scholarly journals Bacterial profile and antibiogram of blood stream infections in febrile neutropenic patients with haematological malignancies

2018 ◽  
Vol 12 (06) ◽  
pp. 442-447 ◽  
Author(s):  
Prathyusha Kokkayil ◽  
Reshu Agarwal ◽  
Sarita Mohapatra ◽  
Sameer Bakshi ◽  
Bimal Das ◽  
...  
Keyword(s):  
Treatment Options ◽  
Empirical Therapy ◽  
Blood Stream ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Haematological Malignancies ◽  
Gram Negative ◽  
Need For Treatment ◽  
Neutropenic Patients

Introduction: Studies have shown a shift in the prevalence from Gram-positive to Gram-negative bacteraemia in patients with haematological malignancies who develop febrile neutropenia. There are also reports on the spread of drug resistant bacteria among these patients. Information about locally prevalent bacteria and their resistance is important to guide empirical therapy. The aim of this study was to characterise the bacterial spectrum and antibiotic resistance pattern of bacteraemia in neutropenic patients with haematological malignancies Methodology: In this retrospective study, patients admitted to Haematology and Oncology units over a period of 6 months with laboratory-confirmed positive blood cultures were enrolled. Information regarding demographic profile, clinical features, and microbiological profile were recorded. Standard procedures were applied to identify the isolates and their resistance patterns. The data collected was analysed statistically. Results:56 isolates from 53 patients were isolated of which majority were gram negative bacilli (GNB; n = 52 or 93%). Klebsiella pneumoniae (43%, n = 24) was the most frequently isolated bacteria followed by Enterobacter sp (20%, n = 11) and Escherichia coli (12%, n = 7). All isolates were susceptible to colistin. Susceptibility to cefaperazone-sulbactam, piperacillin-tazobactam and carbapenems were 32%, 28.6% and 26.8% respectively. The outcome was fatal for 25 patients. Conclusions: The study documented an alarming rise in the prevalence of GNB and their resistance. Though the results of the study may represent only the tip of the iceberg, the results demonstrate the need for treatment options for drug resistant isolates and for surveillance cultures.

scholarly journals Treatment of Multi-Drug Resistant Gram-Negative Bacterial Pathogenic Infections

2020 ◽  
Vol 14 (3) ◽  
pp. 1639-1647
Author(s):  
Wardah Mohammad Akram ◽  
Godfred Antony Menezes ◽  
Nida Abbas ◽  
Wasim Ahmad ◽  
Ahmed Mohamed Ahmed
Keyword(s):  
Acinetobacter Baumannii ◽  
Bacterial Infections ◽  
Empirical Therapy ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Review Management ◽  
Emergence Of Resistance ◽  
Novel Therapeutic

The multidrug-resistant Gram-negative bacteria (MDR-GNB) infections in severely infected patients present numerous difficulties in terms of treatment failure where antibiotics cannot arrest such drug resistant bacteria. Based on the patient’s medical history and updated microbiological epidemiology data, an effective empirical treatment remains critical for optimal results to safeguard human health. The aim of this manuscript is to review management of MDR-Gram negative pathogenic bacterial infections. Quick diagnosis and narrow antimicrobial spectrum require rapid and timely diagnosis and effective laboratories in accordance with antimicrobial stewardship (AS) principles. Worldwide, there is an increased emergence of Carbapenem-resistant Enterobacteriaceae (CRE), Pseudomonas aeruginosa, and Acinetobacter baumannii. Recently, novel therapeutic options, such as meropenem/vaborbactam, ceftazidime/avibactam, ceftolozane/tazobactam, eravacycline and plazomicin became accessible to effectively counteract severe infections. Optimally using these delays the emergence of resistance to novel therapeutic agents. Further study is required, however, due to uncertainties in pharmacokinetic/pharmacodynamics optimization of dosages and therapeutic duration in severely ill patients. The novel agents should be verified for (i) action on carbapenem resistant Acinetobacter baumannii; (ii) action on CRE of β-lactam/β-lactamase inhibitors dependence on type of carbapenemase; (iii) emergence of resistance to novel antibacterials and dismiss selective pressure promoting development of resistance. Alternative treatments should be approached alike phage therapy or antibacterial peptides. The choice of empirical therapy is complicated by antibiotic resistance and can be combated by accurate antibiotic and their combinations usage, which is critical to patient survival. Noteworthy are local epidemiology, effective teamwork and antibiotic stewardship to guarantee that medications are utilized properly to counter the resistance.

