scholarly journals Inpatient Cumulative Antibiotic Susceptibility Report of Afyonkarahisar Health Sciences University Research and Practice Hospital (2020)

Author(s):  
Melahat Gürbüz ◽  
Emek Türkekul Şen ◽  
Cengiz Demir ◽  
Berrin Esen

Objective: Broad-spectrum antibiotics used in empirical treatment lead to an increase in multidrug-resistant bacteria in intensive care units and hospital wards. Cumulative antibiotic susceptibility reports can guide the correct selection of empirical therapy and development of antibiotic resistance policies. In this study, we aimed to prepare a one-year inpatient cumulative antibiotic susceptibility report for our hospital. Method: Identification of bacteria and antibiotic susceptibility tests were performed with the automated VITEK 2 (bioMérieux, France) system and antibiogram results were evaluated according to the recommendations of The European Committee on Antimicrobial Susceptibility Testing (EUCAST, 2021). The cumulative antibiotic susceptibility report has been prepared according to the criteria in the Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data (CLSI 2014, M39-A4). Results: In this study, 1490 isolates were analysed. Vancomycin, teicoplanin, linezolid, and tigecycline were effective against gram positive agents. While tigecycline and cefuroxime were effective against enteric Escherichia coli isolates, nitrofurantoin and meropenem can be used in empirical treatment in urinary enterics. It has been observed that the most effective antibiotics against Proteus mirabilis were meropenem and amikacin. It was found that among the enteric and urinary enteric bacteria, there was no antibiotic option to be preferred in empirical treatment against Klebsiella pneumoniae isolates. Tigecycline was the most effective antibiotic against Acinetobacter baumannii isolates, whereas tobramycin was the most effective antibiotic against Pseudomonas aeruginosa isolates. Conclusion: Empirical treatment options for gram-negative and gram-positive bacteria are limited, and we believe that close monitoring of cumulative antibiotic reports will improve and reduce antibiotic resistance rates.

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Silpi Basak ◽  
Priyanka Singh ◽  
Monali Rajurkar

Background and Objective. Antimicrobial resistance is now a major challenge to clinicians for treating patients. Hence, this short term study was undertaken to detect the incidence of multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacterial isolates in a tertiary care hospital.Material and Methods. The clinical samples were cultured and bacterial strains were identified in the department of microbiology. The antibiotic susceptibility profile of different bacterial isolates was studied to detect MDR, XDR, and PDR bacteria.Results. The antibiotic susceptibility profile of 1060 bacterial strains was studied. 393 (37.1%) bacterial strains were MDR, 146 (13.8%) strains were XDR, and no PDR was isolated. All (100%) Gram negative bacterial strains were sensitive to colistin whereas all (100%) Gram positive bacterial strains were sensitive to vancomycin.Conclusion. Close monitoring of MDR, XDR, or even PDR must be done by all clinical microbiology laboratories to implement effective measures to reduce the menace of antimicrobial resistance.


2005 ◽  
Vol 49 (4) ◽  
pp. 1542-1552 ◽  
Author(s):  
T. Maisch ◽  
C. Bosl ◽  
R.-M. Szeimies ◽  
N. Lehn ◽  
C. Abels

