scholarly journals Catheter-related blood stream infections in hemodialysis patients

2020 ◽  
Vol 9 (4) ◽  
pp. e34-e34
Author(s):  
Babak Hadian ◽  
Azita Zafarmohtashami ◽  
Mahdi Razani
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Signs ◽  
Blood Stream ◽  
Multidrug Resistant ◽  
Hemodialysis Patients ◽  
Empirical Treatment ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Negative Organisms ◽  
Clinical Records

Introduction: Proper care of vascular access in hemodialysis patients is important. Catheter-related bloodstream infection (CRBSI), is a life-threatening complication of hemodialysis. Objectives: Sufficient data about microorganisms and their susceptibility to antibiotics in hemodialysis patients is necessary for handling of CRBSI; therefore, this study performed for better management of patients. Patients and Methods: All hemodialysis patients from March 2015 to March 2018 who had cultures of catheter and blood samples were studied. Clinical records of 122 patients were reviewed for variables such as catheter and blood culture microorganism types, antibiotic resistance, age, gender, site, comorbidities, and various clinical signs. Results: Eighty-four cases of catheter cultures were positive for bacteria. Staphylococcus epidermidis was the most common organism (36%) since Staphylococcus aureus was the second one (28%). In some cases, multidrug resistant organisms such as Enterobacter baumannii or methicillin-resistant Staphylococcus aureus (MRSA) organisms were grown. Twenty-one percent of S. aureus organisms were MRSA. No significant association between important diagnostic data (fever, chills or WBC count) and bacteremia were shown. Gender of patients had a significant statistical association with CRBSI. Conclusion: Given the necessity of proper management, physicians must empirically initiate antibiotic therapy as soon as possible, until receiving definite culture results, in hemodialysis patients suspected of bacteremia. In our study, both gram-positive and gram-negative organisms were common. Hence, when initial empirical treatment is indicated, the coverage of both gram positive and gram negative organisms must be considered. Vancomycin or other antibiotics that are effective on MRSA must be included in empirical treatment.

scholarly journals In Vitro Activities of the Rx-01 Oxazolidinones against Hospital and Community Pathogens

2008 ◽  
Vol 52 (5) ◽  
pp. 1653-1662 ◽  
Author(s):  
Laura Lawrence ◽  
Paul Danese ◽  
Joe DeVito ◽  
Francois Franceschi ◽  
Joyce Sutcliffe
Keyword(s):  
Staphylococcus Aureus ◽  
Moraxella Catarrhalis ◽  
Multidrug Resistant ◽  
Gram Positive ◽  
Gram Negative ◽  
Vancomycin Resistant Enterococci ◽  
The Family ◽  
Vancomycin Resistant ◽  
Gram Negative Organisms

ABSTRACT Rx-01_423 and Rx-01_667 are two members of the family of oxazolidinones that were designed using a combination of computational and medicinal chemistry and conventional biological techniques. The compounds have a two- to eightfold-improved potency over linezolid against serious gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant streptococci, and vancomycin-resistant enterococci. This enhanced potency extends to the coverage of linezolid-resistant gram-positive microbes, especially multidrug-resistant enterococci and pneumococci. Compounds from this series expand the spectrum compared with linezolid to include fastidious gram-negative organisms like Haemophilus influenzae and Moraxella catarrhalis. Like linezolid, the Rx-01 compounds are bacteriostatic against MRSA and enterococci but are generally bactericidal against S. pneumoniae and H. influenzae.

scholarly journals 1554. Epidemiology of Adult Bacterial Hand Infections at Two Urban Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S777-S778
Author(s):  
Arsheena Yassin ◽  
Christine Stavropoulos ◽  
Krystina L Woods ◽  
Jiashan Xu ◽  
Justin Carale ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
Antibiotic Regimen ◽  
Gram Positive ◽  
Gram Negative ◽  
Streptococcus Species ◽  
Urban Hospitals ◽  
Haemophilus Parainfluenzae ◽  
Empiric Antibiotic ◽  
Gram Negative Organisms