scholarly journals Occurrence of Multi-drug Resistant Bacteria in Some Selected Street Food Samples

2019 ◽  
pp. 1-8
Author(s):  
Mohamed H. El-Sayed
Keyword(s):  
Public Health ◽  
Antibiotic Resistance ◽  
Bacterial Species ◽  
Food Samples ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Bacterial Strains ◽  
Gram Negative ◽  
Drug Resistant Bacteria

Antimicrobial resistance is a subject of great concern in the public health. The prevalence of antimicrobial resistance among food pathogens has increased during recent decades. Studying the incidence and antibiotic resistance pattern of bacterial species isolated from fish and vended street fruits.   Eleven fish swabs and thirteen sliced fruit samples were collected and prepared for isolation of bacterial species through inoculation onto selective and non-selective nutrient media. The grown colonies were purified through subculturing on nutrient agar plates then identified by morphological and biochemical methods. The obtained pure cultures were then kept on nutrient agar slants. Testing antibiotic resistance of the isolated bacterial strains was studied by Kirby-Bauer disk diffusion method on Mueller Hinton agar using ten antibiotics belonging to different classes. The resultant inhibition zone was interpreted according to Clinical Laboratory Standard Institute. Twenty-eight bacterial cultures were isolated from the collected food samples. The conventional identification using morphological and biochemical methods of these cultures revealed presence of three Gram positive species; Staphylococcus aureus, Streptococcus sp. and Bacillus subtilis in addition to four Gram negative; Escherichia coli, Brucella sp., Enterococcus faecalis and Proteus mirabilis. The incidence of the obtained bacterial species was arranged as 29.16% for both S. aureus and E. faecalis followed by Brucella sp. 16.66%; B. subtilis & E. coli 12.5% then Streptococcus sp. and P. mirabilis with an incidence of 8.33% each. Testing antibiotic resistance pattern of seven bacterial species against ten antibiotics showed that, among three Gram positive bacterial species, only one (33.33%) strain S. aureus exhibited resistance to six antibiotics; amoxicillin, erythromycin, ciprofloxacin, ceftriaxone, fluconazole and dicloxacillin. Among four Gram negative bacterial strains only one (25.0%) strain Enterococcus faecalis exhibited resistance to eight antibiotics; amoxicillin, streptomycin, chloramphenicol, cotrimoxazole, ciprofloxacin, ofloxacin, sparfloxacin and cloxacillin. Occurrence of multi-drug resistant bacteria in fish and vended street fruits poses not only risk of disease to the foods but public health hazard to food handlers and consumers in general. Also the result of this study recommended augmentin and cephazolin as good choice antibiotics for treatment of infection in the study area. 

scholarly journals Emerging Treatment Options for Multi-Drug-Resistant Bacterial Infections

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 519
Author(s):  
Roberto Giurazza ◽  
Maria Civita Mazza ◽  
Roberto Andini ◽  
Pasquale Sansone ◽  
Maria Caterina Pace ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Treatment Options ◽  
Resistance Mechanisms ◽  
Antimicrobial Treatment ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Gram Positive ◽  
Strict Adherence ◽  
Gram Negative ◽  
Gram Positive Cocci