ABSTRACT The worldwide rise in the rates of antibiotic resistance of bacteria underlines the need for alternative antibacterial agents. A promising approach to the killing of gram-positive antibiotic-resistant bacteria of the skin uses light in combination with a photosensitizer to induce a phototoxic reaction. Different concentrations (0 to 100 μM) of porphyrin-based photosensitizers (CTP1, XF70, and XF73) and different incubation times (5 min, 1 h, and 4 h) were used to determine phototoxicity against two methicillin-resistant Staphylococcus aureus strains, one methicillin-sensitive S. aureus strain, one methicillin-resistant Staphylococcus epidermidis strain, one Escherichia coli strain, and human keratinocytes and fibroblasts. Incubation with 0.005 μM XF70 or XF73, followed by illumination, yielded a 3-log10 (≥99.9%) decrease in the viable cell numbers of all staphylococcal strains, indicating that the XF drugs have high degrees of potency against gram-positive bacteria and also that the activities of these novel drugs are independent of the antibiotic resistance pattern of the staphylococci examined. CTP1 was less potent against the staphylococci under the same conditions. At 0.005 μM, XF70 and XF73 demonstrated no toxicity toward fibroblasts or keratinocytes. No inactivation of E. coli was detected at this concentration. XF73 was confirmed to act via a reactive oxygen species from the results of studies with sodium azide (a quencher of singlet oxygen), which reduced the killing of both eukaryotic and prokaryotic cells. When a quencher of superoxide anion and the hydroxyl radical was used, cell killing was not inhibited. These results demonstrate that the porphyrin-based photosensitizers had concentration-dependent differences in their efficacies of killing of methicillin-resistant staphylococcal strains via reactive oxygen species without harming eukaryotic cells at the same concentrations.


Water ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 3449
Author(s):  
Cristina-Mirabela Gaşpar ◽  
Ludovic Toma Cziszter ◽  
Cristian Florin Lăzărescu ◽  
Ioan Ţibru ◽  
Marius Pentea ◽  
...  

This study aimed to compare the antibiotic resistance levels of the indicator bacteria Escherichia coli in wastewater samples collected from two hospitals and two urban communities. Antimicrobial susceptibility testing was performed on 81 E. coli isolates (47 from hospitals and 34 from communities) using the disc diffusion method according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) methodology. Ten antibiotics from nine different classes were chosen. The strains isolated from the community wastewater, compared to those from the hospital wastewater, were not resistant to gentamicin (p = 0.03), but they showed a significantly higher susceptibility—increased exposure to ceftazidime (p = 0.001). Multidrug resistance was observed in 85.11% of the hospital wastewater isolates and 73.53% of the community isolates (p > 0.05). The frequency of the presumed carbapenemase-producing E. coli was higher among the community isolates (76.47% compared to 68.09%) (p > 0.05), whereas the frequency of the presumed extended-spectrum beta-lactamase (ESBL)-producing E. coli was higher among the hospital isolates (21.28% compared to 5.88%) (p > 0.05). The antibiotic resistance rates were high in both the hospital and community wastewaters, with very few significant differences between them, so the community outlet might be a source of resistant bacteria that is at least as important as the well-recognised hospitals.


2017 ◽  
Author(s):  
Ashleigh R Tuite ◽  
Thomas L Gift ◽  
Harrell W Chesson ◽  
Katherine Hsu ◽  
Joshua A Salomon ◽  
...  

AbstractBackgroundIncreasing antibiotic resistance limits treatment options for gonorrhea. We examined the extent to which a hypothetical point-of-care (POC) test reporting antibiotic susceptibility profiles could slow the spread of resistance.MethodsWe developed a deterministic compartmental model describing gonorrhea transmission in a single-sex population with three antibiotics available to treat infections. Probabilities of resistance emergence on treatment and fitness costs associated with resistance were based on characteristics of ciprofloxacin, azithromycin, and ceftriaxone. We evaluated time to 1% and 5% prevalence of resistant strains among all isolates with: (1) empiric treatment (azithromycin plus ceftriaxone), and treatment guided by POC tests determining susceptibility to (2) ciprofloxacin only and (3) all three antibiotics.FindingsBased on current gonococcal susceptibility patterns in the United States, the model indicated that continued empiric dual antibiotic treatment without POC testing resulted in >5% of isolates being resistant to both azithromycin and ceftriaxone within 15 years. When either POC test was used in 10% of identified cases, this was delayed by 5 years. The three antibiotic POC test delayed the time to reach 1% prevalence of triply-resistant strains by 6 years, while the ciprofloxacin-only test resulted in no delay. Results were less sensitive to assumptions about fitness costs and test characteristics with increasing test uptake. The main limitation of this study is that we made simplifying assumptions to describe gonorrhea transmission and the emergence and spread of resistance in the population.ConclusionsRapid diagnostics that report antibiotic susceptibility have the potential to extend the usefulness of existing antibiotics for treatment of gonorrhea. Monitoring resistance patterns will be critical with the introduction of such tests.


