Report-based antibiotic sensitivity pattern of community-acquired urinary tract infection in rural Bengal

Background: Urinary tract infection (UTI), a common bacterial infection managed in general practice, is the second most common cause for antibiotic use in primary care setting. Antibiotic prescription is mostly empirical in UTI and it is imperative to choose one highly sensitive drug against the common pathogens. Aims and Objectives: In this study, it has been tried to find out the magnitude of community-acquired UTI in a rural population of West Bengal, its causative agents, and the sensitivity pattern of urinary isolates to reduce the development of antibiotic resistance. Materials and Methods: This is an observational, cross-sectional study over 1 year in a rural tertiary care hospital in West Bengal. Culture and sensitivity reports generated from diagnosed UTI patients from the different OPDs of the hospital were analyzed. Results: Out of 603 reports analyzed, culture-positive reports were 463. Escherichia coli was identified to be the most predominant (61.7%) followed by Staphylococcus aureus (17.3%). The sensitivity report of the empirically given antibiotics shows that among the oral antibiotics, nitrofurantoin was the most sensitive one (92%) followed by ciprofloxacin (83.1%) and ofloxacin (66%). Among the injectables, amikacin (84.5%) and ceftazidime (81.8%) were the antibiotics having the highest sensitivity. Conclusion: The sensitivity among the uropathogens to the commonly used antibiotics shows higher resistance rate toward norfloxacin, cephalexin, cotrimoxazole, ampicillin, amoxicillin, co-amoxiclav, and cefuroxime. Oral antibiotics such as nitrofurantoin and ciprofloxacin and parenteral antibiotic amikacin have found to be of higher sensitivity among all organisms identified clubbed together.

Clinicobacteriological profile and antibiotic susceptibility pattern of chronic dacryocystitis in adults

Background: Chronic dacryocystitis is a constant menace to delicate ocular structures. If left untreated, it can lead to sight as well as life-threatening complications. However, such complications may be prevented by timely intervention along with appropriate antibiotic prophylaxis. The objectives are to investigate the current bacterial community profile in adult patients with chronic dacryocystitis attending a referral eye care center in Odisha and to determine their drug susceptibility pattern to commonly used antimicrobial agents. Materials and Methods: An observational study was conducted on 70 adult patients with chronic dacryocystitis. The discharge from the punctum was collected by doing a regurgitation test or lacrimal passage irrigation and sent for microbiological analysis. Results: Out of 70 samples collected, 54 (77.1%) samples showed bacterial growth after 24–48 h of incubation. Among various isolates recovered, 68.5% were gram-positive and 27.8% were gram-negative organisms. Staphylococcus aureus was found to be the most common isolate among gram-positive, and Pseudomonas aeruginosa was most common among gram-negative organisms. Among all drugs used in the susceptibility test; amikacin, piperacilin + tazobactam, and netilmycin were found to be most sensitive and cefixime, and amoxycilin + clavulinic acid was found to be most resistant to gram-positive as well as for gram-negative organisms. Conclusion: Knowledge about the microbiological profile and the drug susceptibility pattern responsible for chronic dacryocystitis in a geographical area is important and should be kept in mind while treating these patients.

Antimicrobial Sensitivity Pattern of Bacterial Isolates Associated with Urinary Tract Infection in a Tertiary Care Hospita