Antimicrobial resistance (AMR) remains one of the top public health issues of global concern. Among the most important strategies for AMR control there is the correct and appropriate use of antibiotics, including those available for the treatment of AMR pathogens. In this article, after briefly reviewing the most important and clinically relevant multi-drug-resistant bacteria and their main resistance mechanisms, we describe the emerging antimicrobial options for both MDR Gram-positive cocci and Gram-negative bacilli, including recently marketed agents, molecules just approved or under evaluation and rediscovered older antibiotics that have regained importance due to their antimicrobial spectrum. Specifically, emerging options for Gram-positive cocci we reviewed include ceftaroline, ceftobiprole, tedizolid, dalbavancin, and fosfomycin. Emerging treatment options for Gram-negative bacilli we considered comprise ceftolozane-tazobactam, ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, aztreonam-avibactam, minocycline, fosfomycin, eravacycline, plazomicin, and cefiderocol. An exciting scenario is opening today with the long awaited growing availability of novel molecules for the treatment of AMR bacteria. Knowledge of mechanisms of action and resistance patterns allows physicians to increasingly drive antimicrobial treatment towards a precision medicine approach. Strict adherence to antimicrobial stewardship practices will allow us to preserve the emerging antimicrobials for our future.

Resistance to nitrofurantoin is an indicator of extensive drug-resistant (XDR) Enterobacteriaceae

2021 ◽  
Vol 70 (4) ◽  
Author(s):  
Balaram Khamari ◽  
Prakash Kumar ◽  
Bulagonda Eswarappa Pradeep
Keyword(s):  
Antimicrobial Agents ◽  
Efflux Pump ◽  
Treatment Options ◽  
Strong Association ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Content Type ◽  
Link Type

Introduction. Nitrofurantoin is one of the preferred antibiotics in the treatment of uropathogenic multidrug-resistant (MDR) infections. However, resistance to nitrofurantoin in extensively drug-resistant (XDR) bacteria has severely limited the treatment options. Gap statement. Information related to co-resistance or collateral sensitivity (CS) with reference to nitrofurantoin resistant bacteria is limited. Aim. To study the potential of nitrofurantoin resistance as an indicator of the XDR phenotype in Enterobacteriaceae . Methods. One hundred (45 nitrofurantoin-resistant, 21 intermediately resistant and 34 nitrofurantoin-susceptible) Enterobacteriaceae were analysed in this study. Antibiotic susceptibility testing (AST) against nitrofurantoin and 17 other antimicrobial agents across eight different classes was performed by using the Vitek 2.0 system. The isolates were screened for the prevalence of acquired antimicrobial resistance (AMR) and efflux pump genes by PCR. Results. In total, 51 % of nitrofurantoin-resistant and 28 % of intermediately nitrofurantoin resistant isolates exhibited XDR characteristics, while only 3 % of nitrofurantoin-sensitive isolates were XDR (P=0.0001). Significant co-resistance was observed between nitrofurantoin and other tested antibiotics (β-lactam, cephalosporin, carbapenem, aminoglycoside and tetracycline). Further, the prevalence of AMR and efflux pump genes was higher in the nitrofurantoin-resistant strains compared to the susceptible isolates. A strong association was observed between nitrofurantoin resistance and the presence of bla PER-1, bla NDM-1, bla OXA-48, ant(2) and oqxA-oqxB genes. Tigecycline (84 %) and colistin (95 %) were the only antibiotics to which the majority of the isolates were susceptible. Conclusion. Nitrofurantoin resistance could be an indicator of the XDR phenotype among Enterobacteriaceae , harbouring multiple AMR and efflux pump genes. Tigecycline and colistin are the only antibiotics that could be used in the treatment of such XDR infections. A deeper understanding of the co-resistance mechanisms in XDR pathogens and prescription of AST-based appropriate combination therapy may help mitigate this problem.

scholarly journals Rapid Detection and Evaluation of Clinical Characteristics of Emerging Multiple-Drug-Resistant Gram-Negative Rods Carrying the Metallo-β-Lactamase GeneblaIMP

1998 ◽  
Vol 42 (8) ◽  
pp. 2006-2011 ◽  
Author(s):  
Yoichi Hirakata ◽  
Koichi Izumikawa ◽  
Toshiyuki Yamaguchi ◽  
Hiromu Takemura ◽  
Hironori Tanaka ◽  
...  
Keyword(s):  
Resistance Gene ◽  
Rapid Detection ◽  
Clinical Characteristics ◽  
The Other ◽  
Resistant Bacteria ◽  
Multiple Drug ◽  
Drug Resistant ◽  
Gram Negative ◽  
Multiple Drug Resistant ◽  
Tract Infections

