ABSTRACT
Resumen Objetivo. Describir el perfil microbiológico y de resistencia bacteriana de los aislamientos en adultos con infecciones adquiridas en comunidad en el Hospital Universitario San José de junio 2016 a diciembre 2019. Metodología. Se realizó un estudio descriptivo de corte transversal, análisis retrospectivo de los aislamientos microbiológicos en adultos desde junio 2016 a diciembre 2019, basado en la data institucional. Se analizó la información con STATA15,0. Se obtuvo la aprobación del comité de ética del hospital. Resultados. Se incluyeron 5121 aislamientos microbiológicos, el 61% en el servicio de urgencias. El urocultivo fue la muestra más frecuente. Escherichia coli fue el germen más común tanto a nivel general como en urocultivos, hemocultivos y cultivos de líquido peritoneal. La resistencia a ampicilina y amp/sul fue elevada, hasta del 68% para E. coli. El 20% de los Staphylococcus aureus fueron resistentes a meticilina. Se observó una resistencia inusual a carbapenémicos por parte de Pseudomonas aeruginosa. Discusión. El perfil microbiológico concuerda con la literatura mundial y nacional, sin embargo, el HUSJ tiene un comportamiento microbiológico que debe ser estudiado a profundidad. Conclusión. Los porcentajes de resistencia a antibióticos de uso frecuente son elevados. Se requiere ajustes de las guías de manejo institucionales y nacionales.
Abstract Objetive. To describe the microbiological profile and resistance spectrum of the community acquired bacterial infection of the San Jose university hospital from june 2016 to december 2019 Methodology. A retrospective transverse descriptive study of microbial organisms found in adults in the institution from June 2016 to December 2019, the study is based in the hospital data. The analysis of the information was made with SATA 15.0. Results. 5121 samples were included, 61% from the emergency department. Urine culture was the most frequent sample taken. Escherichia coli was the most frequent isolated bacterial, in all samples, urine culture, blood culture, and peritoneal culture. Ampiciline r and ampiciline/sulbactam was high up to 68% of the E. Coli cultures. 20% of Staphylococcus aureus were methicillin resistant. Unusual carbapenemic resistance was found in the Pseudomona aeruginosa isolates.. Discussion. The data of the bacterial resistance spectrum Concord which was is found in the general medical literature, nevertheless the HUSJ, has a microbial behaviour that must be studied thoroughly. Conclusion. The antibiotic bacterial resistance to common used antibiotics is high. Adjustments are required in the instucional and national management guidelines
Subject(s)
Humans , Female , Bacterial Infections , Drug Resistance, Microbial , Sepsis , Emergencies , Emergency Service, Hospital , Infections , Anti-Bacterial AgentsABSTRACT
Background: Diabetic foot ulcers (DFU) are debilitating to the patients and significantly impair their quality of life. DFU associated with infection have the worst outcomes and may lead to amputations if timely intervention is not done. In the present study, aim was to identify the association between the type of organism isolated and the rates of amputations in diabetic foot ulcers.Methods: We retrospectively studied 50 diabetic foot ulcers from January 2017 to June 2017, who were in-patients in a single unit of surgery department in King George Hospital, Visakhapatnam. Baseline clinical examination was done. Parameters such as age, sex, duration, diabetic status and its treatment, organisms isolated, various treatment options for ulcers and the outcomes were studies.Results: Males were the predominant study subjects (M: F=32:18). The age of presentation was 18-65 years with an average of 46 years. Gram negative organisms were the frequent microbial isolates, all being mono-microbial infections. It was dominated by E. coli (17), Pseudomonas (12) and Klebsiella (11). Above-knee amputation was done in one patient and below-knee amputations in three patients. Total mortality in our study was 5. After applying the chi-square test, it was found that there is no significant association between the type of organism and the rate of amputations in our study.Conclusions: Diabetes is a significant risk factor for ulceration in the extremities, which possesses considerable mortality and morbidity. Early intervention, control of diabetes and compliance of the patient treatment are all necessary to reduce the rates of amputations and mortality in patients with diabetic foot ulcers.
