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.

Study of prevalence and antimicrobial susceptibility pattern of organisms isolated from various clinical specimen of the patients admitted in intensive care unit of tertiary care hospital

Background: Mostly intensive care unit (ICU) patients are more susceptible to nosocomial infections caused by hospital-based various strains of bacteria and other opportunistic pathogens. Due to the widespread use of broad-spectrum antibiotics, these strains of pathogens are often multi-drug resistant. To prevent resistance against the antimicrobial agent various departments of the health care system have to work together, so we can use the antimicrobial agents as effectively as we can to treat illnesses. Aim and Objectives: The objective of this study was to know the prevalence of different micro-organisms causing infections in ICU and their sensitivity and resistance pattern and to determine the overall microbiological and resistance profile which helps formulate therapeutic guidelines in ICU. Materials and Methods: A cross-sectional study was conducted at a tertiary care teaching hospital in Ahmedabad to assess the culture and sensitivity pattern of clinical samples such as blood, urine, sputum, wound, and endotracheal aspiration for a 1-year duration (August 2019 - August 2020). Results: A total of 941 samples were received for microbiological investigation from ICU, out of which 322 were positive. The Utmost isolated organism was - Klebsiella (37.26%) followed by Escherichia coli (16.45%), Pseudomonas (12.42%), and Staphylococcus aureus (7.45%). The Gram-negative bacteria (GNB) were most sensitive to drugs like colistin (96.26% %) and tigecycline (83.40%) followed by carbapenems (71.79%), aminoglycosides (71.36%), and fluoroquinolones (67.21%). More sensitive drugs for isolated Gram-positive organisms were linezolid (100%) followed by teicoplanin (98.41%) and vancomycin (98.41%). Conclusion: High prevalence of multidrug-resistant organisms such as methicillin-resistant S. aureus, vancomycin-resistant enterococci and GNB producing Extended-spectrum Beta-lactamase, AmpC, or carbapenem-resistant GNB in our study, raise serious concerns about antibiotic resistance. The main reason for increasing antimicrobial-resistant bacteria is poor infection control practices and inappropriate use of antibiotics. Hence, research regarding antibiotic sensitivity and resistance will be very helpful for doctors to initiate appropriate empirical antibiotics in treating critical illnesses.

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.

Prevalence and Antimicrobial Susceptibility of Methicillin Resistant Staphylococcus in a Tertiary Care Hospital in Koshi Region (Northern Bihar)

Introduction: Nosocomial infection is a major problem globally. Methicillin-resistant Staphylococcus aureus (MRSA) remains one of the most important causes of nosocomial infections worldwide. MRSA are the important agents causing nosocomial infections. The study was conducted in the Department of Microbiology to determine the prevalence of MRSA and antibiotic susceptibility pattern. Material and Methods: This was a retrospective study conducted from July 2016 to August 2017 in a tertiary care hospital in Northern Bihar India. All isolates were identified in patients and data provided by the Clinical and Laboratory Standards Institute (CLSI) guidelines and antibiotic susceptibility pattern considered by Kirby Bauer disc diffusion method. The information was definitely recorded and analyzed using Microsoft Excel 2007 edition. Results: 200 Staphylococcus strains isolate of were isolated from various clinical samples, Out of 200 S. aureus isolates, 73 (36.5%) were methicillin resistant S. aureus (MRSA) and 127 (63.5%) were methicillin-sensitive S. aureus (MSSA) in our labs. Although, the majority of the MRSA isolates were resulted from pus samples 30, however, the S. aureus isolates resulted from post-operative wound infection was mostly MRSA. Conclusion: In conclusion, the importance of Isolation of MRSA patients and carriers in the hospitals, regular surveillance of hospital associated infections including monitoring antibiotic sensitivity pattern and strict drug policy for antibiotics may be helpful for reducing the incidence of these infections

Bacteriological Profile And Antibiotic Susceptibility Pattern Of The Isolates Among The Neonatal Septicemia In Northeast India