Gram-negative rods (GNR) carrying the transferable carbapenem resistance gene blaIMP, includingPseudomonas aeruginosa and Serratia marcescens, have been isolated from more than 20 hospitals in Japan. Although the emergence of such multiple-drug-resistant bacteria is of utmost clinical concern, little information in regard to the distribution ofblaIMP-positive GNR in hospitals and the clinical characteristics of infected patients is available. To address this, a system for the rapid detection of theblaIMP gene with a simple DNA preparation and by enzymatic detection of PCR products was developed. A total of 933 ceftazidime-resistant strains of GNR isolated between 1991 and 1996 at Nagasaki University Hospital, Nagasaki, Japan, were screened for theblaIMP gene; 80 isolates were positive, including 53 P. aeruginosa isolates, 13 other glucose-nonfermenting bacteria, 13 S. marcescens isolates, and 1 Citrobacter freundii isolate. Most of the patients from whom blaIMP-positive organisms were isolated had malignant diseases (53.8%). The organisms caused urinary tract infections, pneumonia, or other infections in 46.3% of the patients, while they were just colonizing the other patients evaluated. It was possible that blaIMP-positive P. aeruginosa strains contributed to the death of four patients, while the other infections caused by GNR carryingblaIMP were not lethal. DNA fingerprinting analysis by pulsed-field gel electrophoresis suggested the cross transmission of strains within the hospital. The isolates were ceftazidime resistant and were frequently resistant to other antibiotics. Although no particular means of pathogenesis ofblaIMP-positive GNR is evident at present, the rapid detection of such strains is necessary to help with infection control practices for the prevention of their dissemination and the transmission of the resistance gene to other pathogenic bacteria.

scholarly journals In Vitro Activity of Imipenem-Relebactam and Ceftolozane-Tazobactam against Resistant Gram-Negative Bacilli

2018 ◽  
Vol 62 (8) ◽  
Author(s):  
Suzannah M. Schmidt-Malan ◽  
Avisya J. Mishra ◽  
Ammara Mushtaq ◽  
Cassandra L. Brinkman ◽  
Robin Patel
Keyword(s):  
Antimicrobial Agents ◽  
Empirical Therapy ◽  
Drug Resistant ◽  
Rapid Diagnostics ◽  
In Vitro Activity ◽  
Gram Negative ◽  
Content Type ◽  
Inhibitor Combination ◽  
Selection Of

ABSTRACT Understanding which antimicrobial agents are likely to be active against Gram-negative bacilli can guide selection of antimicrobials for empirical therapy as mechanistic rapid diagnostics are adopted. In this study, we determined the MICs of a novel β-lactam–β-lactamase inhibitor combination, imipenem-relebactam, along with ceftolozane-tazobactam, imipenem, ertapenem, meropenem, ceftriaxone, and cefepime, against 282 drug-resistant isolates of Gram-negative bacilli. For isolates harboring blaKPC (n = 110), the addition of relebactam to imipenem lowered the MIC50/MIC90 from 16/>128 μg/ml for imipenem alone to 0.25/1 μg/ml. For isolates harboring blaCTX-M (n = 48), the MIC50/MIC90 of ceftolozane-tazobactam were 0.5/16 μg/ml (83% susceptible). For isolates harboring blaCMY-2 (n = 17), the MIC50/MIC90 of ceftolozane-tazobactam were 4/8 μg/ml (47% susceptible). Imipenem-relebactam was active against most KPC-producing (but not NDM- or IMP-producing) Enterobacteriaceae and is an encouraging addition to the present antibiotic repertoire.

scholarly journals Bacteraemia and antibiotic susceptibility pattern of isolates from patients visiting a private hospital of Kathmandu

2018 ◽  
Vol 5 ◽  
pp. 39-44
Author(s):  
Nandalal Jaishi ◽  
Pramila Pathak ◽  
Pradeep Kumar Shah ◽  
Puspa Raj Dahal
Keyword(s):  
Antibiotic Susceptibility ◽  
Blood Stream Infection ◽  
Empirical Therapy ◽  
Blood Stream ◽  
Salmonella Typhi ◽  
Diffusion Method ◽  
Microbiological Analysis ◽  
Gram Positive ◽  
Gram Negative ◽  
Causative Agents

