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Background: Urinary tract infection is very commoninfection in the community and hospital and multi drugresistant klebsiella pneumoniae is noted as most alarmingprevalent infecting organism worldwide. The aim was toknow the pattern of susceptibility to antibiotics of klebsiellapneumoniae in urinary tract infection.Materials and methods: In this retrospective cross sectionalstudy morning midstream urine sample of 1550 symptomaticpatients was taken for culture and sensitivity. Only 208patients’ (145 females and 63 males) urine demonstratedgrowth of klebsiella pneumoniae susceptible to differentantibiotics.Results: Out of 208 patients 145 were females (69.71%) and63 males (30.28%). Klebsiella pneumoniae was sensitiveto was highly sensitive to polymyxin (91.82%), colistin(89.42%), Imipenem (88.94%), meropenem (79.32%),ertapenem (75%), moderately sensitive to aminoglycosidegroup (amikacin 59.13%, gentamicin 52.40%, Netilmicin50.96%), piperacillin-tazobactam (53.84%) mildly sensitive totobramycin (49.51%), nitrofurantoin (48.07%), cefoperazonetazobactam (45.67%) levofloxacin (45.19%). Least sensitivedrugs (below 20%) were chloramphenicol, ticarcillin,amoxicillin, amoxicillin-clavulanic acid, cefuroxime,azithromycin, aztreonam, cefoxitin.Conclusion: Since multi-drug resistant klebsiella pneumoniaebecome highly prevalent in the community, so prevention inthe form of health education to the community as well asearly detection of resistance to different antibiotics is veryappropriate to prevent the spread of resistance
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Background: Neonatal sepsis is a major cause of neonatal mortality, accounts for nearly half of all the neonatal deaths in our country. The incidence of neonatal septicemia ranges from 1 to 10 per 1000 live births. In our country the incidence of culture proven neonatal sepsis is 8.6 per 1000 live births, intramural data. Antibiotics are rapidly losing their effectiveness, with some early reports going so far to suggest that we are approaching a post-antibiotic era. Aims of this study was to find out the incidence of culture proven neonatal sepsis and to analyze data collected for mortality and morbidity in culture proven neonatal sepsis and antibiotic sensitivity pattern in culture proven neonatal sepsis at Neonatal Intensive Care Unit of Santokba Durlabhji Memorial Hospital (SDMH), Jaipur.Methods: The study included 129 newborn fulfilling the inclusion criteria, admitted into NICU of SDMH, Jaipur from 01st January 2013 to 31st December 2013, were investigated using various hematological and biochemical test e.g. CBC, Serum CRP, Blood culture and sensitivity, CSF examination includes cell counts, gram staining, biochemistry, culture and sensitivity etc.Results: Overall 722 cases admitted in NICU during the period of one-year 2013. Out of which 129 cases had blood culture proven neonatal sepsis (17.87%). 14.88% cases in P.C.U. and 21.79% cases in I.P.U. had positive blood culture sepsis with statistically significant difference (p value 0.016, <0.05).Conclusions: Antibiotic resistance is an emerging problem requires justified use of antibiotics.
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Background: Urinary tract infection is the second most common bacterial infection seen during pregnancy and is due to the morphological and physiological changes that take place in the genitourinary tract. The pregnant women are two times more commonly affected than age matched non pregnant females and it may lead to less favorable pregnancy outcomes and complications such as premature birth, low birth weight, pyelonephritis, preeclampsia and anemia.Methods: This hospital based cross sectional study was conducted on 350 pregnant women, falling into the inclusion criteria of the study, who attended the antenatal clinic in the Department of Obstetrics and Gynecology at PCMS and RC, Bhopal, irrespective of the gestational age of the cases. The cases found to have asymptomatic bacteriuria were followed till delivery and any adverse antenatal or perinatal outcome was noted.Results: The study was conducted with the aim to know the prevalence of asymptomatic bacteriuria and the obstetrical outcome in pregnant women. The prevalence of asymptomatic bacteriuria was 13% and it was common in the age group of 21-25 years, in primigravidas and with period of gestation less than 12 weeks. E. coli was found to be the commonest causative organism. Asymptomatic bacteriuria was found significantly associated with the presence of anemia. Maternal morbidity in terms of pre term labour was higher in cases with asymptomatic bacteriuria.Conclusions: Urine culture and sensitivity should be done as a routine investigation to screen the patients for asymptomatic bacteriuria and to prevent adverse maternal and fetal outcomes.
