Antibiogram of Medical Intensive Care Unit at Tertiary Care Hospital Setting of Pakistan

Qadeer, Aayesha; Akhtar, Aftab; Ain, Qurat ul; Saadat, Shoab; Mansoor, Salman; Assad, Salman; Ishtiaq, Wasib; Ilyas, Abid; Khan, Ali Younas; Ajam, Yousaf

doi:10.7759/cureus.809

Cited by 23 publications

(33 citation statements)

References 14 publications

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“…In our study, out of the total bacterial isolates, gram-negative bacteria were more prevalent than were gram-positive bacteria. This predominance of gram-negative bacteria is in concordance with the ndings of the similar study conducted (Qadeer et al 2016) [12] and result showed lower resistance in E. coli. According to Saravanan R. et al, 2013 [16] E. coli was found to be the most common and highly resistant organism.…”

Section: Discussionsupporting

confidence: 92%

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Development of Antibiogram for Evaluation of Antibiotic Resistance Pattern in Tertiary Care Teaching Hospital: a Cross Sectional Study

Dikkatwar

Mansuri

Chaudhari

et al. 2020

Preprint

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Background: Antimicrobial resistance threatens the effective prevention and treatment of increasing number of cases of antibiotic resistance worldwide. So there is need of effective implementation of the treatment strategy to rationalize the antimicrobial use in the treatment of infectious disease. So the present study is aims to attempts to find the local antibiotic resistance, various microorganism responsible for infection using the antibiogram in the tertiary care teaching hospital.Methods: A cross-sectional study was carried out to check the Antibiotic resistance pattern based on the inclusion and exclusion criteria at Parul Sevasharam Hospital, Vadodara, Gujarat. Total 150 patients were included in study, culture sensitivity test and bacterial identification was done as per the microbiology department standard guidelines. Patient’s data regarding to demographic details, culture sensitivity test results and prescribed antibiotics was collected for 6 months’ duration from October 2019 to March 2020. Results: Total 150 samples were collected throughout the study period of six months in the various departments in the hospital. The main finding of our study,greater resistance found in Ceftriaxone (78%), Meropenem (71%), Azithromycin (66%), linezolid (66%), Amoxicillin+clavulanic acid (63%), Ciprofloxacin (56%) of patients in these antibiotics. Greater susceptibility was found in Clindamycin (75%), Amikacin (65%), Piperacilline+tazobactum (62%), Cefoperazone (48%), ciprofloxacin (44%) of the patients. During our study, 20 antibiotics were commonly prescribed out of which ceftriaxone was most commonly prescribed in our study and which was found to most resistant in patient population. The most common bacteria identified in our study was gram negative bacteria in that E. Coli, Pseudomonas Aeruginosa and KlebseillaPneuminiae was most commonly isolated.Conclusion: This study shows that there is increasing cases of antibiotic resistance identified in the hospital. Ceftriaxone is found to be most resistant in our study. So there is need of effective treatment strategies and use of antibiogram to find out the local antibiotic resistance pattern and to develop antibiotic policy for the safe use of antibiotic which is helpful for to reduce the antibiotic resistance.

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Section: Discussionsupporting

confidence: 92%

“…In gender wise distribution as 66.6% of total population was male and 33.3% of total population were female and similar study was conducted by Qadeer et al, 2016 [12] where 56.6% were males and 43.3% were female patient were found. Therefore, study data shows that the male was most exposed population to the antibiotic than female.…”

Section: Discussionsupporting

confidence: 75%

Development of Antibiogram for Evaluation of Antibiotic Resistance Pattern in Tertiary Care Teaching Hospital: a Cross Sectional Study

Dikkatwar

Mansuri

Chaudhari

et al. 2020

Preprint

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“…Esposito et al, in their study, also registered high resistance toward carbapenems [5]. Similar to our study, the most sensitivity is shown towards colistin by Qadeer and Rajan [6][7], whereas Ahmad and Esposito showed the highest sensitivity of tigecycline towards Acinetobacter. There has been a lot of concerns regarding the multidrug resistance toward Acinetobacter and its role in nosocomial infections.…”

Section: Discussionsupporting

confidence: 90%

“…A study by Qadeer et al also showed 93% sensitivity toward amikacin and 90% towards carbapenems (meropenem and imipenem). But the most sensitivity in their study was shown toward colistin (100%) [7]. Ahmad et al also demonstrated high sensitivity towards amikacin (80%) and imipenem (100%) [8].…”

Section: Discussionmentioning

confidence: 78%

Antimicrobial Resistance Patterns: Review of the Antibiogram of a Surgical Unit in a Public Tertiary Care Hospital of Pakistan

