Causative Organisms of Urinary Tract Infection and Antibiotic Susceptibility Among Patients Attending in Tertiary Care Hospitals of Bangladesh

Background: Urinary tract infections (UTIs) are considered to be the chronic public health problem due to morbidity and financial cost as urological diseases causes the highest health care cost. UTI is known as one of the most common diseases today. UTI can occur in both men and women, but studies found that the incidence of UTI is more common in women especially among the sexually active women. Material & Methods:This study was a retrospective cross-sectional study which was conducted at the department of Medicine in Tairunnessa Memorial Medical College and Hospital, Gazipur, obstetrics and gynecology in Bikrampur Bhuiya Medical College and Hospital, Munshiganj and Medicine in City Medical College and Hospital, Gazipur. The study was conducted during the period of February 2018- January 2022. The total sample size for this study was 131.Results:Most of the respondents 56(42.7%) were aged from 26-35 years. Majority of them 117(89%) were female whereas only 14(11%) were male. Burning sensation of micturition was found in 115 patients where 46(40%) had burning for 0-3 days, 63(54.8%) for 4-7 days and 6(5.2%) for >7 days. In most cases causative organism was E. Coli in this study. According to sensitivity patterns of E. Coli Amoxiclav was used in 77(59%) cases and followed by Amikacin in 94(72%), Azithromycin in 120(92%), Cefixime in 130(99.2%), Ceftriaxone in 83(63.3%), Cefuroxime in 37(28.2%), Imipenem in 62(47%), Ciprofloxacine 64(49%), and Gentamicin in 38(29%) cases. In assessing the antibiotic resistance pattern of E. coli Ampicillin was used in 55(42%) cases and followed by Amoxycillin in 98(75%), Colchicine in 13(10%), Linezolid in 35(26.2%), Amoxiclav in 54(41.2%), Colistin in 16(12.2%), Imipenem in 69(53%) and Novobiocin in 62(47%) cases.Conclusions:Antibiotics are considered to be the only treatment for UTI. But antibiotic resistance is highly prevalent in bacterial isolates around the world, especially in developing countries.

Prevalence and Antimicrobial Susceptibility Pattern of Pathogens Isolated from Different Age Groups with Urinary Tract Infection at Tangail, Bangladesh

Background: Urinary tract infections (UTIs) are commonly detected in several hospitals and typical medical health centres. The antibiotic policy must be updated based on current knowledge about causative agents and their antibiotic susceptibility patterns. The goal of this study was to find out exactly how frequently microbes cause urinary infections and their antibiotic susceptibility patterns. Methods: Mid-stream urine samples were analyzed microscopically for a routine examination, and bacterial pathogens were isolated by conventional culture method using Chromogenic UTI media and MacConkey agar culture media. A group of biochemical parameters were utilized for bacterial identification and characterization. Finally, in vitro antimicrobial susceptibility was performed by the Kirby- Bauer disc diffusion methods against 14 commercially available antibiotics. Results: A total of 1288 clinical samples from UTI patients were obtained aseptically, with 398 showing positive growth with a range of bacteria. Females have a higher prevalence of UTI than males. E. coli was the most common pathogen found (82.86%), followed by Enterococcus faecalis (8.44%), Klebsiella pneumoniae (5.63%), Pseudomonas aeruginosa (2.81%), and Proteus mirabilis (0.26%). The majority of the bacteria had a high sensitivity to Meropenem (98.25%); moderate sensitivity to Amoxicillin, Azithromycin, Ciprofloxacin, Gentamicin, Levofloxacin, Ceftriaxone, Cefepime, and Nitrofurantoin; and low sensitivity (20%) to Cefixime, Cephradine, Cefuroxime, Clindamycin, and Trimethoprime. Conclusion: These findings have clinical and epidemiological implications, improving study to identify causative pathogens and pathogen sensitivity patterns in urinary tract infections, as well as clinicians' knowledge of how to choose the best antibiotics and, ultimately, contributing to patient diagnosis and treatment.