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Cholecystectomy is currently a frequent performed operation. The presence of gallstones within either the gallbladder or biliary tree is associated with the bacterial colonization of the bile. Acute cholangitis spans a continuous clinical spectrum and can progress from a local biliary infection to advanced disease with sepsis and multiple organ dysfunction syndrome. Therefore, it is important to know the microbiological flora of the gallbladder before prophylactic antibiotics are given. Aim and objectives: 1.To evaluate the bacteriological profile of bile in patients undergoing cholecystectomy. 2. To determine the appropriate antibiotics for prophylaxis in cholecystectomy patients based on the bacteriological profile of bile in our study. Methods: The study was a prospective study carried out in Guru Nanak Dev Hospital, Amritsar. A total of 100 patients undergone cholecystectomy who met the inclusion criteria were included in the study. Bile was aspirated from all patients, this collected bile from gallbladder was transported to the Microbiology Department in 5cc sterile syringe. The specimen was evaluated to find out whether it is sterile or has any bacteria present. Sensitivity of isolated organisms was done against antibiotics. Results: 25 patients showed positive bile culture (25%), whereas bile was sterile in 75 patients (75%). E.Coli was the most common isolated bacteria (60%) followed by Enterococcus (20%), Staph Aureus (8%), Salmonella (8%) and Pseudomonas (4%). Postoperative wound infection was more common (20%) in group of patients with isolated organisms from bile. Conclusion: 25% of bile samples were culture positive. E coli was the most common aerobic bacteria to be isolated from the bile culture . E. coli, salmonella and pseudomonas were most sensitive to piperacillin + tazobactum and imipenum (100%). E. coli also showed sensitivity to amikacin and gentamicin (73.33% each). Enterococcus was most sensitive to linezolid and ampicillin + salbactum (100%) followed by gentamicin and amoxicillin + clavulanate (80% each). Staphylococcus was most sensitive to linezolid (100%). Antimicrobial susceptibility of potential causative organisms and the local susceptibility pattern must be taken into consideration when prescribing drugs to patients with biliary disease.
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Introduction: Incidence of Blood stream infection (BSI) is onthe rise and so is the increasing drug resistance amongdifferent organisms causing BSI. The trend of such infectionand the antibiotic sensitivity pattern may vary from region toregion.Materials and Methods: This study was conducted with thesame aim in which about 240 blood culture and sensitivityresults were noted from the records and were analysed to seethe current trend in this region. Our focus was mainly on Gramnegative organisms, as they have been found to causeincreased number of BSI.Results: Escherichia coli was the main Gram negativeorganism, and Staphylococcus aureus along with Coagulasenegative Staphylococcus (CoNS) were the main gram positiveorganisms isolated. Candida albicans was also found in four ofthe cases. The antibiotic sensitivity pattern of gram negativeisolates showed more than 90% susceptibility to higherantibiotics, whereas the susceptibility to other antibiotics werefound to be variable.Conclusion: E. coli is the main GNB causing the infectionfollowed by K. pneumoniae and P. aeruginosa. Increasingtrend of drug resistance is being noted by GNBs against mostcommonly used antibiotics.