Introduction : Urinary Tract Infection (UTI) is a common infection and a major health problem. Considering the bacterial resistance developed globally, knowledge regarding sensitivity and resistance pattern of isolated uropathogens in a defined area becomes critically important for choosing appropriate antimicrobial agents for treatment. Objectives : We conducted this study to detect the common UTI causing microorganisms and to evaluate their culture sensitivity pattern in a Tertiary Care Hospital. Methods : This retrospective record based observational study was conducted over a period of two months (January and February, 2021). Patients in the General Ward in the Department of General Medicine, Medical College, Kolkata whose urine samples were collected within 48 hours of admission were included. Identification of bacteria was done by standard microbiologic methods and using Kirby disc diffusion test their antimicrobial susceptibility test was performed. The causative organisms for UTI along with its antibiotic sensitivity pattern were retrospectively reviewed and analysed. Results : Among 150 culture positive samples 34.67% were from male and 65.33% were from female with highest prevalence in the age group of 21-30 years (22.67%). Most prevalent uropathogens isolated was Escherichia coli (E coli) (60.66%) followed by Enterobactor (21.33%) and Klebsiella (9.33%). E coli showed most sensitivity against ceftazidime, clarithromycin, piperacillin-tazobactam and clindamycin (100% in all cases). Resistance (>70%) of E coli was found against levofloxacin and cefotaxime. Conclusion : The present study reveals microbiological profile regarding UTI in patients attending our hospital. As resistant to first line antibiotic is increasing, antibiotic stewardship programme should be strengthened. Antibiotic policies agreed among Clinicians, Microbiologists and Pharmacologists will guide good prescribing, provide maximum coverage for treating infections and ensure antibiotic cycling.

A comparative study of proportion of resistance to multiple antibiotics in infected wounds of diabetic versus non-diabetic patients in a tertiary care hospital

Background: Infectious diseases are more frequent and serious in patients with diabetes mellitus and contribute potentially to increased morbidity and mortality. Multidrug-resistant organisms (MDROs) are bacteria resistant to current antibiotic therapy and difficult to treat. Healthy people are at low risk for developing MDRO infections. Wound infection by MDRO in diabetic patients makes them recalcitrant to healing. Aims and Objectives: This study aims to compare the proportion of resistance to multiple antibiotics in infected wounds of diabetic versus non-diabetic patients. Materials and Methods: A total of 200 diabetic and non-diabetic patients with infected wounds aged between 18 and 89 years, attending the surgical outpatient department or admitted to surgical wards, having positive wound cultures were enrolled in the study after obtaining consent. Other laboratory reports such as hemoglobin percentage, random blood sugar (RBS), and total leukocyte count were noted. Data obtained were analyzed using SPSS.v.20. Results: The diabetics (n = 100) had significantly higher RBS levels [186.86 (±75.37) mg/dl] compared to non-diabetics (n = 100) [93.87 (±41.59) mg/dl] (P < 0.0001). The diabetics had significant history of previous antibiotic usage in the past (72%), compared to non-diabetics (58%) (P = 0.003). Gram-negative bacilli most commonly infected diabetics compared to Gram-positive cocci in non-diabetics. Staphylococcus aureus (67%) was the most commonly isolated organism among both diabetics (24%) and non-diabetics (43%). Pseudomonal infections were higher in diabetics (22%) compared to nondiabetics (10%). Diabetics (87%) showed significantly higher prevalence of resistance to multiple antibiotics compared to non-diabetics (69%) (P = 0.002). Antimicrobial agent most frequently reported sensitive, and resistant to most infection causing organisms was amikacin (75%) and ampicillin (93%), respectively, in both groups. Conclusion: S. aureus is the most commonly isolated organism among both groups. Resistance to multiple antibiotics is higher in diabetics. Infection causing organisms is frequently sensitive to amikacin in both groups; however, its use needs care due to increased chance of nephrotoxicity in diabetics.

Study of antibiogram pattern of organisms isolated from urinary tract infections from a tertiary care hospital from central India

Introduction: Urinary tract infections (UTI) are the most common infection encountered in the life of an individual irrespective of age and sex. Varying degree of antibiotic resistance shown by uropathogens against the routinely used antibiotics in the therapeutic regimen is a serious concern in treatment of UTI. This study was aimed at the isolation and demonstration of antibiogram pattern of organism responsible for acute UTI. Materials and methods: Clean catched mid stream urine (CCMSU) specimens collected from patients of different age group were cultured on blood agar and Mac Conkey’s agar by standard loop culture method. These organisms were further identified by standard methods and antibiotic sensitivity was evaluated using Kirby Bauers disc diffusion method in accordance with CLSI guidelines. Results: A total of 1230 samples were collected from both males and females of age group 5 to 80. Among the total, 443 (36%) samples were positive for culture and showed significant bacteruria. Gram negative isolates were responsible for majority of infection and 86.9% isolates and Escherichia coli was the predominant among them (37.2%). Conclusion: Majority of the isolates showed resistance to drugs commonly used to treat UTI. Variations in sensitivity may be due to the inappropriate exposure of different localities as to antibiotics which can drive the development of resistance. From the results of this study, it is certain that choosing drugs for empiric treatment will be challenging as no single common drug can conveniently be recommended for UTI.

