Antimicrobial Resistance Pattern of Bacterial Isolates from Endotracheal Aspirate of Ventilated Patients at a Tertiary Care Hospital

Background: Respiratory infections among critically ill Patient are associated with high morbidity and mortality. Mechanically ventilated patients are at a high risk of acquiring respiratory infections due to complex interplay between the endotracheal tube, host immunity and virulence of invading bacteria. Irrational use of antibiotics increases the emergence of drug – resistant bacteria. Objectives: The aim of study was to investigate the bacterial isolates in the endotracheal aspirates of mechanically ventilated patients in ICU and see the antimicrobial resistance pattern of bacterial isolates. Methods: Analysis of E.T aspirates of 459 patients over a period of 1 year (Aug 14 to Aug 15) was done. Aspirates were cultured on Blood and MacConkey agar isolation and identification was done using conventional techniques and biochemical reactions. Antibiotic sensitivity testing was done by Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: Out of 459 Samples 365 was found to be positive. Acinetobacter sp (44.65%) was the most common isolate followed by Klebsiella sp (18.63%), Pseudomonas sp (11.23%), Candida (10.46%), Escherichia Coli (7.94%), COPS (3.28%), CONS (2.46%), Enterococci (0.82%), and Citrobacter (0.54%). The gram-negative bacilli were mostly sensitive to Tigecycline, Colistin, Imipenem, Meropenem, Amikacin and Piperacillin/Tazobactam. Gram positive Cocci were mostly sensitive to Vancomycin, Linezolid and Gentamicin. Conclusion: The isolation and antimicrobial resistance pattern of the microorganisms is necessary for their effective management. Endotracheal intubation is one of the major risk factors in causing iatrogenic infections to patients. A local antibiogram for each hospital, based on bacteriological patterns and susceptibility is essential to initiate empirical therapy.

Distribution and antimicrobial resistance of the bacterial strains isolated from lower respiratory tract in children / 中国感染与化疗杂志

Objective To study the distribution and antimicrobial resistance of the bacterial strains isolated from lower respiratory tract in children,to provide evidence for better clinical management.Methods The medical data of children (0-5 years of age) with lower respiratory tract infection were retrospectively reviewed.The children were treated during the period from September 2014 to September 2016.Results Of the 4815 sputum samples collected from the lower respiratory tract of children,1582 (32.86％) had a positive bacterial culture.A total of 1614 strains of pathogens were identified.The most common bacterial pathogen was Haemophilus influenzae (9.66％),followed by Streptococcus pneumoniae (7.12％) and Moraxella catarrhalis (5.15％).The bacterial detection rate varied greatly with season and the age of children (P＜0.01).H.influenzae,M.catarrhalis and S.pneumoniae isolates showed lower resistance rate to cefotaxime,all ＜20.0％.Escherichia coli and Klebsiella pneumoniae isolates showed lower resistance rate to cefotetan,imipenem and piperacillin tazobactam,all ＜ 10％.Less than 20％ of the S.aureus strains were resistant to oxacillin.Conclusions H.influenzae is the most frequently isolated pathogen from lower respiratory tract in children aged 0 to 5 years in Neijiang Sichuan Province,followed by S.pneumoniae and M.catarrhalis.The detection rate of bacterial pathogens varies with season and the age of children.Antimicrobial agents should be selected rationally based on the results of antimicrobial susceptibility testing to reduce the occurrence of antibiotic resistance in clinical pathogens.

Distribution and antimicrobial resistance profile of the bacterial strains from lower respiratory tract / 中国感染与化疗杂志

Objective To examine the distribution and antibiotic resistance proifle of the bacterial isolates from lower respiratory tract of hospitalized patients for better empirical therapy.Methods A total of 3 155 lower respiratory tract specimens were collected from Respiratory Department of the First Afifliated Hospital of Chongqing Medical University in 2013 to identify bacterial pathogens for susceptibility testing. The results were compared with the data of 2011 and 2012.Results The top three bacterial species from lower respiratory tract in the period from 2011 to 2013 wereA. baumannii,P. aeruginosa, andK. pneumoniae. The prevalence ofS. aureusincreased, while the prevalence ofS. maltophilia andS. pneumoniae was still low.A. baumannii isolates were highly resistant to antibiotics. Not more than 40% of these strains were susceptible to the antimicrobial agents except minocycline, which was active against more than 60% of the ICU and non-ICU strains. More than 70% of theP. aeruginosa strains from non-ICU were susceptible to cefepime, meropenem, imipenem, levofloxacin, and ciprofloxacin in the three years, 50%-70% of the strains from ICU were susceptible to the antimicrobial agents tested. Carbapenem-resistantA. baumannii andP. aeruginosa strains were identiifed.S. maltophilia strains were relatively susceptible to minocycline and levolfoxacin. All the S. aureus isolates were susceptible to vancomycin, linezolid, and tigecycline. The prevalence of MRSA increased year by year. More than 80% of theK. pneumoniae andE. coli strains were susceptible to imipenem, piperacillin-tazobactam, and cefepime. ESBLs-producingK. pneumoniae was identified. More than 85% of theH. influenzae strains were susceptible to meropenem, ceftazidime, cefuroxime, ciprolfoxacin, levolfoxacin, and amoxicillin-clavulanate potassium. All theS. pneumoniae isolates were susceptible to vancomycin, and 80%-96% of these strains were susceptible to levofloxacin and penicillin.ConclusionsA. baumannii,P. aeruginosa, andK. pneumoniae are the top three bacterial species isolated from lower respiratory tract. Carbapenem-resistantA. baumannii,P. aeruginosa and ESBLs-producingK. pneumoniaeare emerging. The prevalence of MRSA is increasing year by year, which poses a challenge to antimicrobial therapy. It is urgent to contain and control the growing antibiotic resistance.