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Introduction: One of the documented leading cause ofblindness in India is cataract as many patients with cataract donot have access to hospitals and surgery and to avoid blindnessdue to cataract, the only remedy is to perform hospital basedcataract surgery on a large scale. There is an increase in anumber of cataract patients due to improved quality of life,health indices and increased life expectancy. Study aimedto see the visual outcome and complications among patientsundergone manual SICS with PC-IOL implantation.Material and Methods: The present prospectiveobservational study was conducted on 72 patients who wereselected in various screening eye camps to undergo cataractextraction surgery by manual small incision cataract surgerytechnique with posterior chamber IOL implantation (MSICSwith PC-IOL).Results: Total of 72 eyes of patients who underwent manualsmall incision cataract surgery were studied. Best correctedpreoperative visual acuity of ≥ 6/60 was found in 13 patientswhile postoperatively on day1 total of 60 patients had visualacuity of ≥ 6/60. The final 6th week postoperative bestcorrected visual acuity of 6/12-6/9 was found in 65 patients.Iris prolapse was seen in 3 patients followed by posteriorcapsule rent which was seen in 2 patients. Mild postoperativeuveitis was seen in 20 followed by striate keratopathy in 8patients while hyphaema was seen in 2 patients.Conclusion: MSICS is a safe and effective procedure, due toits low rates of intraoperative and postoperative complicationswhich are easily treatable. Visual acuity is only one measureof the functional success of cataract surgery and the goodpostoperative visual outcomes achieved by our patientsfurther adds on to its benefits as a good surgical technique.MSICS can be performed as procedure of choice for largevolume cataract surgeries
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Background: Currently there is a rise in resistance to anti-microbials which is a matter of concern in treatment of systemic infections. Blood culture is considered “gold standard” in diagnosis of suspected systemic infection. The susceptibility to antibiotics thereafter determine the future course of treatment. The current study aims to find out the sensitivity and resistance pattern of the blood culture isolates.Methods: A cross-sectional study was performed on the blood culture samples sent within 24hours of admission of the adult patients reporting fever for 7 days or more with no history of consumption of any antibiotics within last month. Total 134 blood samples were analysed. The proportion of sensitivity and resistance to anti-bacterial agents was calculated among those samples which showed growth in the culture. Background information of the patients in terms of age, sex and religion were also noted.Results: Mean age of the patients was 39.33 (±12.19) years. Overall 47.76% were female patients and remaining were male. Among the Hindu patients majority were male while among Muslims majority were female. Of the total number of blood cultures examined 46.27% showed growth of bacteria. Staphylococcus aureus was the most frequently found bacteria isolated in cultures, followed by coagulase negative Staphylococcus and Pseudomonas. Of the frequently used antibiotics, higher sensitivity was seen with vancomycin, amikacin, netilmycin, imipenem, gentamicin. High resistance was observed in use of antibiotics like cefixime, amoxicillin-clavulanic acid and azithromycin.Conclusions: High level of resistance to several commonly used advanced antibiotics warrant judicial and evidence-based use of these drugs.
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Background: Aerobic bacteria are the major cause of pyogenic infections characterized by local and systemic inflammation and pus formation. Different studies show that bacterial profile of pus samples and their antimicrobial sensitivity pattern shows many variations. Emergence of antimicrobial drug resistance has made the treatment of pyogenic infections difficult. Pus culture and sensitivity testing done prior to start antibiotic therapy help in right approach towards selection of antibiotic and treatment. Methods: A study was conducted in Department of Microbiology of a private tertiary care hospital in Udaipur, Rajasthan from August 2017 to January 2018. Total of 240 pus samples were analyzed for aerobic culture and sensitivity. Processing and identification was done as per standard guidelines. Antibiotic sensitivity testing was performed by Kirby Baur disc diffusion method. Results: In our study, out of 240 pus samples sent from various departments, 160 (66.6%) were positive for bacterial growth. Commonest isolate was Staphylococcus aureus, followed by Pseudomonas species, E. coli, Klebsiella species, Enterococcus species, either alone or in mixed growth. All Staphylococcus aureus were sensitive to Vancomycin and Linezolid. For Pseudomonas species, effective drugs were piperacillin-tazobactem and polymyxin B; for enterobacteriacae, most effective drug was meropenem. Conclusion: It is of utmost importance for a clinician to send the pus sample for microbiological analysis and antibiotic sensitivity testing before starting antibiotic therapy to minimize the emergence of drug resistance.
