Etiology of bloodstream infection and antibiotic susceptibility pattern of the isolates

Bhandari, Prashubha; Manandhar, Sarita; Shrestha, Basudha; Dulal, Nabeen

doi:10.3126/ajms.v7i2.13444

Cited by 3 publications

(5 citation statements)

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“…A total of 88 Salmonella enterica isolates were recovered, with predominance of Salmonella Typhi. Salmonella Typhi was found to be the major causative agent of enteric fever in other similar types of studies but with lower distribution rate [ 12 , 18 ]. However, Salmonella Paratyphi strains have also been reported as predominant causes of enteric fever by Pokharel et al (Paratyphi A 53%) previously from nearby hospital [ 19 ].…”

Section: Discussionmentioning

confidence: 98%

Renaissance of Conventional First-Line Antibiotics inSalmonella entericaClinical Isolates: Assessment of MICs for Therapeutic Antimicrobials in Enteric Fever Cases from Nepal

Khanal

Satyal

Bhetwal

et al. 2017

BioMed Research International

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Enteric fever caused by Salmonella enterica is a life-threatening systemic illness of gastrointestinal tract especially in tropical countries. Antimicrobial therapy is generally indicated but resistance towards commonly used antibiotics has limited their therapeutic usefulness. Therefore, we aimed to determine the antimicrobial susceptibility pattern by minimum inhibitory concentration method of common therapeutic regimens against Salmonella enterica from enteric fever clinical cases. Salmonella enterica clinical isolates recovered from the patients with suspected enteric fever whose blood samples were submitted to microbiology laboratory of Manmohan Memorial Community Hospital, Kathmandu, from March 2016 to August 2016, were studied. These isolates were subjected to antimicrobial susceptibility testing against common therapeutic antimicrobials by Kirby-Bauer disk diffusion method. The minimum inhibitory concentration of ciprofloxacin, azithromycin, chloramphenicol, and cefixime was determined by Agar dilution method based on the latest CLSI protocol. A total of 88 isolates of Salmonella enterica were recovered from blood samples of enteric fever cases. Out of them, 74 (84.09%) were Salmonella Typhi and 14 (15.91%) were Salmonella Paratyphi A. On Kirby-Bauer disk diffusion antimicrobial susceptibility testing, entire isolates were susceptible to cotrimoxazole, cefixime, ceftriaxone, azithromycin, and chloramphenicol. Sixty-four (72.7%) Salmonella enterica isolates were nalidixic acid resistant and nonsusceptible to ciprofloxacin and levofloxacin. On MIC determination, four Salmonella isolates were ciprofloxacin resistant with MIC 1 µg/ml and two isolates were ciprofloxacin intermediate with MIC 0.5 µg/ml. The MIC range of azithromycin was from 0.125 µg/ml to 2.0 µg/ml, whereas that for chloramphenicol was 2.0 µg/ml–8.0 µg/ml and for cefixime was 0.0075–0.5 µg/ml, respectively. Despite global surge of antimicrobial resistance among Salmonella enterica clinical isolates, the level of drug resistance in our study was not so high. However, higher level of NARST strains limits therapeutic use of fluoroquinolones and necessitates the routine monitoring of such resistance determinants in order to effectively and rationally manage enteric fever cases.

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Section: Discussionmentioning

confidence: 98%

Renaissance of Conventional First-Line Antibiotics inSalmonella entericaClinical Isolates: Assessment of MICs for Therapeutic Antimicrobials in Enteric Fever Cases from Nepal

Khanal

Satyal

Bhetwal

et al. 2017

BioMed Research International

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“…Among studies examining Salmonella spp. (S. Typhi and S. Paratyphi) resistance rates in bacteremia isolates between 2012 and 2017, the rate of ciprofloxacin non-susceptibility ranged from 25% to 94% (126)(127)(128)(129)(130)(131)(132)(133)(134)(135). A limited number of studies examined the resistance rates of other organisms isolated from blood cultures (132)(133)(134)(135)(136).…”

Section: Nepalmentioning

confidence: 99%

“…(S. Typhi and S. Paratyphi) resistance rates in bacteremia isolates between 2012 and 2017, the rate of ciprofloxacin non-susceptibility ranged from 25% to 94% (126)(127)(128)(129)(130)(131)(132)(133)(134)(135). A limited number of studies examined the resistance rates of other organisms isolated from blood cultures (132)(133)(134)(135)(136). Among these studies, which were conducted between 2012 and 2016, third-generation cephalosporin resistance among E. coli ranged from 0% to 60% (132)(133)(134)(135)(136), and the proportion of MRSA ranged from 25% to 40% (132,(134)(135)(136).…”