Bacteriology and outcome of Neonatal Septicaemia: Experience from a mission hospital in Nigeria

Introduction@#One in every three preventable under-five deaths occur in the neonatal period and one of the leading causes of neonatal death in Low and Middle-Income Countries (LMIC) is sepsis. Organisms isolated varies between and within geographical locations, its trend changes with time. Each setting hence needs to have its antibiogram for susceptible isolates to optimize treatment outcome, the background on which this study was conducted. @*Methodology@#A retrospective study was done on neonates admitted to the Neonatal Intensive Care Unit of Bowen University Teaching Hospital, a missionary hospital in South West Nigeria, between January 2016 and December 2017. The medical records of these neonates were retrieved from the comprehensive electronic database for all neonates admitted into the unit. @*Result@#Of the 129 newborns eligible for the study, early-onset sepsis (56.6%) predominated. There were 79 (61%) males giving a M:F ratio of 1.6:1. The incidence rate of neonatal sepsis was 15 per 1,000 live births with a mortality rate of 24%. Gram-Negative Bacilli were mostly isolated in positive cultures. The likelihood of getting a positive culture was unrelated to the age and sex of patients at presentation. There was a varying resistance pattern of the isolates to commonly used empiric antibiotics. @*Conclusion and Recommendation@#Gram-Negative Bacilli was the commonest cause of neonatal sepsis in our center, associated with poor outcome. The high incidence of resistance to the commonly used empirical treatment calls for an urgent review of practice if the trend of high morbidity and mortality would be curtailed, as well as improved infection control practices.

Antibiotics susceptibility of Burkholderia species of Sarawak origin

Aims@#The Burkholderia species is comprised of more than 70 members which co-exist in the same ecological niche including Burkholderia pseudomallei, which causes fatal melioidosis infections in humans and animals. Many of the members of the Burkholderia species share similarities in their biochemical and morphological profiles. B. pseudomallei is intrinsically resistant to a myriad of antibiotics and hence, the treatment of melioidosis involves various types of antibiotics with prolonged prescription. Apart from B. pseudomallei which has been widely described due to its clinical importance, little is known about the antibiotics mechanisms and susceptibility profile of Burkholderia species. This leads to the question of whether the antibiotics susceptibility profile of the Burkholderia species is similar to that of B. pseudomallei. @*Methodology and results@#In this study, Burkholderia species isolated from environmental samples were tested for their susceptibility against gentamicin, ceftazidime, cotrimoxazole (trimethoprim/sulfamethoxazole) and azithromycin using the disk diffusion test method. The antibiogram profiles Burkholderia species isolates tested in this study suggested that the antibiogram profile of Burkholderia spp. resembles that of B. pseudomallei for some antibiotics while totally different for other antibiotics.@*Conclusion, significance and impact of study@#The actual mechanisms which render these observations and whether the interaction of these subspecies within the same ecological niche attribute to these observations warrant further investigation.

Clinical Analysis of Staphylococcus aureus Keratitis according to Methicillin-resistance

PURPOSE: This study analyzed clinical characteristics of Staphylococcus aureus keratitis according to methicillin-resistance. METHODS: The authors performed a retrospective chart review of 46 isolates in 46 eyes with Staphylococcus aureus keratitis that were followed up for more than 2 months between January 1998 and December 2014. Comparative analyses of the epidemiology, predisposing factors, initial clinical manifestations, antibiotics susceptibility and clinical outcome between methicillin-resistant Staphylococcus aureus (MRSA) keratitis and methicillin-sensitive Staphylococcus aureus (MSSA) keratitis were performed. Risk factors of poor visual outcome were analyzed using logistic regression analysis. RESULTS: Among 46 eyes, MRSA was present in 15 eyes (33%) and MSSA in 31 eyes (67%). Male (61%) and older than 60 year-old group (48%) were common. Ocular surface disease/ocular surgery history and trauma were more common as a predisposing factor. Vancomycin was 100% sensitive to both the MRSA and MSSA groups. Antibiotics susceptibility to MRSA was significantly low in the oxacillin (0%), gentamicin (13.3%) and trimethoprim/sulfamethoxazole (53.3%) groups. Sensitivity to fluoroquinolone was 81.3% (MRSA 64.3% vs. MSSA 94.4%; p = 0.064). There were no differences in early corneal findings between the groups. The ratio of BCVA 0.5 or more was 24.4% initially and increased to 44.4% after treatment among all eyes (p = 0.046). Risk factors for poor visual outcomes included a BCVA less than 0.1 at initial evaluation (p = 0.033). CONCLUSIONS: Among eyes with Staphylococcus aureus keratitis, 33% were MRSA. The ratio of BCVA 0.5 or more increased after treatment among all eyes. There were no differences between MRSA and MSSA eyes in terms of epidemiology, predisposing factors, initial clinical manifestations or clinical outcome, except for antibiotic susceptibility. For positive patient outcomes, a treatment approach considering methicillin-resistance as well as various factors affecting clinical course is recommended.