GYNECOLOGY ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 60-63
Author(s):  
Tatiana Yu Pestrikova ◽  
Elena A Yurasova ◽  
Igor V Yurasov

Relevance. Antibiotic resistance of microbial pathogens is an interdisciplinary and interstate problem of major medical and socio-economic importance. If multiresistant microbial flora is detected in patients with acute or chronic forms of pelvic inflammatory diseases alternative antimicrobial combined therapy an advisability should be considered. Current trends of an increase in multiresistant gram-negative infections along with limited range of alternative treatment options dictate a need for further research. Study of alternative antibiotics effectiveness in pelvic inflammatory diseases treatment is necessary for a further development of optimal treatment regimens. Aim. To search for adequate combinations of antimicrobial therapy aimed at antibiotic-resistant pathogens. Materials and methods. To write this review a search for domestic and foreign publications in Russian and international search systems (PubMed, eLibrary, etc.) for the last 2-12 years was conducted. The review includes articles from peer-reviewed literature. Results. Fosfomycin possesses a broad spectrum of antibacterial effects including gram-positive and gram-negative aerobic bacteria. The drug is highly effective against Pseudomonas aeruginosa and Escherichia coli, anaerobic bacteria (Proteus mirabilis and Klebsiella pneumoniae) as well as against gram- positive bacteria (Staphylococcus spp., including S. aureus, S. epidermidis; Streptococcus spp., including Enterococcus faecalis). Conclusions. When multiresistant microbial flora is detected in patients with acute or chronic forms of pelvic inflammatory diseases an advisability of fosfomycin administration should be considered.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adeeb Salah ◽  
Ibrahim Al-Subol ◽  
Ahmed Hudna ◽  
Ali Alhaj ◽  
Abdulhabib R. Alqubaty ◽  
...  

Abstract Background Neonatal sepsis is a global concern with increasing morbidity and mortality. The burden of neonatal sepsis is highest in developing countries, especially in those lacking proper surveillance systems. The causative pathogens and their drug-resistance levels vary between countries with emergence of multidrug resistance organisms. Thus, accurate records on the recent trends of organisms causing neonatal sepsis will provide vital information for appropriate intervention. We aimed to investigate neonatal sepsis, identify its associated factors and causative pathogens and to assess the antibiotic susceptibility patterns in Sana’a city, Yemen. Methods A cross-sectional study was conducted on neonates admitted to intensive care units of six hospitals in Sana’a city, Yemen, in the period from January 15, to March 30, 2020. Natal and prenatal medical data were collected using well-structured questionnaire. Neonates were subjected to sepsis work-up including blood culture, complete blood count and C-reactive protein. Organisms were identified by Gram staining and analyzed by the VITEK II system for bacterial bio-typing and antibiotic susceptibility testing. Findings Of the 199-neonates with suspected neonatal sepsis, 154 (77.38%) had culture-proven sepsis. Early-onset neonatal sepsis (EOS) was higher (50.25%; 100/199) than late-onset neonatal sepsis (LOS) (27.13%; 54/199). Multivariable analysis identified vaginal delivery as an independent risk factor for neonatal sepsis p = 0.005. Majority of isolated bacteria (74.39%) were gram-negative with Burkholderia cepacia (39%) and Klebsiella oxytoca (13%) being the most common pathogens of EOS and LOS. The most common gram-positive pathogens were Staphylococcus haemolyticus (9.1%) and Staphylococcus epidermidis (7.1%). B. cepacia showed multidrug resistance except for cefepime. All Klebsiella species isolates (100%) and most Pantoea species (93%) were ESBL and carbapenemase positive. All Escherichia coli and Acinetobacter baumannii isolates were ESBL positive. A significant number of gram-positive bacteria showed resistance to vancomycin. Conclusion The study findings show a high proportion of neonatal sepsis among neonates admitted to hospitals in Sana’a city with antibiotic-resistant B. cepacia being the single most common pathogen causing EOS and LOS. Findings also emphasize the emerging threat of multidrug-resistant bacteria in neonatal units and will help develop evidence-based management of neonatal sepsis in Yemen.