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Background: The battle against micro-organisms, in their role as primary cause of the disease and infective complications of medical and surgical techniques, has not decreased in spite of modern antimicrobial therapy. Chronic suppurative otitis media (CSOM) is a disease with worldwide prevalence having potentially serious long term effects. The disease remains an important global public health problem leading to hearing impairment, and due to wide spread irrational use microbial resistance is very common to these antibiotics, thereby leading to treatment failure. Hence it is important to know the type of bacteria and their sensitivity pattern so that appropriate antibiotics may be given for treatment and prevention of complications.Methods: 428 patients of otitis media were enrolled from ENT OPD of Tertiary Care Hospital. Ear swab was taken from diagnosed cases of CSOM and culture and sensitivity were done.Results: The microbiology of the swab showed no growth in (25.4%) of samples. Staphylococcus aureus (26%) and Pseudomonas (25%) were the main organisms isolated. Staphylococcus aureus isolated was sensitive to vancomycin, clindamycin, cefixime, gentamicin and cefipime in descending order. Pseudomonas aeruginosa was sensitive to ceftazidime, imipenem, piperacillin, gentamicin, cefipime. In the present study Staph. aureus and Pseudomonas were the predominant bacteria, it is suggested to undertake a gram staining in all patients. If gram positive organisms are isolated it is suggested that presumptive treatment should be directed against Staphylococcus aureus and if gram negative then against Pseudomonas aeruginosa. Such a treatment is not only likely to be effective but will also go a long way in preventing emergence of drug resistance.Conclusions: The antimicrobial therapy should be based on locally determined microbiological isolates and local sensitivity patterns to a particular antimicrobial agent. The presumptive antimicrobial therapy should therefore be directed against these organisms.
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OBJECTIVE@#Treatment of prostatitis continues to be a challenge. The authors evaluated the culture andsensitivity of expressed prostate secretion of patients with bacterial prostatitis in the local setting.@*MATERIALS AND METHODS@#All patients who were suspected to have prostatitis underwent expressedprostate secretion cultures. All positive cultures were then included in the study.@*RESULTS@#One hundred six (106) culture positive examinations were included in the study.Staphylococcus species were the most common organisms at 55% (59/106), followed by Enterococcusspecies at 17% (19/106). Over-all, Vancomycin was still the antibiotic the organisms were mostsensitive to among all the antimicrobials regardless of organism cultured at 69% (74/106) followedby Ciprofloxacin at 43% (46/106).@*CONCLUSION@#The study showed some discrepancy with current known epidemiological studies on theincidence of the organisms causing bacterial prostatitis. It also showed that the current most commonlyused antimicrobial agent (fluroquinolone) may have a high resistance rate that is not acceptable as anempiric treatment hence the investigators recommend at least the use of expressed prostate secretionculture study as guide for the management of prostatitis.
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Aims and objectives: To identify the prevalence of bacteremia and the spectrum of antimicrobial sensitivity in our community, because it will guide the clinician to institute proper antimicrobial therapy. Background: Bacteremia originates from either intravascular sites or extraVascular sites. In case of bloodstream infection, either Gram-positive or Gram-negative bacteria are responsible. Of these bacterial isolates, Gram-negative bacteria are responsible for higher mortality and morbidity. Since 20 to 30 years, coagulase-negative Staphylococci are responsible for most infection. Materials and methods: In this retrospective study, blood samples were collected aseptically from 11,581 patients and were injected into the bottles containing bile-broth and brainheart infusion broth and allowed to be incubated at 37°. Then subculture was done on blood agar, chocolate agar, as well as MacConkey agar media and was kept for 7 days or till the appearance of growth of the organism. After identification of isolates, Kirby Bauer disk diffusion test on Mueller-Hinton agar II was performed to detect antimicrobial sensitivity. Results: Our study documented 8.58% positive cultures in the last 7 years. Gram-negative bacterial isolates were significantly higher than Gram-positive isolates (64.19% vs 34.80%, p = 0.00). Lowest number of positivity was seen in Morganella (0.40%) followed by Proteus (0.50%) and Enterococcus