Antibiotic Susceptibility Pattern of Shigella spp. Isolated from Patients Suspected of Acute Gastroenteritis

Shigellosis, an intestinal infection caused by Shigella species, is manifested by bloody diarrhea. Due to the surge in multidrug-resistant (MDR) Shigella species, the control of shigellosis has been a big challenge. This study aims to determine the prevalence and assess the antibiotic susceptibility pattern of Shigella species. During our study period of five months from April 2014 to August 2014 at Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, a total of 653 stool samples were collected from the patients suspected of acute gastroenteritis. The standard microbiological procedure was followed for the isolation and identification of Shigella species. Assessment of antibiotic susceptibility pattern of the Shigella species was done by Kirby-Bauer disk diffusion method following CLSI guidelines. The study found 25(3.82%) cases were Shigella positive. Among them, 18(72%) were S. flexneri, 6(24%) were S. dysenteriae, and 1(4%) was S. sonnei. The patients in the age group 16-45 years were highly susceptible to infection as the higher proportion 16(64%) of Shigella species were isolated from this age group (p> 0.05). Shigella species were found to be highly susceptible to Cefotaxime (100%), a third-generation cephalosporin. Nalidixic acid, on the other hand, was the least effective antibiotic as 20(80%) of the Shigella isolates were resistant, followed by Ampicillin 18(72%), Cotrimoxazole 13(52%), and Ciprofloxacin 9(36%). A higher proportion of [10(40%)] of our study isolates were MDR. Our results show that Nalidixic acid, Ampicillin, Cotrimoxazole, Ciprofloxacin, and Ofloxacin cannot be used as empirical therapy for the treatment of Shigella infection as Shigella species were highly resistant to these antibiotics. So, for the MDR Shigella infection, we suggest third-generation cephalosporin as an option.

Mycobacterial profile and antibiotic susceptibility pattern in chronic suppurative otitis media: a cross- sectional study

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is a disease of mucoperiosteal lining of the middle ear cleft. The poor compliance of patients to antibiotic treatment, Incomplete treatment, misuse/improper choice of antibiotics have resulted in changes in susceptibility to antibiotics and also development of resistant strains by microbes to commonly used antibiotics. This study aimed to identify the mycobacteriological profile and determine antibiotic susceptibility pattern in CSOM patients.</p><p class="abstract"><strong>Methods:</strong> This cross sectional study was conducted on 120 clinically diagnosed cases of CSOM attending otolaryngology department. Ear discharges obtained were processed for microbial culture (aerobic, anaerobic and fungi). Antimicrobial susceptibility testing was done by Kirby–Bauer disc diffusion method. </p><p class="abstract"><strong>Results:</strong> Of total 120 cases, pathogens were isolated from 114 cases. The commonest aerobic organism isolated was <em>Pseudomonas aeruginosa</em> (34.5%) followed by <em>Staphylococcus aureus</em> (29.4%). <em>Staphylococcus aureus</em> showed maximum sensitivity to erythromycin (70%), followed by cotrimoxazole (62.5%) and ampicillin (55%). Maximum resistance was observed for ciprofloxacin (77.5%), followed by amoxiclave (55%). <em>Pseudomonas aeruginosa</em> showed maximum sensitivity to piperacillin (89.36%) followed by gentamicin (70.2%), amikacin (70.2%), moderate sensitivity to ceftazidime (51.06%); however resistance to carbpenicillin (60%). Ciprofloxacin which is the most prescribed topical antibiotic showing an increase in resistance to causative organisms of CSOM.</p><p class="abstract"><strong>Conclusions:</strong> Hence, it becomes essential to study each case of CSOM bacteriologically to formulate local antibiotic policy for appropriate use of antibiotics. This will certainly help in achieving a safe ear and to control the organisms developing resistance to prevalent antibiotics.</p>

A STUDY ON ANTIBIOTIC SUSCEPTIBILITY PATTERN OF ESCHERICHIA COLI ISOLATES FROM EXTRA INTESTINAL INFECTIONS IN A TERTIARY CARE HOSPITAL

Escherichia coli (E.coli), a common human intestinal commensal causes infections in bodily sites outside the gastrointestinal tract and are called Extra-intestinal pathogenic E.coli. ExPEC causes Urinary tract infections, Blood stream infections, Pneumonia, meningitis,bone, skin, and soft tissue infections including both nosocomial and community acquired infections. The increasing trend of developing antibiotic resistance in ExPEC is of global treat which causes increasing morbidity and mortality.As there is no vaccination forExPEC so it is necessary to analyze the antibiotic susceptibility pattern for empirical treatment in emergency situations.Extended spectrum beta lactamases (ESBLs) hydrolyze β-lactam antibiotics of third generation Cephalosporins, Penicillins and Monobactams. Since the ESBL enzyme genes are usually found in large plasmids, they also contain other antimicrobial resistant genes.AmpC production in E.coli is through plasmids and mutation in their porin structure. Carbapenems are the drug of choice for ESBL producing Ecoli but recent time development of resistance is increasingly reported due to production of Carbapenemase.The aim of this study is to test the Antimicrobial susceptibility pattern of Extra-intestinal Ecoli isolates. The study was conducted in the department of Microbiology, Stanley Medical College, Chennai during the period October 2018 to May 2019.The institutional ethical committee approval was obtained and clinical samples such as urine, blood, pus, sputum and sterile body fluids were received from 983 patients suspected of bacterial infections. The samples were processed and biochemical test identified 84 Ecoli Isolates. Antimicrobial testing, ESBL, AMPC screening and carbapenemase production were tested. E.coli isolates showed resistance to most of the beta lactam antibiotics such as Ampicillin, CefotaximeandCeftazidime and also to Ciprofloxacin &Cotrimoxazole.