Background: Bacteraemia can develop a broad array of complications that may be difficult to recognize initially and can increase morbidity. The study was thus conducted to identify the causative agents of bacteraemia and to assess antibiogram of the isolates among the patients suspected of blood stream infection visiting Everest hospital, New Baneshwor Kathmandu. Methods: Altogether 400 blood cultures were processed during March, 2015 to August, 2015. Standard Operating Procedures (SOPs) was followed during the processing of the specimens. Antibiotic susceptibility testing of bacterial isolates was done by Kirby Bauer disc diffusion method with Muller-Hinton agar using the guidelines and interpretive criteria of the Clinical and Laboratory Standards Institute (CLSI 2013). Result: The positivity of blood culture was found to be 48 (12%). Gram negative bacterial were found to be more predominant 27(56.2%) than gram positive bacteria 21(43.7%) in causing bacteraemia. The most prevalent isolate was Staphylococcus aureus 15 (31.2%) followed by Salmonella Paratyphi A 10 (20.8%) and Salmonella Typhi 8 (16.6%), E. coli & CoNS 4 (8.3%), Pseudomonas aeruginosa 3 (6.2%) and Klebsiella pneumoniae & Streptococcus pneumoniae 2 (4.1%) respectively. All gram-positive isolates were found to be sensitive to Cefoxitin, Ceftriaxone and Vancomycin followed by Ampicillin (90.42%), Erythromycin (85.71%), Ciprofloxacin (83.33%), Doxycycline (75%) and Cephalexin (70.58%) whereas gram negative isolates were sensitive to Ceftriaxone followed by Chloramphenicol (92%), Gentamicin (88.8%), Cefixime (85.71%), Ofloxacin (83.3%) and Amoxycillin and Ciprofloxacin (71.3%) Conclusion: The isolation of etiological agents of blood stream infection should be assessed by proper microbiological analysis and it would be helpful for controlling of the outbreaks of resistance strains through effective empirical therapy.

scholarly journals Prevalence of multi-drug resistant bacteria in selected street food and water samples

2018 ◽  
Vol 44 (4) ◽  
pp. 621-627 ◽  
Author(s):  
Anika Tabassum ◽  
Mihir Lal Saha ◽  
Mohammad Nurul Islam
Keyword(s):  
Antibiotic Sensitivity ◽  
Penicillin G ◽  
Multi Drug Resistance ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Gram Positive ◽  
16S Rdna Sequence Analysis ◽  
Drug Resistance Pattern ◽  
Bacillus Spp

Present study was conducted to determine the bacteria and their multi-drug resistance pattern of Velpuri and water of Velpuri shop of different areas of Dhaka city. A total of 74 bacteria were isolated of which 26 isolates were subjected for further study. Eleven and 15 isolates from 26, were found Gram-positive and Gram-negative bacteria, respectively. Three isolates of Gram-positive bacteria were found rod shaped and spore formers which were identified as Bacillus spp. while eight isolates were found round shaped and nonspore formers and identified as Staphylococcus, Streptococcus, Planococcus, Micrococcus. In case of Gramnegative bacteria, Alcaligenes, Escherichia, Pseudomonas, Enterobacter, Proteus, Klebsiella, Yersinia were found to be associated with the samples. Among 26 isolates Pseudomonas and Planococcus were found to be dominating genera. Besides provisional identification, four selected isolates were further confirmed through molecular characterization based on 16S rDNA sequence analysis. Antibiotic sensitivity test results revealed that isolated bacteria were resistant against common antibiotics like penicillin G (80.77%), vancomycin (61.53%) and rifampicin (57.70%). Among the isolates Pseudomonas, Enterobacter cloacae, Eshcherichia coli, Klebsiella, Proteus morganii, Yersinia enterocolitica were found to be multi-drug resistant which is very much alarming for the consumers.

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