Abstract Background Hand infections represent a major source of morbidity, which can result in hand stiffness and amputation. Early appropriate empiric antibiotic regimen may reduce the associated morbidity, hence the importance to examine local epidemiology. The aim of this study was to define the current epidemiology of adult hand infections at two urban hospitals in New York City. Methods We performed a double center, retrospective study of adult patients hospitalized from March 2018 to May 2020. Patients with positive cultures associated with the hand infections were included. Retrospectively, 100 patients were reviewed. Data on baseline demographic, clinical, surgical, microbiology, and treatment parameters were collected. Results Of the 100 patients, 76% were male, with median age of 47.5 years (35, 58.25) and average C-reactive protein (CRP) of 50.66 mg/L (± 64.64) on admission (see Table 1). Previous hospitalization within 1 year (38%), previous surgical procedures (39%) and recent IV medication use (26%) were common. 130 bacterial isolates were identified (see Table 2). The most frequent organisms were Gram-positive, with Methicillin susceptible Staphylococcus aureus (MSSA, 25.38%), Streptococcus species (20.08%), and Methicillin resistant Staphylococcus aureus (MRSA, 15.38%) being the most common. Gram-negative organisms were infrequent, with Haemophilus parainfluenzae (3.85%), Enterobacter cloacae (3.85) and Pseudomonas aeruginosa (3.08%) being the most prevalent. Of the 100 patients, 27% had polymicrobial infections, associated with trauma (6%), illicit IV use (6%) and unknown (7%) etiologies. Table 1: Baseline demographics and co-morbid conditions Table 2: Types and numbers of organisms in relation to etiologies Conclusion Within our population, the most common organisms associated with hand infections were Gram-positive, with Staphylococcus aureus and Streptococcus species being the most prevalent. Gram-negative pathogens were infrequently isolated. The results within this study can provide guidance to clinicians on assessing the appropriate empiric antibiotic regimen in patients with hand infections, and can serve as a basis for further studies identifying risk factors associated with isolation of organisms associated with hand infections. Disclosures All Authors: No reported disclosures

scholarly journals NEW INSIGHT ON EPIDEMIOLOGY AND MANAGEMENT OF BACTERIAL BLOODSTREAM INFECTION IN PATIENTS WITH HEMATOLOGICAL MALIGNACIES

2015 ◽  
Vol 7 ◽  
pp. e2015044 ◽  
Author(s):  
Sara Lo Menzo ◽  
Giulia La Martire ◽  
Giancarlo Ceccarelli ◽  
Mario Venditti
Keyword(s):  
Febrile Neutropenia ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Empirical Treatment ◽  
Rational Approach ◽  
Attributable Mortality ◽  
Low Grade ◽  
Gram Positive ◽  
Adequate Treatment ◽  
Gram Negative

Bloodstream infections (BSI) are an important cause of morbidity and mortality in onco-hematologic patients. The Gram-negative etiology was the main responsible of the febrile neutropenia in the sixties and its impact declined due to the use of fluoroquinolone prophylaxis; this situation was followed by the gradual emergence of Gram-positive bacteria also following of the increased use of intravascular devices and the introduction of new chemotherapeutic strategies. In the last decade the Gram-negative etiology is raising again because of the emergence of resistant strains that make questionable the usefulness of currentstrategies for prophylaxis and empirical treatment. Gram-negative BSI attributable mortality is relevant and the appropriate empirical treatment significantly improves the prognosis; on the other hand the delayed adequate treatment of Gram-positive BSI does not seem to have an high impact on survival. The clinician has to be aware of the epidemiology of his institution and of colonizations of his patients in order to choose the most appropriate empiric therapy. Ina setting of high endemicity of multidrug-resistant infections, even the choice of a targeted therapy can be a challenge, often requiring strategies based on off-label prescriptions and low grade evidences.In this review we summarize the current evidences for the best targeted therapies for difficult to treat bacteria BSIs and future perspectives in this topic. We also provide a flow chart for a rational approach to the empirical treatment of febrile neutropenia in a multidrug resistant high prevalence setting.

scholarly journals Susceptibility Pattern of Pathogens Causing Blood Stream Infections in a Tertiary Care Hospital: A Two-year Retrospective Study from Southern Nigeria

2021 ◽  
pp. 53-60
Author(s):  
Bassey Ewa Ekeng ◽  
Ubleni Ettah Emanghe ◽  
Bernard Ekpan Monjol ◽  
Anthony Achizie Iwuafor ◽  
Ernest Afu Ochang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Blood Culture ◽  
Blood Stream ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Blood Stream Infections ◽  
Gram Negative ◽  
Antimicrobial Sensitivity ◽  
Culture Positive