Isolation, identification and antibiotic sensitivity pattern of Escherichia coli isolated from various clinical sample in a tertiary care hospital, Jaipur, Rajasthan, India

Background: Escherichia coli is one of the most frequent causes of many bacterial infections, including Urinary Tract Infections (UTI), blood stream infections, otitis media, pneumonia, meningitis, traveler’s diarrhoea, enteric infections and systemic infections. This study was done with the aim to surveying antibiotic sensitivity pattern of isolated Escherichia coli in both sex attended in NIMS Hospital, Jaipur under the taken time period.Methods: In this cross-sectional study, 62 Escherichia coli were isolated from various clinical specimens of the patients attending both OPD and IPD. The strains were selected using the laboratory standard methods and culture-specific. The antibiotic susceptibility testing was performed using Kirby-Bauer disk diffusion method.Results: Out of total 62 isolates of Escherichia coli 26(41.93%) isolates were from male while 36(58.064%) from female patients. Maximum sensitivity were shown by Polymyxin B and Colistin i.c 100% followed by Nitrofuratonin 82.5% followed by Meropenem 79.03%, Aztreonam 72.58%, Piperacillin/ Tazobactam and Ciprofloxacin 61.30%, each Amikacin 56.45%, Imipenem 54.83%, Ofloxacin 45.16%, Cefepime 43.54%, Ceftazidime 38.71%, Gentamycin and Ceftriaxone 37.09% each, Cefotaxime 30.64%, Norfloxacin 27.5%. Maximum resistance shown against Norfloxacin 72.5%, followed by Gentamycin and Ceftriaxone 62.90%, Ceftazidime 61.30%.Conclusions: Escherichia coli infected more in urinary tract infection as compare to other sample in human, and it is common in female than male. Regular monitoring of antimicrobial susceptibility for E.coli is recommended to improve treatment. A changing trend in antibiotic sensitivity profile of the isolates need to be monitored as there is limited availability of newer drugs and the emergence of resistant bacteria far exceeds the rate of new drug development.

Prevalence of Urinary Tract Infection and the Antibiotic Sensitivity Pattern of the Most Common Uropathogen from a Tertiary Care Hospital of Jamshedpur

Introduction: Urinary tract infections are one of the mostcommon infections encountered and pose a major threat topublic health. Strict antibiotic policies based upon theknowledge of regional susceptibility pattern, may be of greathelp for the clinicians and also prevent emergence of resistantstrains of pathogens.Aim: The aim of this study was to observe the prevalence andanalyse the antibiotic sensitivity pattern of the most commonlyisolated uropathogen in urinary tract infection.Materials and Methods: In this study a total of 338 urinarysamples of suspected urinary tract infections were collectedfrom the microbiology laboratory of M.G.M. Medical Collegeand Hospital, a tertiary care hospital. The age and sex ofpatients, the organisms isolated and antimicrobial susceptibilityprofile of the most frequently isolated uropathogens wasobserved.Results: Out of 338 samples suspected of UTI 118samples showed positive growth in MacConkey agar.Antibiotic susceptibility test was done by disc diffusion method.The most frequently isolated uropathogen was E.coli ie 51%and the antibiotic susceptibility pattern of E.coli was observed.Resistance to the commonly used drugs was high.Conclusion: Drug resistance has become a global problemthese days so proper surveillance and coordinance with theclinicians is required for the judicious selection of effectiveempirical treatment of UTI.