2005 ◽  
Vol 68 (10) ◽  
pp. 2022-2029 ◽  
Author(s):  
SHIN-HEE KIM ◽  
CHENG-I WEI ◽  
YWH-MIN TZOU ◽  
HAEJUNG AN

Multidrug-resistant enteric bacteria were isolated from turkey, cattle, and chicken farms and retail meat products in Oklahoma. Among the isolated species, multidrug-resistant Klebsiella pneumoniae was prevalently isolated from most of the collected samples. Therefore, a total of 132 isolates of K. pneumoniae were characterized to understand their potential roles in the dissemination of antibiotic-resistance genes in the food chains. Multidrug-resistant K. pneumoniae was most frequently recovered from a turkey farm and ground turkey products among the tested samples. All isolates were resistant to ampicillin, tetracycline, streptomycin, gentamycin, and kanamycin. Class 1 integrons located in plasmids were identified as a common carrier of the aadA1 gene, encoding resistance to streptomycin and spectinomycin. Production of β-lactamase in the K. pneumoniae isolates played a major role in the resistance to β-lactam agents. Most isolates (96%) possessed blaSHV-1. Five strains were able to express both SHV-11 (pI 6.2) and TEM-1 (pI 5.2) β-lactamase. Transfer of these antibiotic-resistance genes to Escherichia coli was demonstrated by transconjugation. The bacterial genomic DNA restriction patterns by pulsed-field gel electrophoresis showed that the same clones of multidrug-resistant K. pneumoniae remained in feathers, feed, feces, and drinking water in turkey environments, indicating the possible dissemination of antibiotic-resistance genes in the ecosystem and cross-contamination of antibiotic-resistant bacteria during processing and distribution of products.


Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 2113
Author(s):  
Anna Duse ◽  
Karin Persson-Waller ◽  
Karl Pedersen

Mastitis is one of the most important infectious diseases and one of the diseases that causes the greatest use of antibiotics in dairy cows. Therefore, updated information on the bacteria that cause mastitis and their antibiotic susceptibility properties is important. Here, for the first time in over 10 years, we updated the bacterial findings in clinical mastitis in Swedish dairy cows together with their antibiotic resistance patterns and risk factors for each bacterial species. During the period 2013–2018, samples from clinical mastitis were collected, together with information on the cows and herds of origin. The samples were cultured, and a total of 664 recovered bacterial isolates were subjected to susceptibility testing. Staphylococcus aureus (S. aureus) was the most common pathogen and accounted for 27.8% of diagnoses, followed by Streptococcus dysgalactiae (S. dysgalactiae) (15.8%), Escherichia coli (E. coli) (15.1%), Streptococcus uberis (S. uberis) (11.4%), Trueperella pyogenes (T. pyogenes) (7.7%), non-aureus staphylococci (NAS) (2.8%), Klebsiella spp. (2.7%), Enterococcus spp. (1.3%), and Streptococcus agalactiae (S. agalactiae) (1.2%). Various other bacteria accounted for 2.6%. Staphylococci were, in general, susceptible to most antibiotics, but 2.6% of S. aureus and 30.4% of NAS were resistant to penicillin. No methicillin-resistant staphylococci were found. All S. agalactiae were susceptible to penicillin. Bimodal and trimodal MIC distributions for penicillin in S. dysgalactiae and S. uberis, respectively, indicate acquired reduced susceptibility in some isolates. The mostly unimodal MIC distributions of T. pyogenes indicate that acquired resistance does usually not occur in this species. Among E. coli, 14.7% were resistant to at least one antibiotic, most often ampicillin (8.7%), streptomycin (7.8%), or sulphamethoxazole (6.9%). Klebsiella spp. had low resistance to tetracycline (9.1%) but is considered intrinsically resistant to ampicillin. Pathogen-specific risk factors were investigated using multivariable models. Staphylococcus aureus, S. dysgalactiae, and T. pyogenes were more common, while E. coli was less common in quarters with more than one pathogen. S. aureus and T. pyogenes were mostly seen in early lactation, while E. coli was more common in peak to mid lactation and S. dysgalactiae in early to peak lactation. Trueperella pyogenes and Klebsiella spp. were associated with a previous case of clinical mastitis in the current lactation. Staphylococcus aureus was associated with tie stalls and T. pyogenes with loose housing. All pathogens except E. coli and S. dysgalactiae had a seasonal distribution. In conclusion, the aetiological agents for clinical bovine mastitis have remained relatively stable over the last 10–15 years, S. aureus, S. dysgalactiae, E. coli and S. uberis being the most important. Resistance to penicillin among Gram-positive agents was low, and in general, antibiotic resistance to other compounds was low among both Gram-positive and Gram-negative agents.