Analysis of Microorganisms and Antibiotics Susceptibility in Dacryocystitis

PURPOSE: This article analyzes the microorganisms and antibiotics susceptibility in dacryocystitis. METHODS: In this study, patients who were diagnosed with acute and chronic dacryocystitis with nasolacrimal duct obstruction were selected and underwent endoscopic endonasal dacryocystorhinostomy. Cultures were obtained from the lacrimal sac during operation from January 2008 to January 2016, and were used to analyze the microorganisms and antibiotics susceptibility. RESULTS: The 67 patients, 9 were diagnosed with acute dacryocystitis and 58 were diagnosed with chronic dacryocystitis. Among them, 64 cases showed bacterial growth (95.5%). The most frequently detected bacteria was Staphylococcus epidermidis (S. epidermidis) (33.8%), followed by Staphylococcus aureus (S. aureus) (25.4%) and Enterobacter aerogenes (18.3%). S. epidermidis had the most powerful resistance to ciprofloxacin compared to the other bacteria (58.3%, p = 0.02). Except for S. epidermidis and S. aureus, the other bacteria responded to ciprofloxacin and gentamycin. CONCLUSIONS: As a causative microorganism of dacryocystitis, S. epidermidis is becoming more prominent, and it is thought that S. epidermidis may be resistant to quinolones (i.e., broad-spectrum antibiotics). This resistance might be increasing the percentage of present S. epidermidis when viewed as a causal pathogen in dacryocystitis.

Prevalence and antibiotic susceptibility of Bacteroides fragilis group isolated from stool samples in North Lebanon

Fifty one strains of the Bacteroides fragilis group were isolated from 45 fecal samples. Classical phenotypic identification showed that 16 isolates were B. thetaiotaomicron, 12 B. uniformis, 9 B. eggerthii,7 B. vulgatus,3 B. caccae,2 Parabacteroides distasonis with 1 identified B. ovatus and 1 B. fragilis. The 51 strains were tested for susceptibility against 16 antimicrobial agents and the MICs for metronidazole were determined. The tests showed that imipenem, meropenem and chloram-phenicol were the most effective antibiotics (98%, 98% and 92.16% of susceptibility, respectively) followed by ticarcillin/clavulanic acid, piperacillin/tazobactam, rifampin (88.24% susceptibility), moxifloxacin 86.27% and tigecycline 84.31%. Ofloxacin and cefotaxime were the least effective antibiotics with 27.45% and 0% of activity respectively. Only six of the 51 isolated strains were resistant to metronidazole with MICs = 64 mg/L (1 strain) and > 256 mg/L (5 strains).

Evaluation of antimicrobial activity of certain combinations of antibiotics against in vitro Staphylococcus epidermidis biofilms.

Background & objectives: Staphylococcus epidermidis is the most common pathogen associated with infections of surgical implants and other prosthetic devices owing to its adhesion and biofilm-forming ability on biomaterials surfaces. The objective of this study was to compare susceptibilities of biofilm-grown cells to single antibiotic and in combination with others to identify those that were effective against S. epidermidis biofilms. Methods: Biofilms were grown in the MBEC™ assay system. The use of this methodology allowed a rapid testing of an array of antibiotics alone (eight) and in combination (25 double combinations). The antibacterial effect of all treatments tested was determined by colony forming units (cfu) enumeration method. Results: The MBEC™ assay system produced multiple and reproducible biofilms of S. epidermidis. Although none of the antibiotics tested have demonstrated an antimicrobial effect (log reduction >3) against all S. epidermidis isolates biofilms, but combinations containing rifampicin showed in general a broader spectrum namely rifampicin-gentamicin and rifampicin-clindamycin. Levofloxacin in combination with rifampicin showed a killing effect against three isolates but failed to attain a bactericidal action against the other two. Interpretation & conclusions: Our findings showed that rifampicin should be a part of any antibiotic therapy directed against S. epidermidis biofilms. However, the efficient antibiotics combination might be dependent on S. epidermidis isolate being tested.