Aim: Bloodstream infections are a major cause of morbidity and mortality worldwide. The prevalence of causative microorganisms varies from one geographical region to another. This study was aimed at determining the etiological agents prevalent in our environment and their susceptibility profile. Study design: This is a retrospective study carried out at the University of Calabar Teaching Hospital, Calabar, Nigeria. Methodology: Blood culture results of patients documented over a two-year period were retrieved and analyzed. Blood culture positive isolates were detected using conventional method and Oxoid signal blood culture systems. Antimicrobial sensitivity tests were carried out by Kirby-Bauer disc diffusion method. Methicillin resistance in Staphylococcus aureus and coagulase negative Staphylococcus species (CoNS) was detected by disk diffusion method using 30 µg cefoxitin disk. ESBL production was detected by phenotypic confirmatory disc diffusion test (PCDDT) and the double disc synergy test (DDST). Results: A total of 413 blood culture antimicrobial susceptibility test results were analyzed, of which 116 (28.09%) were identified as culture positive. Sixty-nine (59%) of the positive isolates were from female patients. Out of 116 positive cultures, 58.62% (68/116) were Gram positive organisms, 40.52% (47/116) were Gram negative organisms, non albicans Candida accounted for 0.86% (1/116).  Staphylococcus aureus (n=41, 35.3%) was the predominant isolate and showed high sensitivity to levofloxacin (100%), Linezolid (100%) and Amikacin (100%). Twelve isolates of S. aureus were methicillin resistant, while 1 isolate was inducible clindamycin resistant. Of the 116 isolates identified in this study, forty-three (43) were multidrug resistant with highest number of multidrug resistant isolates from Staphylococcus aureus (n=20). 21.28% (n=10) of the Gram-negative isolates were positive for extended spectrum beta lactamases. Conclusion: A high rate of antimicrobial resistance is observed among microorganisms causing blood stream infections. This emphasizes the need for antimicrobial sensitivity testing in the management of blood stream infections.

scholarly journals Microbiological Profile of Uropathogens and their Antibiotic Susceptibility Pattern in Pediatric Population from A Tertiary Care Hospital in Amritsar, Punjab

2021 ◽  
Vol 10 (11) ◽  
pp. 306-312
Author(s):  
Manpreet Kaur Bhatha Loveena Oberoi ◽  
Sapna Soneja Anuradha Malhotra ◽  
Kamaldeep Singh
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Susceptibility ◽  
Pediatric Population ◽  
Age Group ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative ◽  
Gram Negative Organisms ◽  
Gram Positive Cocci

Urinary tract infection(UTI) is one of the most commonest bacterial infection encountered in the pediatric age group. Early diagnosis is of utmost importance to preserve renal function and reduce long term complications such as renal scarring. The objective of this study was to determine the prevalence of UTI in pediatric population, identify the common uropathogens and study the antibiotic susceptibility pattern of bacterial isolates. Materials and Methods: A retrospective study was carried out in Department of Microbiology, GMC Amritsar for a period of 6 months from 1 Jan 2021 till 30 June 2021 amongst the pediatric patients (1 month-12 years age group) with clinically suspected UTI including both indoor and outdoor patients. Clean catch midstream urine samples received in the laboratory were processed as per the standard microbiological guidelines. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: A total of 549 samples were received and processed during study period from which 164(29.87%) were culture positive. Culture positivity was more prevalent in females (61.58%) than males (38.41%). Gram negative organisms were predominant (74.4%) followed by gram positive cocci (22.56%) and Candida (3.05%). Among gram negative organisms Escherichia coli was most predominant followed by Klebsiella spp., Pseudomonas spp., Acinetobacter spp., Proteus spp. and Citrobacter spp. Among gram positive cocci Staphylococcus aureus was most predominant followed by Coagulase negative Staphylococci and Enterococcus spp. Majority of gram negative bacilli were resistant to fluroquinolones, 3rd generation cephalosporins and co-trimoxazole while nitrofurantoin, piperacillin-tazobactam and gentamicin were most sensitive drugs. Among Staphylococcus aureus, methicillin resistance was seen in 17% isolates. High sensitivity was seen to linezolid and vancomycin in gram positive cocci. Conclusion: This study highlights increased prevalence of MDR uropathogens in pediatric population which indicates that antibiotic selection should be based on knowledge of local prevalence of bacterial organisms and their antibiotic sensitivities with rational use of antibiotics.

scholarly journals Bacteriological profile of surgical site infections in a tertiary care hospital of western Nepal

2021 ◽  
Vol 14 (1) ◽  
pp. 33-38
Author(s):  
Dharm Raj Bhatta ◽  
Abhijit Adhikari ◽  
Jampa Lhamo Gurung ◽  
Niroj Man Amatya ◽  
Niranjan Nayak ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Multidrug Resistant ◽  
Care Hospital ◽  
Gram Positive ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Resistance Patterns ◽  
Microbiological Techniques

