Bacteriological Profile and Antibiotic Susceptibility Patterns in Neonatal Septicaemia in Tertiary Care Hospital

Introduction: Neonatal septicaemia has great role in morbidityand mortality among neonates. Neonatal mortality rate hasbeen reported in India as 17 per 1000 live births as per 2016-17 data. Neonatal septicaemia may be of early onset or lateonset depending of the age of the neonates. The mostcommon bacterial agents involved are Group B Streptococcus,Klebsiella pneumoniae, CoNS, Streptococcus pneumoniae,Haemophilus influenzae etc. Diagnosis is done by manymethods but the most important and absolute mode ofdiagnosis is blood culture.Aims and Objectives: The present study is done for thedetection of bacteriological profile and their antibioticsusceptibility pattern in case of neonatal septicaemia. Earlydiagnosis and specific treatment can save the lives of manyneonates who are suffering from neonatal septicaemia.Materials and Methods: The material used for the diagnosis isvenous blood of the suspected neonates. Blood culture methodis used for the diagnosis of Neonatal septicaemia. Repeatedsubculture is done on Blood agar, Nutrient agar, andMacConkey agar plates. Confirmation of organism is donethrough different biochemical tests. The antibiotic susceptibilitytesting was performed on Muller Hinton agar (MHA) by KirbyBauer disc diffusion method for bacterial isolates, as perclinical and laboratory standards institute (CLSI) guideline.Results: Total 206 cases of suspected neonatal septicaemiawere investigated in which 142 cases are found positive. Mostcommon organism isolated was Klebsiella pneumoniae(39.44%) than Staphylococcus aureus (33.8%), otherorganisms are Escherichia coli (9.86%), CoNS (8.48%),Pseudomonas (5.63%), Enterococcus (2.82%) etc. overallincidence of Gram negative organism (54.93%) was more thanGram positive organism (45.07%). As far as antibioticsensitivity pattern was concerned most of the organism were100% sensitive to imipenem, meropenem and colistin B andresistant to Ampicillin.Conclusion: Gram negative isolates were more common thanGram positive as the causative agents of neonatal sepsis. Themost common causative organism was Klebsiella pneumoniae.The other organisms isolated were Pseudomonas aeruginosa,Staphylococcus aureus, CoNS, etc. Most of the Gram negativeisolates were sensitive to Amikacin, Gentamycin, Ofloxacin andCiprofloxacin but were highly susceptible to Meropenem,Imipenem and Collistin-B. The Gram positive isolates werebetter sensitive to Amikacin, Cephalosporin, Ciprofloxacin andClindamycin but were less sensitive or resistant to Ampicillinand Erythromycin. They showed high susceptibility toTicoplanim, Linezolid, Vancomycin and Methicillin.

Introduction of Clinical and Laboratory Standards Institute Antibiotic Susceptibility Testing Subcommittee Meeting / 대한임상미생물학회지

Laboratory medicine is a specialized division that supports physicians in the care of patients by providing rapid and accurate in vitro diagnostic tests. Standardization of every component of a specific test is essential for producing accurate results. The Clinical and Laboratory Standards Institute (CLSI) was founded to develop a formal consensus process for standardization in 1968, and has been publishing standards and guidelines covering all aspects of clinical, research, and other laboratory work. CLSI guidelines are widely used around the world for standardization. The CLSI antimicrobial susceptibility testing subcommittee (AST SC) consists of 6 standing and many ad hoc working groups. Members of the AST SC review submitted proposals and suggestions, decide on approving these submissions in face-to-face meetings held twice a year, and revise CLSI documents accordingly. As these face-to-face meetings are open to anyone who registers to attend, I strongly encourage the members of our Society to attend and actively participate in document development.

Drug susceptibility of rapid and slow growing non‑tuberculous mycobacteria isolated from symptomatics for pulmonary tuberculosis, Central India.

Background: Non‑tuberculous mycobacteria (NTM) are emerging as important pathogens. Their treatment also differs from that of Mycobacterium tuberculosis. In India, any datum on them is scarce as species identification and drug susceptibility are not performed in most laboratories. Susceptibility also differs from one geographic area to another, and in our country, there are no data even to guide the clinicians to start treatment empirically. Methodology: The present study endeavours to generate drug susceptibility data on NTM isolated from sputum samples collected and stored from 6445 symptomatics for pulmonary tuberculosis during a prevalence survey and from specimens received from the hospital. Isolates were not necessarily associated with the disease. Species were identified and antibiotic susceptibility was performed using micro‑broth dilution technique as per the standard Clinical and Laboratory Standards Institute guidelines. Results: A total of 65 NTM with 11 species were identified, of which 27 belonged to Mycobacterium fortuitum complex, 14 Mycobacterium gordonae, 9 Mycobacterium avium, 7 Mycobacterium flavescens, 4 Mycobacterium scrofulaceum and one each of others. Sensitivity to amikacin for M. fortuitum was 95.22% (20 out of 21), followed by ciprofloxacin (76.19%) and clarithromycin (71.42%). All the 9 M. avium isolates, 11 of M. gordonae (78.57%), 5 of M. flavescens and 2 of M. scrofulaceum were sensitive to clarithromycin. All NTM were resistant to first‑line antitubercular drugs except 8, which were sensitive to streptomycin. Conclusions: Drug sensitivity of NTM varies from species to species. While amikacin was the best for rapidly growing mycobacteria, clarithromycin was the most active drug against M. avium and other slow growers.