Comparative Evaluation of Methicillin Resistant and Methicillin Sensitive Staphylococcus aureus of Livestock Origin for Antibiotic Sensitivity, Biofilm Formation and Virulence in Galleria mellonella

The objectives of the study were to isolate and identify livestock associated methicillin resistant Staphylococcus aureus (LA-MRSA) and methicillin sensitive S. aureus (LA-MSSA) from clinical mastitis cases and to compare their antibiotic susceptibility, biofilm formation and in vivo pathogenicity in Galleria mellonella larva model. A total of 60 milk samples were collected from cows suffering from mastitis and processed for isolation and identification of S. aureus using standard conventional methods. All the recovered S. aureas isolates were subjected for detection of MRSA and/or MSSA employing phenotypic (Cefoxitin disc assay) and genotypic (the mecA gene PCR) assays. Antibiotic susceptibility pattern of LA-MRSA and LA-MSSA test isolates was determined using disc diffusion method, biofilm formation by 96 well microtiter plate assay and pathogenicity testing in G. mellonella larvae. On microbiological, biochemical and PCR analyses, 14 S. aureus isolates were confirmed. Of these, 4 were tested as LA-MRSA and the remaining 10 isolates were LA-MSSA. Comparative evaluation suggested that MRSA isolates were resistant to different classes of antibiotics and were equally lethal to G. mellonella larvae. However, bioflim forming ability was significantly higher (p < 0.001) in the MSSA test isolates. An association of biofilm formation and pahogenicity testing was not observed between LA-MRSA and LA-MSSA test isolates. Further, LA-MRSA were resistant to different classes of antibiotic and were more lethal to G. mellonella larvae. These preliminary observations are of great concern as the LA-MRSA infections in the community have been documented and warrant in depth research for such pathogens

Antimicrobial sensitivity pattern from clinical isolates at a tertiary care teaching hospital of rural Bengal: a pilot study

Background: Antimicrobial sensitivity pattern from clinical isolates can reveal important information that can help in drafting the hospital antibiotic policy as well as help improve prescribing patterns and patient outcome in a particular region.Methods: Data from the results of the antimicrobial sensitivity pattern of clinical isolates of the patients between 1stJuly and 31st December 2018 were collected on a pre-designed and pre tested case study form and analysed with the help of descriptive statistics.Results: A total of 75 blood culture reports were obtained which showed 58 gram positive cultures. Further 46 of the gram positive samples were positive for Coagulase negative Staphylococcus. A total of 305 urine samples were obtained for culture which showed gram negative cultures. Paediatric and medicine wards were the common yielding sites. A total of 242 pus reports were obtained which showed 47 gram positive cultures. A total of 154 wound swab samples were obtained which showed 47 gram positive cultures. For pus and wound swab samples, surgery wards were the common yielding sites. Common gram negative organisms seen were Klebsiella sp., E. coli, Citrobacter sp., Pseudomonas, Proteus and Enterobacter. Gram positive organisms were commonly resistant to Erythromycin, orally active Penicillins, Vancomycin and Teicoplanin and gram negative organisms were commonly resistant to Cephalosporins, Aminoglycosides, Colistin, Fluroquinolones and Meropenem.Conclusions: This study showed that over six months samples of body pus, wound swab, blood culture and urine showed high levels of resistance to commonly used antibiotics. This would provide an outline for development of an effective hospital Infection Control Policy.

Candida Species Isolation, Identification and Biofilm Detection at a Tertiary Care Hospital

Introduction: Early diagnosis and accurate treatment ofcandida infected patients helps to reduce the risk of infectionand improves patient outcome. Candida isolation, speciationand its invasiveness can be determined by culture, antigen andantibody estimation, glucan estimation and PCR. The presentstudy aimed at candida isolation, speciation and detection ofbiofilm production among various clinical samples.Material and Methods: Various clinical samples such asurine, pus, blood, cerebrospinal fluid, body fluids, tissue, oraland ear swabs etc. were collected from patients in a sterilecontainer and transported immediately to Microbiologylaboratory and processed according to standard protocols.Results: Out of 64 candida isolates from various clinicalisolates, Majority were Candida albicans (37.5%), followed bycandida tropicalis (32.8%), candida krusei (20.3%), Candidaparapsilosis (6.2%) and Candida glabrata (3.1%).Conclusion: Early diagnosis and accurate treatment ofcandida infected patients helps to reduce the risk of infectionand improves patient outcome. Assessing biofilm productionof candida isolates helps us to plan treatment and identify theniche for production of biofilms

Antibiotic resistance pattern in intensive care unit of a tertiary care teaching hospital

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents.