Introduction: Surgical site infections are one of the most commonly reported nosocomial infections resulting into significant morbidity and mortality. Hospital admission and surgical procedures increase the risk of infection with multidrug resistant pathogens. This study was aimed to determine the bacterial agents associated with surgical site infections and antibiotic resistance patterns of the isolates. Methods: A total of 161 specimens from patients with surgical site infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Results: Out of 161 samples, 94 bacterial isolates were recovered. Gram positive bacteria were isolated in 57.4% (54/94) cases and Staphylococcus aureus was the most common organism (49/54) with 65.3% (32/49) methicillin resistant Staphylococcus aureus isolates. All S. aureus isolates were susceptible to vancomycin. Gram negative bacteria constituted 42.6% (40/94) of total isolates and Escherichia coli was the commonest organism (13/40). Majority of Gram negative isolates were susceptible to amikacin, imipenem and piperacillin-tazobactam. Resistance to imipenem was detected among isolates of E coli, Pseudomonas and Acinetobacter species. Conclusion: Gram positive isolates were more commonly associated with surgical site infections. High percentage of MRSA was detected among the S. aureus isolates but no vancomycin resistant S. aureus. High percentage of Gram negative isolates was susceptible to imipenem, piperacillin-tazobactam, amikacin and gentimicin.

90 Efficacy of Topical Antimicrobial Agents Against Bacterial Isolates from Burn Wounds

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
William A Nethery ◽  
Petra Warner ◽  
Paula J Durkee ◽  
Jacquelyn Zembrodt ◽  
Angela Dwyer ◽  
...  
Keyword(s):  
Polymyxin B ◽  
Multidrug Resistant ◽  
Silver Sulfadiazine ◽  
Gram Positive ◽  
Gram Negative ◽  
Topical Antimicrobials ◽  
Neomycin Sulfate ◽  
Gram Negative Organisms ◽  
High Degree ◽  
Topical Antimicrobial

Abstract Introduction Topical antimicrobials are key to prevention of infection and mortality in the acute burn patient population. The purpose of this study was to determine the effectiveness of commercially available and in-house compounded topical preparations. Methods One hundred isolates from 15 different microorganisms were used to evaluate topical antimicrobial effectiveness. The isolates included 40 Gram-positive and 60 Gram-negative microorganisms. Sixteen multidrug-resistant organisms were included in the study. The study was conducted using the Nathan Topical Well Assay method to assess in-vitro activity. Twenty-two various irrigation solutions and ointments were tested. Since there are no standardized zones to determine susceptibility for topical antimicrobials, any zone of inhibition (>8 mm) was considered to show effectiveness. Results The compounds 1:1:1 + DAB (1 part bacitracin: 1 part silver sulfadiazine: 100,000 units per gram nystatin + 5mg/gram neomycin sulfate + 500 units/gram polymyxin B) and 3:1 + DAB (3 part bacitracin: 1 part silver sulfadiazine + 5mg/gram neomycin sulfate + 500 units/gram polymyxin B) in both irrigation and ointment dosage form demonstrated 100% effectiveness against all isolates. Sodium hypochlorite 0.5% solution appeared to be very effective against gram-negative organisms, but moderately effective against gram-positive organisms. Double antibiotic solution was highly effective against all gram-negative bacteria. 3:1 ointment and 1:1:1 ointment were highly effective against gram-positive organisms and moderately effective against gram-negative organisms. The data indicates that many of the topical antimicrobials target certain bacteria more readily than others. Besides 1:1:1 + DAB and 3:1 + DAB, it shows that more than one drug product is necessary to demonstrate adequate killing ability of a broad spectrum of organisms. Multidrug resistant organisms also indicate more resistance against topical antimicrobials. The only compounds that showed a high degree of effectiveness against MDROs were sodium hypochlorite 0.5% solution, 1:1:1 + DAB ointment and solution, and 3:1 + DAB ointment and solution. Conclusions The bacitracin and silver sulfadiazine component of 3:1 and 1:1:1 has a high degree of effectiveness against Gram-positive organisms. Double antibiotic ointment was moderately effective against Gram-negative organisms. However, when the two were combined into one ointment it created a synergistic effect, which killed all the organisms tested. Applicability of Research to Practice Antimicrobial effectiveness and adverse effects must be considered when selecting the appropriate topical agent to be used on wounds. Further research is needed to determine the production of resistant bacteria and topical antimicrobials and the clinical usefulness of topical antimicrobial susceptibilities.

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