Antibiotic Sensitivity and Spectrum of Bacterial Isolates in Otorhinolaryngological Infection: A Retrospective Study

Objectives: To identify the common bacteria of otorhinolaryngological (ORL) infection in three general hospitals in the state of Sarawak, East Malaysia and to determine the antibiotic sensitivity of the common bacteria to update local antibiotic policy. Methods: All specimens with positive monoclonal culture, received from inpatient and outpatient Otorhinolaryngology Department in the year 2009 and 2010 were included in the study. Patients’ demographics, nature of specimens, bacterial isolates and antibiotic sensitivity were analysed by using the Statistical Package for the Social Sciences (SPSS). Results: A total 244 positive monoclonal cultures were identified. Staphylococcus species and Gram negative bacilli were the commonest bacteria of ORL infections. Common ORL bacteria remain sensitive to our front line antibiotics. There are a number of multi-drug resistant isolates of MRSA, ESBL Klebsiella pneumoniae and Acinetobacter baumanii in the hospital-acquired infections. Conclusion: Although resistance to antimicrobial agents is growing worldwide, first line antibiotics still show significant therapeutic advantage in our local setting. The low resistance of bacterial isolates in our community reflects judicious use of antibiotics in our routine clinical practices.

Diagnostico Etiológico en Enfermedades Infecciosas

Background: The finding of a disease etiology is achieved through a wide range of laboratory tests with different sensitivity and specificity, and also subject to the availability in time and space to carry them. The most requested laboratory samples in infectious diseases are growing and cytochemical analysis of body fluids. We studied 300 medical records of patients admitted to the Adult Infectious Disease Service of the Institute of Tropical Medicine from January to November 2010, of which: 37.3% were respiratory infections, gastrointestinal infections and 34.3% 28 4% CNS infections. Ratio F: M 1:1.29 (56% F). The microbiological diagnosis was positive in 32%, 28% and 27% of patients with diseases of the respiratory Rev, Rev Gastrointestinal and CNS involvement, respectively, and the most common germs S. pneumoniae, C. and C. parvum neoformans in the order listed previously

El hallazgo etiológico de una enfermedad se logra gracias a una amplia gama de exámenes laboratoriales con diferentes valores de sensibilidad y especificidad, y también condicionados a la disponibilidad en el tiempo y espacio para la realización de los mismos. Las muestras de laboratorio más solicitadas en patologías infecciosas son: cultivo y análisis citoquímico de fluidos corporales. Se estudiaron 300 historias clínicas de pacientes internados en el Servicio de Infectología de Adultos del Instituto de Medicina Tropical de enero a noviembre del año 2010, de los cuales: 37,3 % correspondieron a infecciones respiratorias; 34,3% infecciones gastrointestinales y 28,4% infecciones del SNC. Relación F:M 1:1,29 (56% F). El diagnóstico microbiológico fue positivo en 32%, 28% y 27% de los pacientes con patologías del Ap. respiratorio, Ap. Gastrointestinal y con afectación del SNC respectivamente, y los gérmenes más frecuentes S. pneumoniae, C. parvum y C. neoformans en el orden citado previamente.

Clinicobacteriological Significance in Congenital Dacryocystitis.

In the present study, 37 eyes of 30 congenital dacryocystitis patients (7 bilateral) were studied, out of which 60% of patients were male and 40% female. Gram positive cocci constituted the major bacterial isolate (56.7%) with Streptococcus pneumoniae (27.9%) predominating. Most effective antibiotics against the commonest organism Streptococcus pneumoniae were Tobramycin and Gentamycin showing 100% effectivity. Staphylococcus albus 17.4% was the most common normal conjunctival commensal isolated.