Terengganu, Malaysia

@#Aims: The study was carried out to investigate Staphylococcus aureus in clinical and subclinical mastitis in small ruminant and to identify the antibiotic sensitivity profiles of the isolates. Methodology and result: A total of 171 milk samples from lactating sheep and goats were collected from Besut and Setiu districts in Terengganu, Peninsular Malaysia. All animals were screened for mastitis using the California Mastitis Test (CMT). Phenotypic identification of S. aureus was determined using Gram-staining, catalase test, coagulase test, and oxidase test. The genotypic identification was conducted using Polymerase Chain Reaction (PCR) to detect the nuc gene. The susceptibility of S. aureus to the antibiotic was tested by using the Kirby-Bauer method. In this study, subclinical and clinical mastitis were detected in 66/171 (39%) and 41/171 (24%) respectively. The cultures and PCR results showed that 18/39 (46%) samples (9 subclinical and 9 clinical mastitis) were positive for S. aureus. The antimicrobial susceptibility tests profiles shows 4/18 (22%) and 2/18 (11%) isolates were resistant to penicillin and tetracycline, respectively. However, all isolates were tetK and tetM negative. On the other hand, these isolates susceptible to amoxicillin, gentamicin, nitrofurantoin, oxacillin, cefoxitin, norfloxacin, chloramphenicol, amikacin, kanamycin, doxycycline and cefotaxime. Conclusion, significance and impact of study: The presence of S. aureus from milk samples of both clinical and subclinical mastitis goats indicates, potential hazard on the livestock as well as public health settings. The occurrence of penicillin and tetracycline resistance should not be undermined. Milk from mastitis samples may play an important role as potential reservoir and transmission of this pathogen in posing disease regardless of antibiotics resistance background.

Retrospective Analysis of Gram-Negative Bacteria Isolated at a Tertiary Hospital in Maiduguri, Nigeria.

Background: Gram negative bacteria accounts for significant proportion of hospital and community associated infections responsible for significant proportion of hospital admission, and associated increased level of antibiotic resistance pattern. Based on this information, we retrospectively analyzed the prevalence and resistance pattern of gram negative bacteria isolated from clinical specimens submitted in a tertiary hospital in Maiduguri, Nigeria. Methodology: Bacteriological data of gram negative bacteria isolates recovered from clinical specimens submitted to medical microbiology laboratory of University of Maiduguri Teaching Hospital (UMTH) between 2007-2011were extracted and analyzed. A total of 36,800clinical specimens were examined. Results: The prevalence level of gram-negative bacteria isolates was 24.09% (8865/36,800), majority (29.16%, n=2585) of the isolates were recovered from wound specimens. Escherichia coli accounted for 31.8% (n=2823) of the total isolates. High susceptibility was observed with fluoroquinolones, aminoglycosides and cephalosporin tested, and resistance with cotrimoxazole and chloramphenicol. Overall, 7.6% (n=671) of the gram negative isolates exhibited multidrug resistance pattern, Escherichia coli accounted for 39.9% (268/671) of the multidrug resistant isolates. Conclusion: The study highlights epidemiological characteristics of the gram-negative bacteria isolated in our hospital, with prevalence level of 24.09% and diverse isolation pattern which affirmed gram-negative bacteria clinical implication in hospital and community associated infections. In addition, the multidrug resistance pattern level of 7.6% is an indication for laboratory personnel to be aware of possible emergence of multidrug resistant strain among gram-negative isolated in the hospital.

Antibiotic Susceptibility Pattern from Pathogens Causing Acute Pyogenic Meningitis in a Teaching Hospital, South India.

Background and Objectives: Acute pyogenic meningitis is one of the most serious infections in infants and children. It is associated with serious complications and risk of morbidity and mortality. The purpose of present study was to identify the pathogen in acute pyogenic meningitis and to determine its antibiotic susceptibility pattern. Methods: Present study was undertaken for a period of one year from July 2009 to June 2010 included 100 CSF samples of clinically suspected acute pyogenic meningitis cases in children below 12 years. The samples were subjected to Gram’s stain, culture and antibiotic sensitivity test. The cases positive in either of Gram stain or culture were diagnosed as acute bacterial meningitis cases. Results were tabulated and antibiotic sensitivity pattern was compared. Results: Of the 100 cases studied, 26 cases were diagnosed as acute bacterial meningitis. Gram’s stain positivity was 73% (19/26 cases), culture positivity was 100%. The most common organism isolated in the study was Streptococcus pneumoniae, followed by Haemophilus influenzae, Escherichia coli and Klebsiella pneumoniae. Aminoglycosides, cefotaxime and cotrimoxazole showed high sensitivity. Interpretation and conclusion: Though Gram stain is very essential in diagnosis of meningitis, it may miss some cases. Culture and latex agglutination tests overcome this disadvantage. Streptococcus pyogenes still remains predominant pathogen. Antibiogram of the bacteria causing meningitis is also slowly undergoing a change. This calls for change in the empirical therapy for bacterial meningitis cases.

Significance of Coagulase Negative Staphylococci with Special Reference to Species Differentiation and Antibiogram.