Background: Bacterial resistance to antibiotics was a global problem. Multidrug-resistant bacteria causing neonatal septicemiaswere increasing in the world. It was difficult to compare the bacterial profile and antibiotic susceptibility pattern of the isolatesamong the neonatal septicemia between countries because the epidemiology of neonatal septicemia was extremely variable.Objective: Timely identification of bacterial profile and antibiotic susceptibility pattern of the isolates among the neonatalsepticemias are essential to guide the clinicians regarding both the empirical and definitive treatments of neonatal septicemia.Materials and Methods: Based on the AIIMS protocol 2014 of neonatal sepsis-World Health Organization newborn CC,an operational definition of clinically diagnosed neonatal septicemia was established for the selection of participants inthe study for blood culture and sensitivity test (CST). Hence, in this study, blood CST was done only among the selectedpatients for clinically diagnosed neonatal septicemia as recommended in the National Committee for Clinical LaboratoryStandards.Results: This study observed that there was a shift from the predominance of Gram-negative organisms to Gram-positiveorganisms, especially Staphylococcus aureus. Acinetobacter and Citrobacter were emerging organisms.In this study,aminoglycosides and fluoroquinolones were sensitive to organisms, especially in Gram-negative organisms. Imipenem andmeropenem were also sensitive in both Gram-positive and Gram-negative organisms. Imipenem was more sensitive toorganisms than meropenem. Tobramycin, doxycycline, gatifloxacin, and chloramphenicol were more sensitive to organismsthan erythromycin, azithromycin, and clindamycin.Conclusion: Early clinical diagnosis and prompt initiation of empirical antimicrobials therapy to patients of pending culturesensitivity reports for definitive therapy may be life-saving. Hence, periodic surveillance for bacteriological profile and antibioticsusceptibility pattern of the isolates among the neonatal septicemia for appropriate choice of antimicrobials for empirical therapycan be outlined and reevaluated in a timely manner to save the life of 5 million neonatal deaths a year, with 98% occurringin developing countries and limited resource rural areas. This study concluded that empiric therapy for clinically diagnosedneonatal septicemia should cover both Gram-negative and Gram-positive organisms. Hence, the combination of one antibioticfrom each of the following two groups, (1) Imipenam/piperacillin/cefotaxime and (2) amikacin/gentamicin/netilmicin, can beincluded as an initial therapy for neonatal septicemia.

Changes in Antimicrobial Susceptibility Pattern of Blood Isolates at a University Hospital in the Kyungnam area during 2005–2014 / 고신대학교의과대학학술지

OBJECTIVES: Blood culture is a one of the most important procedure for diagnosis and treatment of infectious disease, but distribution of pathogenic species and the antimicrobial susceptibility can be vary from pathogen, individual trait, regional or environmental features. In this study, we investigated the changes in frequency of occurrence and antimicrobial susceptibility pattern of blood isolates from 2005 to 2014. METHODS: Data of blood isolates from Kosin Gospel Hospital during 2005 to 2014 were analyzed retrospectively. Blood isolates were cultured for 5 days using BACTEC Plus Aerobic/F and BACTEC lytic/10 Anaerobic/F. Identification and antimicrobial susceptibility test was performed using VITEK 1 system, VITEK 2 XL, PHOENIX 100 and conventional method. RESULTS: 9,847 isolates were identified during 10 years. Among the isolates aerobic or falcutative anaerobic bacteria were isolated in 99.5% specimens, anaerobic were 0.1%, and fugi were 0.4%. Most commonly isolated bacteria were coagulase-negative Staphylococcus (CoNS) followed by Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae. Candida parapsilosis were most frequently isolated among fungi. The proportion of S. aureus, A. baumannii and E. faecium were increased, while Pseudomonas aeruginosa and Streptococcus pneumoniae decreased over decennium. Imipenem resistant K. pneumoniae were identified. Vancomycin resistant E. faecium and imipenem resistant A. baumannii were increased (7.1% in 2005 to 12.3% in 2014, 0% in 2005 to 55.6% in 2014, respectively). CONCLUSIONS: Over the last 10 year, CoNS were the most frequently isolated pathogen. Imipenem resistant K. pneumoniae was emerged. Vancomycin resistant E. faecium and imipenem resistant A. baumannii increased during this period.

Successful therapy in unusual generalized Dermatophilus congolensis infection in a calf based on modified in vitro disk diffusion test / Sucesso no tratamento de infecção generalizada em bezerra por Dermatophilus congolensis baseado em teste in vitro modificado de difusão com discos

Bovine dermatophilosis is a dermatitis characterized by typical focal or localized lesions with "paintbrush" aspect and occasionally as disseminated cutaneous disease. We report the case of a one-year-old Nelore female with history of chronic cutaneous disseminated lesions that appeared immediately after a rainfall period. Serous to purulent exudates, hair with tufted appearance, hyperkeratotic, non-pruritic, hardened, yellowish to brown, and coalescent crusty lesions were observed distributed all over its body. Removal of the crusts revealed ulcerated or hemorrhagic areas, with irregular elevated crusts like "paintbrush". Microbiological diagnosis enabled the identification of a microorganism, the Dermatophilus congolensis. Despite disseminated and chronic lesions, we obtained a successful therapy with parenteral therapy using long-acting tetracycline based on modified in vitro disk diffusion test. The present report highlights success therapy in uncommon generalized bovine dermatophilosis with selection of first-choice drugs based on modified in vitro susceptibility test, and need of responsible use of antimicrobials in livestock.(AU)