Bacteriological Profile and Antibiogram of Gram Negative Bacteria Isolated from Blood Culture

Introduction: Blood stream infections are one of the important cause of morbidity and mortality all over the world. Bacteraemia ranges from self-limiting infections to life-threatening septicaemia that requires rapid and aggressive antimicrobial treatment. The mortality rate ranges from 20% to 50% in cases of bacteraemia infections. Aim and Objective: The present study was undertaken to know the profile of gram negative organism causing  bacteraemia with their Antibiogram from suspected cases. Material and Method: During a one-year period, 400 blood samples were taken from bacteraemia suspected patients. Blood culture was done by using BacT/Alert 3D system.  Further identification of organism was done by different biochemical test. Antimicrobial sensitivity pattern was determined by Kirby Bauer Disc Diffusion method according to CLSI guidelines. Result: Out of 400 samples, the total number of culture positive cases were found to be 131 giving culture positive rate of 32.75%. Gram positive organism were more than gram negative organism, constituting about 75 (57.69%) of total isolates. 56(42.74%) Gram negative organism were isolated in this study. Most frequent pathogen identified among gram negative bacteria were Klebseilla 24(42.8%), followed by E. coli 18(32.14%), Acinetobacter 10(17.85%), Pseudomonas 2(3.57%) and Salmonella 2(3.57%) respectively. Isolated gram negative organism was highly sensitive to Polymyxin B 51(91.07%). After Polymyxin B isolated gram negative bacteria show high sensitivity for Levofloxacin(60.71%), Cefixime (57.78%), Gentamicin, Meropenem, Piperacillin/tazobactum (50%), Cefepime (44.64%) with least sensitivity for Ampicillin/Sulbactum (14.28%). Conclusion: The present study provides information about gram negative pathogens responsible for blood    stream infection along with their sensitivity towards commonly used antimicrobial. Antibiotic sensitivity pattern of isolates provides useful guidelines to clinicians in initiating empiric therapy and help in management of blood stream infections.

Asymptomatic bacteriuria in type 2 diabetic women patients who are attending Medicine OPD of Government Dharmapuri Medical College, Dharmapuri

Introduction: Infection is a leading cause of hospitalization among diabetic patients. Diabetes is associated with increased risk of developing infection increased severity of infection and prolonged hospital stay. Urinary tract infection, respiratory tract infection and soft tissue infection are common infections with increased incidence of diabetes. Altered host defenses, vascular abnormalities, frequent hospital admissions are responsible for increased incidence. Aim of the study: To find out the prevalence of Asymptomatic Bacteriuria in type 2 diabetic women, to analyze the spectrum of organisms responsible for Asymptomatic Bacteriuria in this group and its antimicrobial sensitivity pattern. Materials and methods: There was 164 participants in the study group and 56 non-diabetic women in the control group GROUP-I: Women with type 2 diabetes were recruited randomly from the Female patients of General Medicine OPD and Diabetic OPD, Government Dharmapuri Medical College Hospital, Dharmapuri. GROUP-II: Women without diabetes were selected randomly from the general population. They were relatives and friends of inpatients admitted in general medical ward. The following laboratory data were included: fasting plasma glucose, blood urea, serum creatinine, albuminuria, glycosuria, and leucocyturia. These patients were evaluated for microvascular and macrovascular complications of diabetes. Results: Overall the prevalence of ASB was 22.56% in the study group and 5.36% in control group. G. Ranjani. Asymptomatic bacteriuria in type 2 diabetic women patients who are attending Medicine OPD of Government Dharmapuri Medical College, Dharmapuri. IAIM, 2017; 4(9): 36-42. Page 37 Conclusion: Asymptomatic bacteriuria was significantly more among diabetics with nephropathy. Simple bedside method to screen asymptomatic bacteriuria is leucocyturia and it has a positive predictability (72.7%) to detect bacterial isolates. Among asymptomatic bacteriuria, gram-negative isolates were greater than gram-positive ones Isolates were resistant to most of the commonly used antimicrobials (Ciprofloxacin, Ofloxacin, Gentamicin, and Cefotaxime) in clinical practice.