ABSTRACT
Background: Initiation of early appropriate antibiotic therapy influences the outcome of perforation peritonitis, which otherwise is delayed till culture reports are available. The knowledge of microbial profile and sensitivity of peritoneal fluid culture with respect to the anatomical site of perforation peritonitis will help in initiation of early appropriate antibiotic therapy in the post-operative period.Methods: A cross-sectional study conducted from January 2017 to December 2017 where intraoperative peritoneal fluid sample in patients of perforation peritonitis was subjected to culture (aerobic and anaerobic) and sensitivity and results analysed with respect to anatomical site of perforation.Results: 50 patients were studied. The most common site of perforation was ileum (32%) followed by appendix (18%) and stomach (18%). In aerobic culture, the culture positivity rate was highest in colonic perforation (100%) and least in gastric perforation (44.4%). The most common organism isolated in all sites of perforation peritonitis was E. coli followed by Klebsiella spp. In anaerobic culture, although facultative anaerobes were isolated, no strict anaerobe was isolated. The most sensitive antibiotics covering all isolated organisms were gentamycin (p=0.006), colistin (p=0.018), piperacillin and tazobactum (p=0.022).Conclusions: The predominant differential normal flora according to site of gastrointestinal tract was not reflected in the peritoneal fluid culture of patients with perforation peritonitis and E. coli was the most common organism isolated in all sites of perforation peritonitis. The antibiotic sensitivity profile showed the increasing resistance against third generation cephalosporins. Aminoglycosides, piperacillin and tazobactum, meropenem and colistin showed a significant antimicrobial activity against organisms isolated from cases of perforation peritonitis.
ABSTRACT
Purpose: To study the demographic details, risk factors, microbiological profile, and clinical outcomes of pediatric infectious keratitis cases in North India. Methods: This retrospective case series included review of medical records of pediatric patients (0–16 years) diagnosed with infectious keratitis in a tertiary care center of North India during December 2011 to January 2017 was done. Demographic details, predisposing factors, microbiological investigations, and clinical outcomes were analyzed. Results: In this time period, 104 eyes of 104 children had a diagnosis of infectious keratitis. Culture was obtained for all 104 eyes and was positive in eighty eight eyes (84.2%). The most common causative factor was trauma, seen in 77 eyes (74%). Bacteria was the most common agent isolated in culture (54.2%) followed by fungi (40.8%) and acanthamoeba (2.1%). Successful healing of the keratitis with appropriate medical treatment occurred in 84 (80.7%) eyes, while 13 (12.5%) eyes required therapeutic keratoplasty. Of the 80 eyes with documentation of both preliminary and final visual acuity, improvement of two lines was seen in 35 eyes (43.7%), stayed the same in and worsened in 17 eyes (21%). Mean time to resolution of infection on medical treatment for bacteria was 23.65 ± 4.78 days, fungi 32 ± 5.19 days, and acanthamoeba 53.67 ± 4.78 days. Conclusion: Gram positive organism is the most common etiological agent of keratitis in children in our study population which is in contrast to pediatric infective keratitis study conducted by Aruljyothi et al. in South India (2011--2013). Though less in number than bacterial keratitis, fungus also remains an important causative agent. Along with early diagnosis and immediate medical intervention, it is important to identify regional profile of organisms and risk factors for good visual and anatomical outcome.
ABSTRACT
Background: Diabetes Mellitus is reported to increase the risk of Urinary Tract Infection (UTI) with higher probability of drug resistant organisms. Understanding the burden, microbiological profile and antibiotic sensitivity pattern is vital for effective prevention and management. To assess the microbiological profile and antibiotic sensitivity pattern of Urinary Tract infections among type 2 diabetes mellitus patients.Methods: The study was A prospective observational study done on 117 type 2 diabetic subjects aged above 18 years presenting with symptoms of UTI in a tertiary care hospital Urine was analyzed for urine routine examination, culture and antibiotic sensitivity using standard testing methods on a midstream urine sample. Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables.Results: The mean age of the study population was 57 years. Females constituted 62.39% of participants. Burning micturition (52.99%) was the most common presenting symptom. The prevalence of culture positive UTI was 51.28%. Among gram-negative bacilli, Escherichia coli (20.51%), Klebsiella (6.85%) dominated the culture reports. Enterococcus (4.27%) and Staphylococcus aureus (2.6%) were the common gram-positive organisms isolated. Meropenem was the most effective antibiotic against E. coli (87.5%) and Klebsiella (95%) Vancomycin had 100% sensitivity against Enterococci and S. aureus.Conclusions: More than half of diabetic patients presenting with symptoms of UTI had culture positive UTI, predominantly caused by gram negative organisms. There is a need for comparative studies of Diabetes and controls to explore the key differences in the pattern of UTI.