2019 ◽  
Vol 4 (2) ◽  
pp. 69-74
Author(s):  
Ghazaleh Ilbeigi ◽  
Ashraf Kariminik ◽  
Mohammad Hasan Moshafi

Introduction: Given the increasing rate of antibiotic resistance among bacterial strains, many researchers have been working to produce new and efficient and inexpensive antibacterial agents. It has been reported that some nanoparticles may be used as novel antimicrobial agents.Here, we evaluated antibacterial properties of nickel oxide (NiO) nanoparticles. Methods: NiO nanoparticles were synthesized using microwave method. In order to control the quality and morphology of nanoparticles, XRD (X-ray diffraction) and SEM (scanning electronmicroscope) were utilized. The antibacterial properties of the nanoparticles were assessed against eight common bacterial strains using agar well diffusion assay. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were measured. Antibiotic resistance pattern of the bacteria to nine antibiotics was obtained by Kirby-Bauer disk diffusion method. Results: The crystalline size and diameter (Dc) of NiO nanoparticles were obtained 40-60 nm. The nanoparticles were found to inhibit the growth of both gram-positive and gram-negative bacteria with higher activity against gram-positive organisms. Among bacterial strains, maximum sensitivity was observed in Staphylococcus epidermidis with MIC and MBC of 0.39 and 0.78 mg/mL, respectively. The bacteria had high resistance to cefazolin, erythromycin, rifampicin,ampicillin, penicillin and streptomycin.Conclusion: NiO nanoparticles exhibited remarkable antibacterial properties against gram positive and gram-negative bacteria and can be a new treatment for human pathogenic and antibiotic-resistant bacteria.


2021 ◽  
Vol 27 (3) ◽  
pp. 214-221
Author(s):  
Georgios Feretzakis ◽  
Aikaterini Sakagianni ◽  
Evangelos Loupelis ◽  
Dimitris Kalles ◽  
Nikoletta Skarmoutsou ◽  
...  

Objectives: In the era of increasing antimicrobial resistance, the need for early identification and prompt treatment of multi-drug-resistant infections is crucial for achieving favorable outcomes in critically ill patients. As traditional microbiological susceptibility testing requires at least 24 hours, automated machine learning (AutoML) techniques could be used as clinical decision support tools to predict antimicrobial resistance and select appropriate empirical antibiotic treatment.Methods: An antimicrobial susceptibility dataset of 11,496 instances from 499 patients admitted to the internal medicine wards of a public hospital in Greece was processed by using Microsoft Azure AutoML to evaluate antibiotic susceptibility predictions using patients’ simple demographic characteristics, as well as previous antibiotic susceptibility testing, without any concomitant clinical data. Furthermore, the balanced dataset was also processed using the same procedure. The datasets contained the attributes of sex, age, sample type, Gram stain, 44 antimicrobial substances, and the antibiotic susceptibility results.Results: The stack ensemble technique achieved the best results in the original and balanced dataset with an area under the curve-weighted metric of 0.822 and 0.850, respectively.Conclusions: Implementation of AutoML for antimicrobial susceptibility data can provide clinicians useful information regarding possible antibiotic resistance and aid them in selecting appropriate empirical antibiotic therapy by taking into consideration the local antimicrobial resistance ecosystem.


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