Surveillance data on micro-organisms in respiratory tract infections at a tertiary care teaching hospital in South India.

Background: Respiratory tract infections are the leading cause of infections and associated hospitalizations in India. Generally, there is little control on the use of antibiotics. Community awareness of the issues involved in antibiotic therapy is poor and this is compounded by over-the-counter availability. The main aim was to compare the resistance developed by respiratory microbes. Methods: A retrospective and prospective study was designed and conducted to compare the pattern of resistance developed by microorganisms affecting the respiratory tract. Results: The sensitivity of K. pneumoniae to cefepime/tazobactum has decreased from 91.9% to 47.6% and S. aureus to Linezolid has decreased from 93.4% to 80% and S. pyogenes to azithromycin from 51.4% to 24.8%. Whereas sensitivity pattern of S. pneumoniae to amoxicillin/clavulanate is increased from 65.6% to 82.3%. The prevalence of Klebsiella pneumoniae was increased 19% to 25.2% whereas the prevalence of S. pneumoniae was decreased from 66.8% to 65.2%. Our study suggests that all microorganisms isolated are susceptible to carbapenems and cefepime/tazobactum in the cephalosporin class. Conclusions: There is major shift in the sensitivity pattern of microorganisms towards antibiotics. Therefore, these results must be kept in mind by the practitioners in the study site, prior to making decisions over a medication regimen empirically for patients and also to maximize the output of medications by rational prescribing and dosing.

Current Microbial Isolates from Wound Swab and Their Susceptibility Pattern in a Private Medical College Hospital in Dhaka city.

Background: Wound infection is one of the major health problems that are caused and aggravated by the invasion of pathogenic organisms where empiric treatment is routine. Objective: To isolate and identify the bacteria causing wound infection and to determine the antimicrobial susceptibility pattern. Materials and method: A total of 263 wound swab and pus samples were collected during the period of January to December 2012 from Delta Medical College and Hospital, Dhaka, Bangladesh. Swabs from the wound were inoculated on appropriate media and cultured and the isolates were identified by standard procedures as needed. Antimicrobial susceptibility testing was performed by disk diffusion method according to ‘The Clinical Laboratory Standard Institute’ guidelines. Results: In this study 220 bacterial isolates were recovered from 263 samples showing an isolation rate of 83.65%. The predominant bacteria isolated from infected wounds were Staphylococcus aureus 89 (40.45%) followed by Escherichia coli 62 (28.18%), Pseudomonas aeruginosa 34 (15.45%), Enterococci 18 (8.18%), Acinetobacter 5 (2.27%), Klebsiella 9 (4.09%) and Proteus 3 (3.36%). Staphylococcus aureus was sensitive to linezolid (94.38%), fusidic acid (91.01%), vancomycin (87.64%), amikacin (74.15%) and gentamicin (73.03%). Among the Gram negative isolates Escherichia coli was predominant and showed sensitivity to imipenem (93.54%) amikacin (83.87%) colistin (53.22%) and piperacillin and tazobactum (53.22%) and pseudomonas showed sensitivity to amikacin (73.52%), imipenem (70.58%) and colistin (70.58%). Conclusion: Staphylococcus aureus was the most frequently isolated pathogen from wound swab and the antibiotic sensitivity pattern of various isolates help to assist the clinician in appropriate selection of empirical antibiotics against wound infection.

Pattern of antibiotic sensitivity of bacteria causing urinary tract infection in a private Medical College Hospital in Dhaka.