ABSTRACT
Introduction: Catheter associated urinary tract infections (CAUTI) is the most common health care associated infection (HAI), accounting for 40% of all HAIs in particularly in patients admitted to intensive care units (ICU) due to their more frequent necessity of urinary catheterization and longer duration of catheter use. Knowledge about Microbiological profile and antimicrobial sensitivity pattern of CAUTI is essential to implement the infection control system in a proper manner.Aims and objectives: To study the rate and microbiological profile of catheter associated urinary tract infections and in patients admitted in Intensive Care Units.Materials and methods: A one-year prospective study was conducted in which urine samples were collected from patients admitted in Medical ICUs on indwelling urinary catheter for >48 hours and processed in Microbiology Department according to standard procedures. CA-UTI rate was calculated and their microbiological profile and various resistance patterns were studied as per CLSI guidelines.Results: Out of 1406 enrolled patients, 64 patients developed CAUTI. Overall CAUTI rate was 4.06/1000 catheter days. Most common isolate in CAUTI cases was Klebsiella spp. (32.3%), followed by Escherichia coli (24.6%). Gram negative isolates showed higher sensitivity to aminoglycosides, imipenam and nitrofurantoin as compared to cephalosporins The Enterococcus spp. were 100% sensitive to linezolid and 71.4% sensitive to both vancomycin and teicoplanin.Conclusion: CAUTI rate in our ICUs was high compared to the benchmarks. Antibiotic sensitivity pattern of the pathogens involved was also low. This study provides the data of predisposing risk factors and its causative microbial flora for CAUTI in our tertiary care.
ABSTRACT
Background: The incidence of infectious keratitis has risen inthe last decade, partially due to an increasing number ofcontact lens users and immune-compromised patients. Hence;the present study was undertaken for assess themicrobiological profile of patients with infection keratitis.Materials & Methods: A total of 96 patients of infectionkeratitis were enrolled in the present study. Completedemographic and clinical details of all the patients wereobtained. Slit-lamp biomicroscope examination of all thepatients was done. This was followed by collection of cornealscrapings under septic conditions by experienced and skilledophthalmologist. Inoculation of the material directly on the solidmedia was done. The media used were blood agar, chocolateagar and Sabouraud dextrose agar (SDA). Overnightincubation of seeded media was done. Assessment of cultureand colonies was done by skilled and experiencedmicrobiologists.Results: Only bacterial isolates were found to be present in54.2 percent of the patients. Only fungal isolates were foundto be 39.6 percent of the patients. Mixed infection wasfound to be present in 6.2 percent of the patients. Fusarium,Aspergillus, Hyalohyphomycetes, Curvularia and Candida werethe most common fungal species encountered. S.aureus,S.pneumoniae, Pseudomonas aeruginosa and Klebsiellapneumonia were the most common bacterial speciesencountered.Conclusion: Infection keratitis comprises of mixed spectrum ofbacteria and fungi.
ABSTRACT
INTRODUCTION:- the present study was planned and the aim of the present study was to compare the clinical, radiological and laboratory manifestations of PTB among geriatric patients. The biological changes associated with aging, associated malnutrition and acute or chronic diseases have been reported to disrupt protective barriers, contribute to the expected age-related diminution in cellular immune responses and impair microbial clearance mechanisms against Mycobacterium TB. METHODOLOGY:- This study analyzed the 100 elderly pulmonary tuberculosis cases. This study was conducted in the Department of TB & Respiratory Diseases, Shri Dev Suman Subharti Medical College, Dehradun. The duration of study was over a period of two year. RESULTS:- In the present study, 85% people had cough, 92% fever, 42%anorexia, 30% chest pain, 21% hemoptysis, 52% weakness. In the sputum microscopy, 23% negative, 11% scanty, 22% 1+, 25% 2+,19% 3+ we were found according to grading of RNTCP. CONCLUSION:- Elderly patients of PTB presented with recognized clinical and radiological features of disease, but a fair number had to be prescribed nonstandard regimens.