Kathia¹,

Munir²,

Fateh³

et al. 2020

Cureus

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Introduction Antimicrobial resistance (AMR) has become a challenge in modern-day medical practice. The pace at which microbes are becoming resistant to antibiotics is greater than the discovery of novel antimicrobial agents. There is a need to study these antimicrobial patterns and, for this purpose, antibiograms should be developed at the levels of wards and hospitals and studied to guide us better on how to choose suitable empirical therapy for our patients. Methods and materials A total of 286 reports were studied, which contained the culture and sensitivity data of all the patients admitted under the care of Surgical Unit-1 in Lahore General Hospital between April 1, 2019, and October 31, 2019. All the samples for culture and sensitivity were sent to the in-house laboratory of the hospital where the reporting was done by the pathology department. They were inoculated and then intubated, and gram staining was performed. Antibiotic resistance and susceptibility were measured by the disk diffusion method according to the Clinical and Laboratory standards institute (CSLI) guidelines. Results The most common isolated organism was Escherichia coli (E. coli) in 65 (24%) patients, the next most common was Acinetobacter species in 62 (23%), followed by Pseudomonas species 52(19%), Klebsiella species 32 (13%), Staphylococcus aureus 30 (11%), Coagulase-negative Staphylococci 20 (7%), Enterobacter species (2%), and Citrobacter species (1%). The antimicrobial susceptibility of E. coli was highest for aminoglycosides and carbapenems like amikacin (78%), meropenem (71%), and imipenem (63%). Acinetobacter was most sensitive to colistin (100%), amikacin (31%), meropenem (21%), and cefoperazone + sulbactam (21%). Pseudomonas was also most sensitive to colistin (93%) and after that amikacin (52%), meropenem (52%), and imipenem (44%). Klebsiella was most sensitive to colistin (86%), imipenem (60%), and aminoglycosides (50%). Among gram-positive organisms, Staphylococcus aureus was sensitive to linezolid (100%) and vancomycin (100%). Conclusion The vast majority of isolated organisms in this study were gram-negative bacteria, and most were showing high antimicrobial resistance. The antibiograms should be developed and regularly updated at every ward and hospital. There is a need to bring more awareness about the proper use of antimicrobials among healthcare workers, and antimicrobial stewardship programs can help in this matter.

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“…P. aeruginosa isolated from other body site infections often showed much higher resistance than eye isolates. In separate studies, isolates of P. aeruginosa from urinary tract infection, multiple body sites of intensive care unit patients and cystic fibrosis cases showed only 62, 41 and 44 per cent sensitivity to ciprofloxacin, respectively.…”

Section: P Aeruginosa In Eye Infectionsmentioning

confidence: 99%

Overview of mechanisms of antibiotic resistance in Pseudomonas aeruginosa: an ocular perspective

Subedi

Vijay

Willcox

2018

Clinical and Experimental Optometry

114

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Treatment of Pseudomonas aeruginosa eye infections often becomes a challenge due to the ability of this bacterium to be resistant to antibiotics via intrinsic and acquired mechanisms. Transfer of resistance due to interchangeable genetic elements is an important mechanism for the rapid transfer of antibiotic resistance in this pathogen. As a result, drug-resistant strains are becoming increasingly prevalent worldwide. This review systematically analyses data from recent publications to describe the global prevalence and antibiotic sensitivity of ocular P. aeruginosa. Thirty-seven studies were selected for review from PubMed-based searches using the criteria 'microbial keratitis OR eye infection AND Pseudomonas aeruginosa AND antibiotic resistance' and limiting to papers from 2011 onward, to demonstrate the antibiotic resistance from isolates from around the world. Subsequently, we reviewed the ways in which P. aeruginosa can become resistant to antibiotics. Both the rate of isolation of bacteria in general (79 per cent of cases), and prevalence of P. aeruginosa (68 per cent of all isolates) were highest in contact lens-related microbial keratitis. The average resistance rate to common ocular antibiotics such as ciprofloxacin (9 per cent), gentamicin (22 per cent) and ceftazidime (13 per cent) remained relatively low. However, there were large variations in resistance rates reported in studies from different countries, for example resistance to ciprofloxacin reached up to 33 per cent. We next reviewed the types of mobile genetic elements (MGEs) such as plasmids, integrons and transposons that are frequently associated with drug resistance in P. aeruginosa. MGEs are important for the transmission of resistance to beta-lactams and aminoglycosides and recently have been shown to be potential factors for the transmission of fluoroquinolone resistance. Studies on the molecular mechanisms of resistance transfer in ocular P. aeruginosa have begun to be reported and will provide valuable information on the emergence of new antibiotic resistance and potential to treat resistant strains.

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Antibiogram of Medical Intensive Care Unit at Tertiary Care Hospital Setting of Pakistan

Cited by 23 publications

References 14 publications

Development of Antibiogram for Evaluation of Antibiotic Resistance Pattern in Tertiary Care Teaching Hospital: a Cross Sectional Study

Development of Antibiogram for Evaluation of Antibiotic Resistance Pattern in Tertiary Care Teaching Hospital: a Cross Sectional Study

Antimicrobial Resistance Patterns: Review of the Antibiogram of a Surgical Unit in a Public Tertiary Care Hospital of Pakistan

Overview of mechanisms of antibiotic resistance in Pseudomonas aeruginosa: an ocular perspective

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