Coagulase negative staphylococci (CoNS)are part of normal human flora increasingly recognized as significant nosocomial pathogens, infection often associated with implanted devices, joint prosthesis and different indwelling devices, especially in very young, old immunocompromised patients. Aims: To identify CoNS species, their distribution and antibiotic susceptibility pattern from different clinical samples. Method: A total 185 CoNS isolates were collected from various clinical samples followed for species identification by a practical scheme adapted using simple ,useful test selected from various references. Antibiotic susceptibility done by Kirby Bauer disc diffusion method. Results: The study yield that 185 CoNS,strains were isolated out of 1514 positive cultures from various clinical specimens. Among species ; S. epidermidis was the most commonly isolated species (68.65%), followed by S. heamolyticus (16.75%),followed by S. saprophyticus(9.8%)and few other species also identified. The antibiotic susceptibility pattern against commonly used antibiotic showed multidrug resistance with more than 90% resistance to penicillin and no strains was resistance to vancomycin. The methicillin resistance was 63% among all isolates of CoNS. Conclusions: Study suggest increasing pathogenic potential of CoNS as well as emerging of drug resistance amongst them, that necessitates the need to adopt simple laboratory procedure to identify CoNS species and understand definitive therapy for CoNS isolates from various clinical samples. This scheme was able to identified 98.9% isolates up to species level.

Microbiological profile of diabetic foot ulcers and its antibiotic susceptibility pattern in a teaching hospital, Gujarat.

Background: Diabetic foot lesions are a major medical, social and economic problem and are the leading cause of hospitalization for patients with diabetes worldwide. Infection sometimes leads to amputation of the infected foot if not treated promptly. The present study was conducted to isolate and identify the bacterial pathogens associated with diabetic foot ulcer and to find out its antibiotic susceptibility pattern to reduce the risk of complications. Methods: Total 100 pus samples were collected from patients having diabetic foot ulcer, during July to October 2012. Samples were processed as per standard guidelines. Results: Out of 100 pus samples, 73 (73%) yielded growth of organisms making total of 92 isolates. Out of 92 bacterial isolates, 72 were gram negative and 20 were gram positive. Pseudomonas aeruginosa 25 (27%) was most common isolate causing diabetic foot infections followed by 20 (22%) Klebsiella sp., 17 (19%) E. coli, 15 (17%) S. aureus, 6 (7%) Proteus sp. and 4(3%) Enterococci, 2 (2%) Acinetobacter sp. and 2(2%) CONS and 1(1%) Providencia. Out of 72 GNB, 50 (69.4%) were extended spectrum β lactamase (ESBL) producer. Most gram negative isolates were resistant to levofloxacin, gentamicin, ampicillin-sulbactam and gatifloxacin. All GNB were sensitive to imipenem. Out of 15 S. aureus, 9 (60%) were Methicillin Resistant Staphylococcus aureus (MRSA) and were sensitive to vancomycin and linezolid. Conclusions: Pseudomonas sp. was the most common cause of infections. Most isolates were multi drug resistance.

Urinary Tract Infection and Drug Susceptibility Pattern in Patients of a Medical College Hospital in Bangladesh.

Background: Urinary tract infection (UTI) is a common and frequently encountered serious morbidity that afflicts the tool not only to all segments of human population but also results in increasing antibiotic resistance due to persistence and mismanagement of the ailment. The present study aimed to ascertain the current situation of antimicrobial resistance of urinary tract infection. Objectives: To find out pyuria by direct microscopy, isolation and identification of the organisms by culture and to know the susceptibility pattern of organisms causing urinary tract infection. Materials and Methods: A total of 180 midstream urine samples were subjected to aerobic bacteriologic culture in the department of Microbiology, Cox’s Bazar Medical College and 250-bedded Sadar Hospital, Cox’s Bazar during the period of March to October 2012. Specimens were collected from hospitalized and outdoor patients of different age and sex groups. All specimens were examined by routine microscopy to find out significant pyuria (>5 pus cells/HPF). Strict aseptic precautions were taken all through the culture system. Results: Out of 180 specimens, 101 (56.11%) culture yielded significant growth of single organism and 79 (43.89%) yielded no growth. The isolated organisms were E. coli 74.26%, Klebsiella species 12.87%, Enterococci 4.95%, Staphylococcus saprophyticus 3.96%, Pseudomonas species 1.98% and Proteus species 1.98%. The highest sensitivity was shown by imipenem (100%) followed by ceftriaxone (65%), azithromycin (65%), ciprofloxacin (60%) and less sensitive to amoxycillin, cotrimoxazole, cephradine and nalidixic acid ranging 15–30%. Conclusion: The findings of the present study recommends that UTI should be treated by selective antibiotics obtained from culture and sensitivity test to minimize increasing trend of drug resistance.

Incidence of neonatal sepsis in tertiary care hospital: An overview.

Background: Neonatal sepsis is one of the commonest causes of neonatal mortality in the developing world. Aims & Objective: To determine the bacteriological profile of neonatal septicaemia, their antibacterial susceptibility pattern (AST) and production of extended spectrun β-lactamase (ESBL) by gram negative bacteria. Material and Methods: Blood culture specimens were collected from 238 neonates. Identification of organisms, their AST, methicillin resistant Staphylococcus aureus (MRSA) and ESBL detection was done. Results: Gram negative bacteria were more frequently isolated than gram positive bacteria. The gram positive bacteria were highly resistant to penicillin. Vancomycin and amoxyclav exhibited good activity against both Staphylococcus aureus and coagulase negative Staphylococcus. Gram negative bacteria also exhibited high resistance to the commonly prescribed group of drugs such as penicillins, cephalosporins and aminoglycosides. Out of the total 16 isolates of S. aureus, 31.25% were MRSA. ESBL production was seen in 52.9% of Escherichia coli and 50% of Klebsiella pneumoniae. Conclusion: E. coli and S. aureus were the most common bacteria associated with neonatal sepsis. Gram negative bacteria were isolated predominantly and many of them were resistant to several groups of drugs. Also high resistance was seen to third generation cephalosporins in case of E. coli and K. pneumoniae due to ESBL production.