A dermatofilose bovina é uma dermatite caracterizada por lesões focais ou localizadas com aspecto de "pincel" e, ocasionalmente, como lesão cutânea disseminada. Relata-se o caso de uma fêmea bovina de um ano de idade, que foi atendida apresentando história de lesões cutâneas crônicas imediatamente após um período de alta pluviosidade. Ao exame clínico, lesões serosas a purulentas, com hiperqueratose, coalescentes, não pruriginosas, ressecadas, de coloração amarelada à acinzentada foram observadas distribuídas de modo generalizado pelo animal. A remoção das crostas revelou áreas ulceradas ou hemorrágicas, com crostas irregulares e elevadas semelhantes a "pincel". O diagnóstico microbiológico possibilitou a identificação do micro-organismo Dermatophilus congolensis. Apesar das lesões disseminadas e crônicas, a cura do animal foi obtida com tratamento parenteral usando oxitetraciclina de longa duração, baseado em teste in vitro de sensibilidade microbiana modificado. O presente relato ressalta o sucesso no tratamento de caso incomum de lesões generalizadas de dermatofilose bovina com respaldo de teste in vitro de sensibilidade modificado, bem como a necessidade do uso responsável de antimicrobianos em animais de produção.(AU)

Study Of Bacteriological And Antimicrobial Susceptibility Pattern Of Uropathogens.

Background & Objective: Urinary tract infection is one of the common infections in the Indian community. Distribution and susceptibility of UTI-causing pathogens change according to time and place. This study aims to analysis present trend of locally prevalent uropathogens and their antibiotic susceptibility for prudent use of antibiotics to combat antimicrobial resistance. Methodology: Total 135 urine samples from suspected UTI was collected from both outdoor and indoor patients during the study period of August 2014 to Jun 2015.Culture and antibiotic sensitivity testing of the isolates were done. At the last, analysis of uropathogen and antibiotic susceptibility pattern was done. Results: Total 54(40%) samples were found to be positive for uropathogen in culture, in which gram negative organisms & gram positive organisms were isolated from 45 (83%) & 9(17%) samples, respectively. The E coli was most common organism isolated. Conclusion: Females are predominantly affected by UTI, with most common uropathogen E coli. Antimicrobial susceptibility pattern shows high sensitivity for Amikacin and levofloxacin compared to other routinely used antibiotics.

Antimicrobial susceptibility pattern of bacterial isolates from wound infection and their sensitivity to antibiotic agents at super specialty hospital, Amravati city, India.

Background: Wound infection is one of the health problems that is caused and aggravated by the invasion of pathogenic organisms. Information on local pathogens and sensitivity to antimicrobial agent is crucial for successful treatment of wounds. So the present study was conducted to determine antimicrobial susceptibility pattern of bacterial isolates from wound infection and their sensitivity to antimicrobial agents. Methods: A retrospective study was conducted among patients with wound infection in Suyash super speciality hospital, from January 2012 to December 2013. Wound swab was collected using sterile cotton swabs and processed for bacterial isolation and susceptibility testing to Systemic antimicrobial agents. Results: In this study 78 bacterial isolates were recovered from 258 specimens showing an isolation rate of 31.2%. The predominant bacteria isolated from wounds were gram positive staphylococci 36 (46.2%), followed by gram negative streptococci 18 (23.1%) gram negative pseudomonas 12 (15.4 %) and gram negative proteus 8 (10.4%). The gram positive and gram negative bacteria constituted 68 (87.2%) and 10 (12.8%) of bacterial isolates; respectively. Conclusion: In the present study most of the pathogens isolated from wound isolates showed high rate of resistance to most commonly used newer antibiotics used to treat bacterial infections. Therefore, rational use of antibiotics should be practiced.

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.

Antimicrobial Susceptibility Pattern of Haemophilus influenzae among Under-five Children Presenting at the Emergency Paediatric Unit (EPU) Two Teaching Hospitals in Jos, Nigeria.

Background: Haemophilus influenzae meningitis is a leading cause of endemic bacterial meningitis in infants and under-five children globally. H. influenza infection is severe where vaccine is not routinely used and one-third to half of the children either dies or suffers permanent disability such as deafness, paralysis or mental retardation when prompt and appropriate treatment is not instituted. Aim: This research sets to study and document the antibiotic susceptibility pattern of H. influenzae isolates from cerebrospinal fluids of under-five children presenting at the Emergency Paediatric Units of two Teaching Hospitals in Jos, Nigeria. Methodology: This was a descriptive cross–sectional prospective study conducted from October 2009 to March 2010. One hundred and sixty consecutive under-five children who presented with signs and symptoms consistent with H. influenzae meningitis were recruited. Socio-demography data was obtained with structured questionnaire. Specimens were aseptically collected and carefully processed for isolation and identification of H. influenza and subsequently the antimicrobial susceptibility pattern of the isolates. Results: The prevalence of H. influenzae meningitiswas low in Jos with prevalence of 6.3% among 160 under-five children studied, with mean age of 34 months and M: F ratio of 1:1. About 60% of these isolates were obtained from patients with acute pyogenic bacterial meningitis. Majority of the isolates were ampicillin resistant, β-lactamases producers and were all sensitive to ceftriaxone and azithromycin. Conclusion: The low prevalence of H. influenzae meningitis suggests substantial but not complete coverage of vaccine activity in this region while the susceptibility pattern of the isolate reveals and supports the vital role ceftriax one plays in the management of invasive H. influenzae infections to avoid pathologic complications.

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.