ABSTRACT
Purpose: The aim of this article to study causative organisms for scleral buckle (SB) infections in North India. Methods: A retrospective review of records was done for all patients who have undergone SB removal at our institute between January 2009 and December 2017. The records were analyzed for etiological agent of the infected buckle and its antibiotic sensitivity. Results: A total of 43 samples were analyzed and a positive culture was noted in 35 (81.40%) cases. The buckle infection rate at our institute was noted to be 2.53%. The commonest organism causing SB infections was Staphylococcus – 15 (42.6%) cases, followed by Pseudomonas – 6 (17.14%) cases and Fungi – 6 (17.14%) cases. The median interval between retinal detachment surgery and buckle explantation was 3 years. Conclusion: A large variety of organisms may cause SB infections. The commonest organism found to cause buckle infections in our study was Staphylococcus sp.
ABSTRACT
Objective: The aim of this study is to characterise the clinical and microbiological profile of adult patients treated at our orthopaedic unit with septic arthritic between 2006 and 2017. Materials and Methods: A total of 70 patients who were admitted with a diagnosis of septic arthritis between 2006 and 2017 were included in the study. The patients' clinical and epidemiological characteristics were surveyed; microbiological profile and the complications relating to the patients' treatment were identified. Results: Septic arthritis was more common among males (83%). About 75% of the patients presented with a history of fever. The knee was the most commonly affected joint (71%), followed by the hip. While C-reactive protein was found to be consistently >75, total blood white blood cell (WBC) counts were found not to be reflective of the presence of infection with a mean WBC count of only 13,561/cu.mm, and Gram stain examination had a poor sensitivity of 47%. Among the co-morbidities, the most prevalent association was with diabetes mellitus. The infectious agent most frequently isolated was Staphylococcus aureus(42.85%). The antibiotic sensitivity pattern has evolved since the early years, with resistant strains becoming increasingly prevalent. Unusually, high incidence of streptococci was noted (30%), contrary to the published literature. One-third of the patients had multi-resistant organisms. Septic arthritis left 70% of the patients with a significant residual disability at 6 months follow-up and had 4.25% mortality. Conclusion: Changing sensitivity patterns of microbes in septic arthritis point to a need for reconsidering empirical antibiotic therapy. Joint damage following infection can lead to significant disability.
ABSTRACT
Background: Prosthetic joint infection (PJI) is one of the most challenging cases that confront modern orthopaedics. Two-stage revision, which is the standard of care for PJI, is the preferred mode of treatment for these infections. Aims and Objectives: To study the microbiological profile of prosthetic joint infections (PJI) in the hip and to assess the efficacy of a two stage revision surgery for PJI. We also aimed to study the sensitivity and specificity of ESR and CRP in the diagnosis of PJI. Materials and Methods: The microbiological profile, clinical and radiological outcomes of 22 patients who had a two-stage revision for PJI of the hip between 2013 and 2017 were retrospectively analysed. PJI was defined using the criteria provided by the International Consensus Statement on PJI 2013. Results: Staphylococcus aureus was found to be the most common organism in PJI. Debridement was successful in removing the organism in 74% of PJI. At the time of re-implantation (second stage), six joints grew organisms that were different from that isolated at the index debridement - coagulase-negative staphylococci (3cases) and enterococci (3cases). Other infection parameters for these patients were negative. None of the patients who had two-stage revision surgery had clinical evidence of reinfection or radiological evidence of loosening at a mean of 2-year follow-up. An ESR cut off of >30mm/hr had a sensitivity of 75% and specificity of 88% in predicting PJI. A CRP >10mg/L had a sensitivity of 75% and specificity of 69%. The sensitivity and specificity of using both ESR and CRP cut-offs in the diagnosis of infection were 57% and 94%, respectively. The positive predictive value was 94% and negative predictive value was 56%. Conclusion: The outcomes of the study justify a two-stage revision arthroplasty for PJI of the hip. The use of ESR and CRP as screening tests for the success of debridement has value - but should be interpreted with caution.