Isolation of the Causative Microorganism and Antimicrobial Susceptibility of Impetigo / 대한피부과학회지

BACKGROUND: Impetigo is a common bacterial infection caused by Staphylococcus aureus, and group A beta-hemolytic Streptococcus or both. Recently, S. aureus has been reported as the most frequently isolated pathogen of impetigo and the incidence of methicillin-resistant S. aureus (MRSA) among patients with impetigo has increased. OBJECTIVE: To investigate the predominant microorganism and the antibiotic susceptibility of the impetigo causative pathogen. METHODS: Bacterial culture and antimicrobial susceptibility testing were performed in patients with impetigo from June 2006 to May 2012. RESULTS: Of 164 patients, bacteria were cultured from 139 patients. Among them, S. aureus was isolated from 114 (82%) patients. The others were Acinetobacter baumannii, Enterobactercloacae, Enterococcus species, Enterococcus faecium, Enterococcus faecalis, Klebsiella oxytoca, and Candida albicans. The resistance rates of S. aureus against antibiotics were as follows: penicillin, 95.6%; erythromycin, 43.9%; fusidicacid, 38.1%; clindamycin, 24.5%; gentamycin, 21%; tetracycline, 12.3%; trimethoprim-sulfamethoxazole, 0.9%; ciprofloxacin, 0%; habekacin, 0%; linezolid, 0%; teicoplanin, 0%; and vancomycin, 0%. Thirty-four (29.8%) S. aureus isolates were MRSA, and the prevalence of MRSA increased during the 6-year period. CONCLUSION: The most predominant pathogen in impetigo was S. aureus, which was sensitive to ciprofloxacin, habekacin, linezolid, trimethoprim-sulfamethoxazole, teicoplanin, and vancomycin. An increase in the prevalence of MRSA was observed during the 6-year period, and the effective antibiotics for MRSA were trimethoprim-sulfamethoxazole, teicoplanin and vancomycin.

RAPD analysis and antibiotic susceptibility for Mycobacterium tuberculosis strains isolated from different locations in Egypt

The routine identification of mycobacterial strains isolated from patients in different locations in Egypt was confirmed by specific DNA fragment amplification. The susceptibilities of 72 Mycobacterium tuberculosis strains against the four antibiotics used in tuberculosis treatment (Isoniazid, INH; Rifampicin, Rif; Streptomycin, St and Ethambutol, E) were examined. Our results indicated that, multi drug resistant tuberculosis (MDR-TB) represents about 19.5% of the tested strains, whereas sensitive strains represented 26.4%. The genetic polymorphism of the tested strains was examined using RAPD analysis. Six selected strains represent the different antibiotic susceptibility groups were examined using RAPD fingerprinting. No difference between the strains was recorded using the RFLP analysis of amplified specific fragment. The discrimination power of RAPD analysis was inadequate to clarify the genetic correlation between the tested strains. MDR-TB was approximately double time in 2008 compared with the value in 2007. Most of the new MDR-TB was correlated with resident dense population regions.