Veracidad de un analizador de gasometria para determinar glucemia, respecto a un metodo de laboratorio convencional / Reliability of a gas analyzer to determine glycemia compared to the conventional laboratory method

Objetivos:Determinar el grado de veracidad en los resultados de glucosa, medidos en un equipo de gasometría, mediante lacomparación con un procedimiento de uso habitual en el laboratorio, siguiendo el procedimiento indicado en la guía EP9–A2 delClinical and Laboratory Standards Institute(CLSI).Diseño:Estudio descriptivo con muestreo no probabilístico.Institución:HospitalEdgardo Rebagliati Martins, EsSalud, Lima, Perú.Material:Muestra sanguínea de 234 sujetos provenientes de los servicios deemergencia y la unidad de cuidados intensivos.Métodos:Se procesó glucemia en los equipos ADVIA1800 y el gasómetro ABL800.Se comparó los resultados de ambos analizadores siguiendo las directrices de la mencionada guía, además del análisis gráfico deBland-Altman y el cálculo del coeficiente de concordancia correlación (CCC) de Lin.Principales medidas de resultados:Concentraciónde glucosa sérica.Resultados:La media de glucemia obtenida fue 1,6 mg/dL mayor para ABL800 que para el ADVIA1800. Los dosmétodos de medida seguían una relación lineal, obteniéndose un coeficiente de correlación de 0,9995, con un intervalo de confianza(IC) al 95% de 0,9994a 0,9996. Los resultados de glucosa del método de estudio fueron aceptables según los requerimientos decalidad, lo cual se confirmó con los análisis estadísticos de Bland-Altman y el valor del CCCL de 0,9995, con un IC de 95% de 0,9993a 0,9996.Conclusiones:El analizador ABL800 resultó adecuado para la monitorización de glucemia; presentó una buena asociaciónlineal y veraz, cuando fue comparado con el método de referencia del laboratorio.

Objectives: To determine the glucose reliability results measured in a gas equipment as compared with a reference method commonly used in the laboratory. The Clinical and Laboratory Standards Institute (CLSI) guide EP9- A2 instructions were followed. Design: Descriptive study with non-probability sampling. Setting: Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Peru. Materials: Blood sample of 234 subjects from the emergency services and intensive care unit. Methods: Blood glucose was processed with the ADVIA1800 equipment and the ABL800 gasometer. Results of both analyzers were compared following the mentioned guide directives, the Bland-Altman plot analysis and the Lin’s concordance correlation coefficient (CCC) calculation. Main outcome measures: Serum glucose concentration. Results: Average blood glucose levels obtained were 1.6 mg/dL higher for ABL800 than for ADVIA1800. Both methods showed a high positive correlation (beta coefficient 0.9995 and 95 per cent, 95 per cent CI 0.9994 to 0.9996). Glucose results for the method studied were acceptable, as confirmed with the Bland-Altman statistical analysis (0.9995 CCC value, 95 per cent CI 0.9993 to 0.9996). Conclusions: The ABL800 analyzer is suitable for blood glucose monitoring, presenting an excellent correlation with the reference laboratory method.

Comparison of susceptibility testing by EUCAST and CLSI broth microdilution methods against Aspergillus isolates / 中国感染与化疗杂志

Objective To compare the results of susceptibility testing by European Committee on Antimicrobial Susceptibility Testing (EUCAST)and Clinical and Laboratory Standards Institute (CLSI)broth microdilution methods against Aspergillus isolates.Methods The susceptibilities of 116 Aspergillus isolates were determined for amphotericin B, voriconazole, itraconazole,caspofungin and micafungin according to EUCAST (E.DEF 9.1 )and CLSI (M38-A2)methods.The essential agreement (EA),categorical agreement (CA),very major errors (VME)and major errors (ME)of the two methods were compared.Results The EA was 96.3%-100% between the two methods.The CA ,ME,and VME were 98.8%,0-1.2% and 0 respectively for the susceptibility of Aspergillus fumigatus to voriconazole.The CA,ME and VME was 1 00%,0 and 0 respectively for the susceptibility of Aspergillus fumigatus and Aspergillus niger to amphotericin B,or the susceptibility of Aspergillus fumigatus and Aspergillus flavus to itraconazole.Conclusions The results of susceptibility testing by EUCAST and CLSI broth microdilution methods are well consistent against Aspergillus isolates.