Section: Nepalmentioning

confidence: 99%

“…A limited number of studies examined the resistance rates of other organisms isolated from blood cultures (132)(133)(134)(135)(136). Among these studies, which were conducted between 2012 and 2016, third-generation cephalosporin resistance among E. coli ranged from 0% to 60% (132)(133)(134)(135)(136), and the proportion of MRSA ranged from 25% to 40% (132,(134)(135)(136). Carbapenem resistance among Klebsiella spp., Acinetobacter spp., and Pseudomonas spp.…”

Section: Nepalmentioning

confidence: 99%

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Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Alvarez-Uria²,

et al. 2020

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SUMMARY Antimicrobial resistance (AMR) is a serious global health threat and is predicted to cause significant health and economic impacts, particularly in low- and middle-income countries (LMICs). AMR surveillance is critical in LMICs due to high burden of bacterial infections; however, conducting AMR surveillance in resource-limited settings is constrained by poorly functioning health systems, scarce financial resources, and lack of skilled personnel. In 2015, the United Nations World Health Assembly endorsed the World Health Organization’s Global Action Plan to tackle AMR; thus, several countries are striving to improve their AMR surveillance capacity, including making significant investments and establishing and expanding surveillance networks. Initial data generated from AMR surveillance networks in LMICs suggest the high prevalence of resistance, but these data exhibit several shortcomings, such as a lack of representativeness, lack of standardized laboratory practices, and underutilization of microbiology services. Despite significant progress, AMR surveillance networks in LMICs face several challenges in expansion and sustainability due to limited financial resources and technical capacity. This review summarizes the existing health infrastructure affecting the establishment of AMR surveillance programs, the burden of bacterial infections demonstrating the need for AMR surveillance, and current progress and challenges in AMR surveillance efforts in eight South and Southeast Asian countries.

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“…These results do not conform to the findings of a study in Nepal showing Salmonella Typhi as the commonest pathogen isolated in 71% cases of bloodstream infections, followed by Salmonella paratyphi A as the second common bug being isolated in 16% cultures. Escherichia coli was found in 5% and Klebsiella pneumonia in 0.5% cultures respectively 19 .…”

Section: Methodsmentioning

confidence: 97%

Gram negative organisms isolated from Blood Cultures and their Susceptibility Pattern

Munir¹,

Inam²,

Aslam³

et al. 2021

PJMHS

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Background: Bloodstream infections (BSIs) are an important frequent health problem in terms of their high incidence and lethal outcomes. The bacteria that frequently cause bacteremia are Staphylococcus, Streptococcus, Enterococcus, Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, Neisseria and Haemophilus. Gram negative rods constitute a significant bulk in BSIs. The bloodstream infections due to multidrug resistant pathogens are on the rise globally making treatment more challenging. Aim: To identify the gram negative organisms causing blood stream infections and assess their susceptibility pattern so as to provide guidance for the empirical treatment hoping for better clinical outcome. Methodology: A retrospective, cross-sectional descriptive study carried out in Pathology Laboratory of Sharif City Hospital, Lahore. All the blood culture samples received in Microbiology laboratory between June 2017 to June 2019 were included in the study by non-probability consecutive sampling. Blood cultures were proceeded by subculturing on 1st and 5th day on MacConkey and Blood agar. The colonies obtained were identified through gram staining and biochemical profile. API20E was used for Enterobacteriaceae. Antibiotic susceptibility testing of the pathogens was by Kirby Bauer disc diffusion method. Results: In the current study 663 blood cultures were analyzed. Only 11.9% exhibited positive microbial growth. 55.7% of the positive cultures revealed gram negative bacteria. Among the pathogens isolated, E.coli was found to be responsible for BSIs in 22.7% cases, followed by Salmonella Typhi 20.4% and Klebsiella pneumoniae 18.1%.The gram negative rods exhibited a very high resistance for penicillins, cephalosporins and fluoroquinolones. The efficacy of aminoglycosides and results for carbapenems susceptibility were hopeful. Conclusion: The study shows that the Gram negative bacteria causing BSIs have shown unsatisfactory susceptibility to most of the commonly prescribed antimicrobials. The rising drug resistance has a major impact on the selection and prescription of antibiotics and calls for judicious use of antibiotics. Keywords: Gram Negative Organisms, Blood Culture, Antimicrobial Susceptibility Pattern

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Etiology of bloodstream infection and antibiotic susceptibility pattern of the isolates

Cited by 3 publications

References 20 publications

Renaissance of Conventional First-Line Antibiotics inSalmonella entericaClinical Isolates: Assessment of MICs for Therapeutic Antimicrobials in Enteric Fever Cases from Nepal

Renaissance of Conventional First-Line Antibiotics inSalmonella entericaClinical Isolates: Assessment of MICs for Therapeutic Antimicrobials in Enteric Fever Cases from Nepal

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Gram negative organisms isolated from Blood Cultures and their Susceptibility Pattern

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