Occurrence and Anti-microbial Susceptibility Pattern of Extended Spectrum Beta‑Lactamase Producing Enterobacteriaceae in Waste Water Released from Governmental Hospital of Addis Ababa, Ethiopia

Background Worldwide, come out and dissemination of Extended-spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae has been warning the efficacy of antibiotics to treat an infection. Hospital wastewaters were a reservoir of such kind of resistant bacteria. Currently, the predominant antibiotics used for the treatment of hospitalized patients infected by Gram negative bacteria are the 𝛽-lactam antibiotics. So it is an important source to investigate the magnitude of ESBLs producing bacteria and their antimicrobial susceptibility pattern. The aim of this study was to determine the occurrence of ESBLs producing Enterobacteriaceae (ESBLs-pE) and their antibiotic susceptibility pattern in wastewater released from five governmental hospitals in Addis Ababa, Ethiopia. Method A cross-sectional study was carried out from April 1 to May 31, 2020. A total of 100 wastewaters were collected from five governmental hospitals in Addis Ababa using a grap-sampling technique. All Enterobacteriaceae were screened for ESBLs production using cefotaxime and ceftazidime as per 29th CLSI guideline. Each screen positive for ESBLs production was confirmed by the combination disk method (CDT) and their antibiotic susceptibility pattern were done using the Kirby-Bauer disk diffusion method on Muller Hinton agar (MHA). Data were entered and summarized using SPSS version 20 software. Results Of all Enterobacteriaceae, 48.3% were confirmed ESBLs-pE. The highest ratio of ESBLs-PE was observed in adult ward (66.7%) and laundry unit effluent (58.8%). The highest ESBL producers were E. coli (21.8%) and K. pneumoniae (4.8%). The most elevated resistance level of ESBL producer were observed to cefotaxime (95.8%) and amoxacilline/clavunalate (93%). 64% of tested Enterobacteriaceae isolates were multi drug resistant (MDR). Conclusion Higher magnitude of MDR and ESBLs-pE were present in the hospital wastewater. Majority of them were in adult ward and laundry unit effluents. The most frequent ESBLs-pE was among E .coli and K. pneumoniae. Hence, Consistent infection prevention and control procedures should be in practice at each ward/unit.

Neonatal septicemia and current scenario of antibiotic sensitivity pattern – A study of blood culture isolates in a tertiary care hospital, Rajkot

Neonatal sepsis is one of the leading causes of neonatal mortality in developing countries. Neonatal sepsis can be classified into two subtypes depending upon onset of symptoms- before 72 hours of life (early-onset neonatal sepsis—EONS) or later (late-onset neonatal sepsis—LONS). Bacteriological profile and antibiotic susceptibility pattern in neonatal septicemia are changing time-to-time and place-to-place. This study is aimed to know the current scenario of neonatal septicemia and antibiotic susceptibility pattern for determining effective treatment, hence reducing burden of antibiotic resistance.This is a Retrospective study. Data was collected from Bacteriology lab, PDUMC Rajkot (May 2020 – May 2021). Blood cultures were performed on suspected neonates. Both BACTEC and conventional methods were used. Organisms were isolated by standard microbiological protocols and antibiotic sensitivity was performed by Kirby-Bauer disc diffusion method as per CLSI- 2020/2021 guidelines. Total 1402 samples were screened. 326 were positive (23.25%). 214(65.64%) were male and 112(34.36%) were female. CONS (32.21%) was found to be the predominant pathogen followed by Klebsiella (19.63%), Staphylococcus aureus (18.10%), E. coli (15.95%), Acinetobacter (12.27%) and Enterococcus spp. (1.84%). EONS was seen in 195(59.82%) cases and LONS was seen in 131(40.18%) cases. Gram-negative bacteria are predominant in EONS (76.28%) and gram-positive bacteria is predominant in LONS (64.12%). Gram negative isolates are mostly susceptible to Meropenem, Piperacillin-tazobactam, Cefepime, Ceftazidime. Gram positive isolates mostly showed sensitivity to Vancomycin, Linezolid.Multi-drug resistant organism are emerging in neonatal septicemia. Strict antibiotic stewardship should be practiced to avoid the upcoming treatment difficulties.

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

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.

Prevalence of gram negative bacteria in infected burn wounds and antibiotic susceptibility pattern; a study conducted on stable burn patients reporting to out-patient department.

Objective: To study prevalence of various gram negative bacteria in infected burn wounds among stable burn patients reporting to out-patient department on follow-ups. Study Design: Cross Sectional study. Setting: Department of Pathology, Sahara Medical College Narowal. Period: January to June 2020. Material & Methods: Patients with burn wounds with clinical signs and symptoms of infection but vitally stable, wound less than one month old involving < 20% body surface, reporting to out-patient door of study institution on follow-ups were enrolled into the study. Swabs of infected wounds were taken and sent for bacterial culture and sensitivity to the pathology department of the institution, where micro flora were isolated and their antibiotic susceptibility pattern was determined using standard techniques. Consent was taken from patients before including them in study. Results: Total 210 cases were studied. Gram negative bacteria were isolated from 190 cases, out of them 30% were oxidase positive ad 70% were oxidase negative. Most common organism isolated was Pseudomonas Aeruginosa (30%), followed by Proteus Sps. (25.3%) and Entero bacter Sps. (15.8%) etc. Conclusion: Among gram negative bacteria pseudomonas is a major isolated organism from infected burn wounds having high susceptibility to imipenem and cefepime.