faecium (0.90%) in ascending order. Males were significantly more culture positive than females (549/994 vs 445/994, p = 0.00). Most common bacterial isolates were (coagulase negative Staphylococci) CoNS (239, 24.04%) followed by Klebsiella including ESBL (extended spectrum beta-lactamase), carbapenamase producer (234, 23.74%) and Escherichia coli (110, 11.06%). E. coli was >75% sensitive to imipenem group, polymyxin B (98.18%), colistin (96.36%), and amikacin (80.9%). Coagulase negativeStaphylococci showed more than 60% sensitivity to levofloxacin (76.98%), amikacin (82.84%), tigecycline (87.44%), vancomycin (94.45%), teicoplanin (91.63%), linezolid (91.21%), gentamicin (76.56%), netilmicin (74.47%), and tetracycline (75.31%). Klebsiella (non-ESBL and carbapenemase producer) was highly sensitive to polymyxin B (93.06%), colistin (91.90%), meropenem (65.31%), and imipenem (94.73%). Extended spectrum beta-lactamase-producing Klebsiella showed increased sensitivity to meropenem (89.47%), imipenem (94.73%), ertapenem (81.57%), polymyxin B, and colistin (97.36% each). Conclusion: Positive cultures were 8.58% in the last 7 years. Gram negative bacterial isolates were significantly higher. Males were more culture positive. Most common bacterial isolates were CoNS followed by Klebsiella species and E. coli. Gram-negative bacterial isolates were highly sensitive to piperacillin, cefoperazone, imipenem, meropenem, aminoglycoside group of antibiotics, tigecycline, polymyxin B and colistin. Gram-positive bacterial isolates were sensitive to piperacillin, cefoparazone, vancomycin, teicoplanin, linezolid and clindamycin. Salmonella typhi were sensitive to ampicillin, cefoparazone, cefepime, azithromycin, chloramphenicol, and fluoroquinolones. Acinetobacter showed > 50% sensitivity to cefepime and Pseudomonas showed > 50% sensitivity to cefotaxime and levofloxacin. So to prevent resistance of bacterial isolates, a proper antibiotic guideline should be maintained.
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Background: Resistant bacteria are emerging worldwide as a threat to the favourable outcome of common infections in community and hospital settings. Extended Spectrum Beta-Lactamases (ESBLs), AmpC β lactamases and Metallo-β Lactamases (MBL) are the three important mechanism of resistance to beta lactam drugs in the bacteria. The objective of the study was to screen gram negative isolates for co-expression of extended spectrum β-lactamase, Amp C β-lactamase and Metallo β-lactamase production. Methods: In this study 50 (27 male & 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Seven hundred and six isolates from various clinical samples from Kamineni institute of medical sciences Hospital, Narketpally, were processed during the period of October 2010 to September 2012. Gram negative bacilli were identified by colony morphology, gram stain, motility, enzyme detection tests, etc. ESBL detection was carried but by two procedures like double disc synergy tests (DDST) and phenotypic confirmatory disc diffusion test (PCDDT). AmpC Beta-lactamase detection was done by AmpC Disc Test. MBL production was tested by Imipenem-EDTA combined disc test. Conclusions: Klebsiella was the commonest isolate (28.47%) followed by E coli (26.48%), Pseudomonas aeruginosa (19.54%), Enterobacter (8.92%), Acinetobacter (8.92%) and Citrobacter (7.64%). A total of 272 out of 706 gram negative isolates were ESBL producers. ESBL production was seen more in E. coli followed by Klebsiella and P. aeruginosa. A total of 73 out of 706 isolates were inducible Amp C producers. AmpC production was seen more in Acinetobacter. A total of 65 out of 706 isolates were MBL producers. MBL Production was seen more in E. coli.
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Diabetic foot infections make up a significant number of orthopaedic ward admissions. The recommended choice of empirical antibiotics used in Malaysia for diabetic foot infections is based on the National Antibiotic Guidelines 2008. The pattern of bacteriology and the effectiveness of the treatment of diabetic foot infections based on this guideline were analyzed through a retrospective study in our hospital. Data over a period of one year (May 2012- April 2013) was analyzed, and 96 patients were included in this study. Polymicrobial growth (58%) was mainly isolated, followed with an almost equal percentage of gram-negative (22%) and gram-positive organisms (20%). The empirical antibiotics based on the national antibiotic guidelines were used as definitive antibiotics in 85% of the cases. Although there was slight variation in the pattern of organisms as compared to other studies conducted in this country, the high rate of positive clinical response proved that the antibiotic guideline was still effective in diabetic foot infection treatment.