Background: Urinary tract infections (UTI), being the most common infections diagnosed in community and hospital, are to be treated scrupulously considering the type of infecting organism and its antibiotic sensitivity and resistance pattern. Aims and objectives: The aim of the present study was to observe the antibiotic sensitivity pattern of isolated uropathogens from urine samples of patients attending at Shahabuddin Medical College & Hospital, Dhaka, during the period of July 2008 to June 2009. Result: A total of 555 urine samples were studied; of which 84 (15.13%) were culture positive. Among 84 culture positive cases, 84 isolates were identified. Among the isolates, E.coli was the most predominant 61 (62.88%) followed by Enterococci 11 (11.34%), proteus 4 (4.13%) and Pseudomonas 3 (3.09%). Whereas Staphylococcus saprophyticus and Klebsiella showed frequency rate of 2 (2.06%) for each. However Gram positive cocci showed lowest frequency rate of 1 (1.03%). All of the isolates were sensitive to Netilmicin. The majority of isolates were sensitive to Imipenam (92.3%) followed by Amikacin (91.1%), Meropenam (83.3 %), Tetracycline (70%). Sensitivity & resistance rate were same (50%) in Vancomycin & Cefodoxime. Where complete (100%) resistance was shown to Ampicillin, Azithromycin and Cefoxitin. However all isolates were poorly sensitive to cotrimoxazole (35.7%), ciprofloxacin (43%) and nitrofurantoin (44.8%). Conclusion: So, routine urine culture and susceptibility before therapy should be encouraged and periodic evaluation of predominant organisms and their antimicrobial susceptibility pattern should be studied for appropriate selection of antibiotic for effective management of UTI cases.

Isolation and antibiotic susceptibility of bacteria from foot infections in the patients with diabetes mellitus type I and type II in the district of Kancheepuram, Tamil Nadu, India.

Background: Diabetic foot infections are important cause of morbidity and mortality among persons with diabetes mellitus. The reported prevalence rates in India range from 0.9–8.3%. Diabetes foot lesions are the leading cause of non-traumatic amputations worldwide. A study has been conducted to isolate and find the antibiotic susceptibility pattern of the bacteria from diabetic foot infections from the patients of Kancheepuram district, Tamil Nadu, India. Methods: Sixty patients previously diagnosed or newly diagnosed as diabetic, presented with lower extremity infection attending Tagore medical college and hospital and its peripheral centres were selected for the study. Various specimens (pus, wound exudates, or tissues biopsy) for microbiological studies were obtained from the infected region. The specimens were cultured on blood agar and MacConkey agar for aerobic / facultative anaerobic organisms and on Neomycin Blood Agar for anaerobic organism. The plates were then incubated at 37°C. For anaerobic culture the plates were incubated in the McIntosh anaerobic jar. Isolates obtained are identified by standard laboratory techniques. Results: The result showed that Pseudomonas aeruginosa (48.3%) is the predominant bacterium followed by Staphylococcus aureus (38%) and other bacteria. The anaerobic bacteria are also isolated from the diabetic foot ulcers. The Peptostreptococcus species (26.7%) are the predominant bacteria followed by other bacteria. Further the results showed that 22 patients (37%) showed the multi-bacterial infection and remaining 38 patients (63%) showed mono bacterial infection. The drugs like amikacin, cefepine, ciprofloxacin, cotrimoxazole and roxythromycin are sensitive to many gram positive bacterial isolates. Conclusion: The present study has given the data of various bacteria encountered in the diabetic foot ulcer in the district of Kancheepuram, Tamil Nadu, India and its antibiotic sensitivity pattern. The results clearly reveal that there is no definite aetiology in diabetic foot infections. Many patients presented the infection with the involvement of many bacteria. Further it is evident that many bacteria are multi drug resistant and thus complicating the management of diabetic foot infections.

Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital, Indonesia

Objective: To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit (ICU) of a tertiary care of Fatmawati Hospital Jakarta Indonesia. Methods: A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods, and their antibiotic susceptibility testing was performed using disk diffusion method. Results: Specimens were collected from 385 patients who were given antimicrobial treatment, of which 249 (64.68%) were cultured positive and 136 (35.32%) were negative. The most predominant isolate was Pseudomonas aeruginosa (P. aeruginosa) (26.5%) followed by Klebsiella pneumoniae (K. pneumoniae) (15.3%) and Staphylococcus epidermidis (14.9%). P. aeruginosa isolates showed high rate of resistance to cephalexin (95.3%), cefotaxime (64.1%), and ceftriaxone (60.9%). Amikacin was the most effective (84.4%) antibiotic against P. aeruginosa followed by imipenem (81.2%), and meropenem (75.0%). K. pneumoniae showed resistance to cephalexin (86.5%), ceftriaxone (75.7%), ceftazidime (73.0%), cefpirome (73.0%) and cefotaxime (67.9%), respectively. Conclusions: Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins, and quinolone antibiotics. Regular surveillance of antibiotic susceptibility patterns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

Post-operative endophthalmitis: Antibiogram & genetic relatedness between Pseudomonas aeruginosa isolates from patients & phacoemulsifiers.

Background & objectives: Though not frequently but there are reports showing phacoemulsifiers as a potent source of infection in post-operative cases of endophthalmitis. This study was carried out to find antibiogram and genetic relatedness between Pseudomonas aeruginosa isolates from a post-cataract surgery endophthalmitis outbreak (3 patients) and internal tubings of 5 phacoemulsifiers. Methods: In vitro antimicrobial sensitivity patterns of the 8 bacterial isolates were observed. Genetic analysis of the bacterial isolates was done using random amplification of polymorphic DNA (RAPD) assay and PCR ribotyping. The resulting DNA band patterns were examined visually and by computer assisted analysis using unweighted pair group method. Results: The three P. aeruginosa patient isolates were found to be different from the five phacoemulsifier isolates in sensitivity towards 3 antibiotics and by genetic analysis (33 and 44% homology by RAPD assay and PCR ribotyping). Two of the patient isolates shared 100 per cent genetic homology by RAPD assay and another pair shared 100 per cent homology by PCR ribotyping. The five isolates from phacoemulsifiers did not share significant genetic homology. There was significant genetic variation between bacterial isolates from patients and phaco emulsifiers. Interpretation & conclusion: Though the three P. aeruginosa isolates obtained from the patients were phenotypically similar and genetically close, they differed from the phaco-machine isolates both genetically, and in their antibiogram profile. However, the five phacoemulsifier isolates were genetically diverse though they shared the same antibiogram profile. Therefore the Ringer’s lactate from phacomachines could not be conclusively proven to be the source of infection.

Antibiotic sensitivity patterns in childhood urinary tract infections.

Objectives To assess the current antibiotic sensitivity pattern of urinary pathogens and compare it with the pattern 5 years previously. Method A retrospective analysis was performed on 2650 urine samples in 1997 and 2062 samples in 2002 received by the medical laboratory at the Teaching Hospital, Peradeniya from the paediatric ward and paediatric clinics. Results In 1997 there were 155 urine culture reports with significant colony counts of >105 for which ABSTs were performed. 111 were from males and 44 from females. In 2002 there were 278 positive cultures of which 179 were from males and 99 from females. Predominant organism was the coliform, accounting for 90% of isolates in both 1997 and 2002. In 1997 nalidixic acid and nitrofurantoin had high sensitivities of 73.8% and 73.1% respectively, while ciprofloxacin and mecillinam had low sensitivities of 51.9% and 35.5%. In 2002 coamoxiclav had the highest antibiotic sensitivity of 86.7%, while nitrofurantoin, nalidixic acid and norfloxacin had high sensitivities of 80%, 76.6% and 75.7% respectively. Ciprofloxacin and mecillinam had low sensitivity levels both in 1997 and 2002. A change was seen in cotrimoxazole and cephalexin, which had low sensitivities of 40.2% and 54.8% in 1997 and relatively higher sensitivities of 63.8% and 69.2% in 2002 respectively.