High burden of antimicrobial resistance among gram negative bacteria causing healthcare associated infections in a critical care unit of Nepal

Parajuli, Narayan Prasad; Acharya, Subhash Prasad; Mishra, Shyam Kumar; Parajuli, Keshab; Rijal, Basista Prasad; Pokhrel, Bharat Mani

doi:10.1186/s13756-017-0222-z

Cited by 135 publications

(145 citation statements)

References 44 publications

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“…This is comparable with the study [19,20,21]. Reasons for such alarming MDR might be inappropriate and incorrect administration of antimicrobial agents as empirical treatment and lack of appropriate infection control strategies, which can cause a shift to increase prevalence of resistant organism in the community [22][23][24][25].…”

Section: Discussionsupporting

confidence: 68%

Clinical Epidemiology and Antibiogram of UTI Patients Attended Different Hospital in Khartoum, Sudan

Badri¹,

Mohamed²

2017

Clin Microbiol

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Urinary tract infections are the most common bacterial infections in humans, both as community-acquired and healthcare-associated infections. The present study was aimed to determine the distribution and antimicrobial susceptibility of strains isolated from urinary tract infections. A hospital cross-sectional based study includes 150 clinically suspected cases of urinary tract infections attended different hospital in Khartoum. Midstream urine samples were collected and pure isolates of pathogenic microorganisms were characterized by colony morphology, gram-stain and standard biochemical procedures. A standard method of agar disc diffusion susceptibility testing method was used to determine susceptibility patterns of the isolates. The most common pathogens isolated were E. coli (57.3%), K. pneumonia (16.7%), P. aeruginosa (14%), E. feacalis (4%). C. albicans (8%). For all UTI isolates, least resistance was observed, E. coli and Klebsiella pneumoniae showed the highest percentage of resistance to ampicillin, Cefepime, Amikacin and Ciprofloxacin, followed by Gentamycin and Imipenem. Significant bacteriuria has been observed. Majority of the isolates were resistant to the commonly prescribed antibiotics. Identifying the pathogen, choosing correct antibiotics, limiting their excess use, improving resistance surveillance systems will help controlling this global problem.

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Section: Discussionsupporting

confidence: 68%

Clinical Epidemiology and Antibiogram of UTI Patients Attended Different Hospital in Khartoum, Sudan

Badri¹,

Mohamed²

2017

Clin Microbiol

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“…Parajuli et al, from Kathmandu, Nepal, reported Acinetobacter as the most common pathogens from ICU patients followed by Klebsiella, E coli and Pseudomonas species. 21 Study from Bangladesh reported Klebsiella pneumoniae as most common bacterial pathogens from lower respiratory tract. 19 The spectrum of pathogens and drug resistance pattern vary from hospital to hospital, within and outside country along with type of illness among the patients.…”

Section: Discussionmentioning

confidence: 99%

Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

et al. 2019

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Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.

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“…57 In another study, Enterobacteriaceae community were found to be completely resistant to third-generation cephalosporins. 58 Over 80% of the Klebsiella spp. community were resistant to ciprofloxacin, gentamicin, piperacillin, tazobactam, and imipenem showing 48.6% resistance.…”

Section: Prevalence and Brief Outline Of Hcaismentioning

confidence: 99%

“…community were resistant to ciprofloxacin, gentamicin, piperacillin, tazobactam, and imipenem showing 48.6% resistance. E. coli was equally resistant although carbapenems were effective in almost 58 Another study reported that although the Acinetobacter spp. were 76.99%-92.01%, resistant to most antimicrobials, only 30% of Acinetobacter spp.…”

Section: Prevalence and Brief Outline Of Hcaismentioning

confidence: 99%

Health care-associated infections – an overview

Haque¹,

Sartelli²,

McKimm³

et al. 2018

IDR

963

610

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Health care-associated infections (HCAIs) are infections that occur while receiving health care, developed in a hospital or other health care facility that first appear 48 hours or more after hospital admission, or within 30 days after having received health care. Multiple studies indicate that the common types of adverse events affecting hospitalized patients are adverse drug events, HCAIs, and surgical complications. The US Center for Disease Control and Prevention identifies that nearly 1.7 million hospitalized patients annually acquire HCAIs while being treated for other health issues and that more than 98,000 patients (one in 17) die due to these. Several studies suggest that simple infection-control procedures such as cleaning hands with an alcohol-based hand rub can help prevent HCAIs and save lives, reduce morbidity, and minimize health care costs. Routine educational interventions for health care professionals can help change their hand-washing practices to prevent the spread of infection. In support of this, the WHO has produced guidelines to promote hand-washing practices among member countries.

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High burden of antimicrobial resistance among gram negative bacteria causing healthcare associated infections in a critical care unit of Nepal

Cited by 135 publications

References 44 publications

Clinical Epidemiology and Antibiogram of UTI Patients Attended Different Hospital in Khartoum, Sudan

Clinical Epidemiology and Antibiogram of UTI Patients Attended Different Hospital in Khartoum, Sudan

Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

Health care-associated infections – an overview

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High burden of antimicrobial resistance among gram negative bacteria causing healthcare associated infections in a critical care unit of Nepal

Cited by 135 publications

References 44 publications

Clinical Epidemiology and Antibiogram of UTI Patients Attended Different Hospital in Khartoum, Sudan

Clinical Epidemiology and Antibiogram of UTI Patients Attended Different Hospital in Khartoum, Sudan

Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

Health care-associated infections &ndash; an overview

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Health care-associated infections – an overview