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This cross sectional study was carried out at Bangabandhu Sheikh Mujib Medical University (BSMMU) and International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from July 2008 to September 2009. Aim of the study was to find out the antimicrobial susceptibility profile of Helicobacter pylori isolates from dyspeptic patients. Total 224 dyspeptic patients from Out Patient Department (OPD) of BSMMU were initially enrolled after informed written consent. After upper GI endoscopy 157 patients were finally included who had erosions, ulcers or atrophic changes in the stomach or duodenum. Two biopsy samples were taken from each of them. Samples were incubated at 370C in a double gas incubator with 5%O2, 10%CO2 and 85%N2. Total 82 (52.23%) samples were found positive for H. pylori. Isolated organisms were then tested for sensitivity to Amoxicillin, Clarithromycin, Tetracycline, Levofloxacin and Metronidazole by Agar dilution method. Among 82 patients 51(62.2%) were male and 31(37.8) were female with a male:female ratio 1.6:1. Patients were categorized into two groups one having gastric or duodenal ulcer (30.5%) and other having no ulcer (69.5%). Among these isolates 92.7% were sensitive to Amoxicillin, 89% to Clarithromycin, 81.7% to Tetracycline, 80.5% to Levofloxacin and only 26.8% to Metronidazole. Beside these, 81.7% isolates were sensitive to both Amoxicillin and Clarithromycin, 74.4% to Amoxicillin and Tetracycline, 73.2% to Amoxicillin and Levofloxacin, 72% to Clarithromycin and Tetracycline, 59% to Clarithromycin and Levofloxacin and 51% to Tetracycline and Levofloxacin.
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Objective To analysis the infective case of Ureaplasma urealyticum(Uu)in women pregnancy system,in order to get evidence from medicine sensitive test in UU infection case.Method Use fluorescent quantitative PCR(FQ-PCR)to detect,then provide the medicine according UU-DNA value.After half month,apply the pills the patients stop medicine for 10 days to examine culture and sensitivity test.The positive patients is applied the medicine for half month,examine the UU-DNA after stopping medicine 10 days.Results After one treatment course,51.6% patients turn into negative in culture test.48.4% positive patients turn into negative after one medicine treatment course according to medicine sensitive result.Conclusion The FQ-PCR technique with culture and sensitivity test detect and treat infective case of UU combine is useful to clinical practice.
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PURPOSE: Recently, Staphylococcus aureus has been reported as the principal microorganism isolated from impetigo, showing variable degrees of antimicrobial resistance. The aim of this work was to study the causative organism of impetigo the their antimicrobial susceptibility developed in impetigo in the past four years. METHODS: We performed bacterial cultures and antimicrobial susceptibility tests in 73 patients with impetigo who visited the Department of Dermatology and Pediatrics at St. Paul's Hospital of the Catholic University of Korea in Seoul. RESULTS: Of 73 patients, microorganisms were identified in 70 patients between May 1995 and August 1999. Staphylococcus aureus was isolated from 63 (90%) patients. Antimicrobial susceptibility test for Staphylococcus aureus revealed low resistance to bactrim (0.0%), rifampicin (0.0%), van- comycin (3.2%), ceftriaxone (4.0%), imipenem (5.4%), ampicillin-clavulanic acid (6.1%), oxacillin (8.1%), cephazolin(9.1%), cephalothin (9.7%) and cefotaxime (10.8%). However, Staphylococcus aureus had high resistance to erythromycin (65.7%) and gentamicin(85.5%). Thirty-six (57.1%) strains of isolated Staphylococcus aureus showed resistance to more than one drug, including two strains (3.1%) resistant to more than 10 drugs. CONCLUSION: Staphylococcus aureus was the most common cause of impetigo developed in the pa- st four years. It was susceptible to most antimicrobial agents except erythromycin and gentamicin, and methicillin resistance was not strong in our results.