ABSTRACT
Background: Chronic suppurative otitis media (CSOM) is one of the most frequently observed diseases in Otolaryngology practice. The primary objective of the study was to assess the bacteriological and mycological profile in chronic suppurative otitis media among patients visiting a tertiary care hospital in Tamil Nadu. Materials and methods: A total of 268 samples from 200 patients fulfilling the criteria were included. All patients underwent otoscopic examination; Tuning fork test and pure tone audiometry (PTA) were performed. Microbial identification was performed by collecting Aural discharge from the middle ear of each patient by using two sterile swabs. Results: More than half of the patients belonged to 21 to 40 year age group. Only 5.5% of them were aged 20 years and below. Unilateral involvement of CSOM was observed in 66% of the patients with 34% of them affecting both the ears. Microbial assay showed 78% of cases with gram-negative microbial infection while 22% were with gram-positive microbes. Staphylococcus aureus was the commonest gram positive bacteria (90.9%) while Pseudomonas aeruginosa was the most frequent gram-negative microbe. Among fungi, Candida albicans was found in 71.42 patients. V.C. Suresh Chander, A. Kavinkumar. Microbiological profile of chronic suppurative otitis media presenting to a tertiary care teaching hospital - A cross-sectional study. IAIM, 2019; 6(5): 5-11. Page 6 Conclusion: The findings of the study revealed that Staphylococcus aureus and Streptococcus pyogenes were the most prevalent gram-positive bacteria while Pseudomonas aeruginosa and Klebsiella pneumoniae were the commonest CSOM-causing gram-negative microorganisms.
ABSTRACT
Abstract Introduction: Due to the emergence of antibiotic resistance worldwide, the bacterial pathogens and susceptibility patterns causing skin infections should be monitored periodically to alert early intervention. This study aimed to analyse the bacterial profile and their antibiotic susceptibility patterns among the patients with cutaneous infections at Department of Dermatology, Hospital Kuala Lumpur (HKL). Methods: This retrospective analysis analysed the bacterial profile and the antibiotic susceptibility patterns of 1221 positive cultures obtained from skin swabs and biopsy specimens sent from the Department of Dermatology Hospital Kuala Lumpur (HKL) from 2013-2015. Results: Staphylococcus aureus (2/3 methicillin-sensitive, 1/3 methicillin-resistant) was the most frequent isolate (44%), followed by Pseudomonas aeruginosa (17.4%); Acinetobacter sp. (6.7%); Proteus sp. (6.1%); Klebsiella sp. (5.7%), Enterobacter sp. (3.0%), Escherichia coli (2.8%) and others. About 45% and 10% of MRSA was resistant to fucidic acid and mupirocin respectively. About 15% of Pseudomonas aeruginosa was resistant to ciprofloxacin. Majority of Acinetobacter sp. were resistant to most of the common antibiotics used. Conclusion: Staphylococcus aureus remained the main microorganisms isolated from patients with cutaneous bacterial infections. Empirical use of antibiotics prior to availability of culture sensitivity should be avoided for prevention of multi-resistant micro-organisms. We advocate judicious use of antibiotics based on results of the culture sensitivity and strict adherence to infection control measures to prevent development of antibiotic resistance.
ABSTRACT
Background: Nosocomial infections (NIs) in the postoperative period not only increase morbidity and mortality, but also impose a significant economic burden on the health care infrastructure. This retrospective study was undertaken to (a) evaluate the incidence, characteristics, risk factors and outcomes of NIs and (b) identify common microorganisms responsible for infection and their antibiotic resistance profile in our Cardiac Surgical Intensive Care Unit (CSICU). Patients and Methods: After ethics committee approval, the CSICU records of all patients who underwent cardiovascular surgery between January 2013 and December 2014 were reviewed retrospectively. The incidence of NI, distribution of NI sites, types of microorganisms and their antibiotic resistance, length of CSICU stay, and patient‑outcome were determined. Results: Three hundred and nineteen of 6864 patients (4.6%) developed NI after cardiac surgery. Lower respiratory tract infections (LRTIs) accounted for most of the infections (44.2%) followed by surgical‑site infection (SSI, 11.6%), bloodstream infection (BSI, 7.5%), urinary tract infection (UTI, 6.9%) and infections from combined sources (29.8%). Acinetobacter, Klebsiella, Escherichia coli, and Staphylococcus were the most frequent pathogens isolated in patients with LRTI, BSI, UTI, and SSI, respectively. The Gram‑negative bacteria isolated from different sources were found to be highly resistant to commonly used antibiotics. Conclusion: The incidence of NI and sepsis‑related mortality, in our CSICU, was 4.6% and 1.9%, respectively. Lower respiratory tract was the most common site of infection and Gram‑negative bacilli, the most common pathogens after cardiac surgery. Antibiotic resistance was maximum with Acinetobacter spp.