Clinical Features of Infectious Keratitis in West Coast Area of Chungcheongnam-do, Korea

PURPOSE: To evaluate the clinical features of infectious keratitis in the western coastal area of Chungcheongnam-do, Korea. METHODS: We performed bacterial and fungal cultures in patients with findings of infectious keratitis. Any correlations between the culture results and the patients' place of residence, occupation, types of ocular trauma, contact lens wear, previous ocular disease, duration of treatment for complete recovery, time between the onset of symptom and beginning of treatment were evaluated. In addition, we assessed the antibiotic susceptibilities of the cultured organisms. RESULTS: We detected 34 (58.62%) among 58 cultures performed in 55 patients that were positive for organisms; 24 for Gram-positive bacteria, 17 for Gram-negative bacteria, 3 for fungi and 9 for polymicrobial infections. Coagulase-negative staphylococci (CNS) was the most frequent infection. The culture positivity rate was significantly higher (P=0.047) in patients with history of previous ocular disease but no correlations were detected with place of residence, type of ocular trauma or the timing of culture. The average treatment period was 33.95+/-30.59 days, which extended as the lesion size increased (P=0.003). CONCLUSIONS: Pseudomonas species are considered to be the most frequent cause of infectious keratitis in Korea. However, in our study, CNS were the most frequent culture-positive organisms and visual prognosis was poorer in the culture-positive group.

Bacteriologic Study and Antibiotics Sensitivity of Acute Appendicitis Treated with Laparoscopic Appendectomy

PURPOSE: This study was designed to evaluate the bacteriological characteristics and antibiotics sensitivity in acute appendicitis. METHODS: The microbiologic culture and antibiotics sensitivity tests were done on 165 patients who underwent laparoscopic appendectomy under the diagnosis of acute appendicitis. The postoperative complications were also checked. The microbiologic and clinical results were compared between perforated and non-perforated groups. RESULTS: The most common organism cultured from the periappendiceal fluid was Escherichia coli (51.2%), followed by Enterobacter (16.2%) and Pseudomonas (8.9%). In the antibiotics sensitivity test, ciprofloxacin and levofloxacin were highly susceptible. Ceftriaxone and cefotaxime were also highly susceptible. Piperacillin/tazobactam, imipenem and meropenem were very highly susceptible. The complication rate of perforated appendicitis group (17.9%) was higher than that of the non-perforated appendicitis group (7.1%) (P<0.001). A surgical drain was used more frequently in perforated group (23% vs 84.6%, P<0.001). The mean in-patient days were longer in the perforated group (5.7 vs 7.2 days, P<0.001). In the patients with infectious wound complication, antibiotic resistance was more prominent in the non-perforated group than in the perforated group. CONCLUSION: In the perforated appendicitis group, more precise and careful procedure was required. In the non-perforated appendicitis group, more prudent use of the available antibiotics to conserve valuable therapeutic resources and improved infection control to limit the spread of resistant organisms was required.

Antibiotics Susceptibility Analysis of Sixty-two Clinical Streptococcus pneumoniae Isolates / 中华医院感染学杂志

OBJECTIVE To investigate the in vitro antimicrobial susceptibility of Streptococcus pneumoniae and guide the rational use of drug clinically. METHODS We performed statistical analysis of the susceptibility of 62 strains of S.pneumoniae isolated in our hospital from May 2007 to Aug 2008. RESULTS S.pneumonia e could be isolated from various specimens,most of them were isolated from sputum(84.0%).S.pneumoniae could be detected from many hospital wards,but more strains isolated from pediatric(67.8%) and respiratory(11.4%) departments.A total of 67.7% of S.pneumoniae isolates were penicillin non-susceptible,the resistance prevalence to tetracycline was 87.1%,to erythromycin 79.0% and to trimethoprim/sulfamethoxazole 49%,while they were highly susceptible to ofloxacin(90.3%),vancomycin(91.9%),levofloxacin(95.2%),moxifloxacin(96.8%) and rifampicin(98.4%),and more strains showed multi-resistance from penicillin non-susceptible isolates. CONCLUSIONS The resistance to penicillin of S.pneumoniae is serious in our hospital.The tetracycline and erythromycin are not the best ckoice in treating S.pneumoniae infection,and the new fluroquinolones show strong activity against S.pneumoniae.