ABSTRACT
Background: Milk is susceptible to contamination by many microorganisms including microbial pathogens responsible for causing diseases. Various processes including pasteurization, boiling or storage under refrigerated conditions are undertaken to minimize the microbial contamination of milk. Objective: This study was undertaken with an objective to evaluate the effect of household practices on the microbiological profile of milk. Materials and Methods: Milk samples of pasteurized, ultra heat treated (UHT) as well as unpasteurized milk (Vendor's milk) were collected. The effect of different storage practices and treatments on the microbiological profile (standard plate count (SPC), coliform, E. coli, Salmonella, Shigella, Staphylococcus aureus, yeast and moulds, anaerobic spore count, and Listeria monocytogenes) of milk was studied using National/ International Standard Test Methods. Results: Average SPC in vendor's milk was found very high as compared to pasteurized milk. Coliform, yeast and moulds, E. coli, and Staphylococcus aureus were detected in the samples of vendor's as well as pasteurized milk. Boiling the milk reduces SPC and kills the other microorganisms. Storage of boiled milk under room temperature or refrigerated condition resulted in a similar increase in SPC at the end of 24 h, but storage of un-boiled milk even under refrigerated conditions increased SPC manifold after 24 h. Conclusion: The pasteurization process and hygienic conditions at the milk processing units along with cold chain of milk from suppliers to end users needs improvement. Currently, even pasteurized milk does not match the microbiological standards. It is recommended that milk should be boiled before consumption and refrigerated for storage to improve its shelf life/keeping quality.
ABSTRACT
Objetivos: Determinar el perfil microbiológico, de los diferentes focos infecciosos aislados, su espectro antibiótico de sensibilidad y resistencia en pacientes de la Unidad de Terapia Intensiva del Hospital Clínico Viedma. Métodos: Estudio de enfoque cuantitativo, retrospectivo y descriptivo, con una muestra de 40 pacientes que presentaron infección nosocomial con cultivos positivos de los distintos focos infecciosos de aislamiento. Resultados: Todos los pacientes (n=40) fueron sujetos a instrumentalización invasiva, La infección nosocomial más predominante es la neumonía adquirida asociada a ventilador, seguida por las infecciones urinarias. Se aislaron la Klebsiella pneumoniae, Pseudomona Aeruginosa, Acinetobacter Baumannii con sensibilidad al Imipenem y resistencia a la ciprofloxacina, en menor frecuencia el Sthaphylococo aureus SAMR., con sensibilidad a la Vancomicina, resistente a cefotaxima. Conclusiones: El 10% de los pacientes que se internaron en la UTI presentaron infección nosocomial, la instrumentalización invasiva, estadías hospitalarias prolongadas son factores predisponentes importantes.
Objectives:To determine the microbiological profile of the various isolated foci of infection, its antibiotic sensitivity spectrum and resistance in patients at the Intensive Care Unit of Hospital Viedma. Methods: A quantitative approach, retrospective and descriptive, with a sample of 40 patients had nosocomial infections with positive cultures of various infectious, isolation. Results: All patients (n = 40) were subjected to invasive instrumentation, the most prevalent nosocomial infection is the ventilator associated acquired pneumonia followed by urinary tract infections. Klebsiella pneumoniae were isolated, Pseudomonas aeruginosa, Acinetobacter baumannii imipenem-sensitive and resistant to ciprofloxacin, less frequently in Sthaphylococo aureus MRSA. Sensitive to Vancomycin, cefotaxime resistance. Conclusions: 10% of patients who were admitted to the ICU had nosocomial infections, in which the invasive instrumentation, prolonged hospitalization are important predisposing factors.