Staphylococcus Resistance in Nosocomial Infection: An Analysis / 中华医院感染学杂志

OBJECTIVE To study the staphylococcus infection and the drug resistance among the outpetients and the inpatients, and to provide information for the clinical treatment.METHODS To cultivate and isolate bacteria according to the Clinical Laboratory Operation Regulation.Bacteria were identified with the automated analyzer VITEK-60.made by Bio-Merieux Company in France.The drug susceptibility was one with the method of single split agar diffusion.RESULTS Totally 159 strains of Staphylococcus were isolated from the outpatients,(46.1%) of which were MRSA.Most of the infection were caused through genital tract;390 strains of(Staphylococcus) were(isolated) from the inpatients,87.1% of which were MRSA.Most of the infection were caused through respiratory tract.Most of MSSA resisted to penicillin,but MRSA were sensitive to vancomycin and(teicoplanin.) (CONCLUSIONS) Preventing the spread of the MRSA is very important to the control of the nosocomial(infection).As far as the infective situation,most of the outpatients are infected through genital tract;while most of the inpatients are infected through respiratory tract.As far as the drug susceptibility,vancomycin is the best antibiotics,the next is teicoplanin.It is necessary to use combined drugs for the MRSA infection.

Population analysis as a useful method for isolation of herogeneous methecillin-resistant staphylococcus aureus / 临床检验杂志

Objective To develop a new method for the isolation of heterogeneous methecillin-resistant staphylococcus aureus(hetero-MRSA)and study its application in clinical practice.Methods Both the methods of disc agar diffusion and population analysis were used to detect hetero-MRSA from 60 strains of methecillin susceptible staphylococcus aureus(MSSA) which were identified by VITEK AMS.Results Twelve subclones of hetero-MRSA were isolated by population analysis,while only 2 subclones were identified by disc agar diffusion.Conclusion Population analysis is an effective method for the isolation of hetero-MRSA,and its detection rate is higher than that of disc agar diffusion.The heterogeneous methecillin resistance of MSSA should not be overlooked by medical workers.

Detection of Mycoplasma in Vaginal Secretions and Drug Resistance / 中华医院感染学杂志

OBJECTIVE To understand infection status and drug resistance of Ureaplasma urealyticum(Uu) and Mycoplasma hominis(Mh) in female genitourinary tract in the local region.METHODS The results of mycoplasma cultivation and susceptibility tests of female vaginal secretions specimen in 409 cases during from Sep 2007 to Apr 2008 were analyzed retrospectively.RESULTS Among 409 cases,the positive rates were mycoplasma cultivation(57.2%).Uu(72.6%),Mh(3.4%) and combined infection(23.9%).Drug resistance of Uu to ten kinds of common antibiotics showed that minocycline

Bacteriologic features and antibiotic susceptibility in isolates from oral and maxillofacial infections

Oral and maxillofacial infections are most commonly odontogenic in origin. The present study was implemented for patients with oral and maxillofacial infections in order to determine what differences were present in cultured bacteria, depending upon the different types of infection. For the present study, the epidemiological characteristics, the state of infection, and the results of the pus culture and antibiotic susceptibility tests were analyzed for the 159 cases where pus culture tests were performed. The patients were treated at the Oral and Maxillofacial Surgical Department of Chonnam National University Hospital during an 18-months period from March 2003 to August 2004. Among the total 159 pus culture specimens, bacteria were cultured in 111 cases (69.8%). In the 111 pus culture specimens, Streptococcus species, Neisseria species, and Staphylococcus species were cultured from 69 cases (51.1%), 21 cases (15.6%), and 15 cases (11.1%), respectively and were determined to be bacterial strains the predominant bacteria responsible for oral and maxillofacial infectious diseases. Twenty four cases (15.1%) among the 159 specimens showed mixed infections. The mostly isolated bacteria from each of the space abscess, dentoalveolar abscess, inflammatory cyst, and pericoronitis cases were the Viridans streptococci. There was little relevance between the type of infection and the type of cultured bacteria. Antibiotic susceptibility tests showed a high level of susceptibility to teicoplanin(100%), vancomycin(100%), chloramphenicol(96.4%), ofloxacin(88.3%), imipenem(83.3%), erythromycin(82.5%) and a low susceptibility to cefazolin(40.0%), oxacillin(44.7%), ampicillin(49.4%), penicillin(51.1%). These results indicate that there was no significant difference among the cultured bacteria depending on the type of infections and their susceptibility to cephalosporin and penicillin G was low.