scholarly journals Re-thinking antimicrobial resistance transmission dynamics: a meta-analysis of cross-sectional studies at referral hospitals in Uganda

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 878
Author(s):  
Gerald Mboowa ◽  
Ivan Sserwadda ◽  
Dickson Aruhomukama
Keyword(s):  
Antimicrobial Resistance ◽  
Transmission Dynamics ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Extended Spectrum ◽  
Hospital Environments ◽  
Referral Hospitals ◽  
Cross Sectional Studies

Background: Antimicrobial resistance threatens the achievements of modern medicine as well as the sustainability of effective global public health responses to the threat posed by infectious diseases. Extended-spectrum β-lactamase production in bacteria provides the main mechanism of resistance in gram-negative bacteria, particularly those belonging to the Enterobacteriaceae family as well as gram-positive bacteria. This study hence aimed at providing insights into the potential role of in-patients, their immediate hospital environments, out-patients, and their communities in the transmission of antimicrobial resistance via identifying gram-negative and gram-positive bacteria commonly isolated in samples collected from each of these patients/sites as well as their antimicrobial susceptibility profiles using extended-spectrum β-lactamase production in the same as the basis. Methods: Our study reviewed four cross-sectional studies conducted at national and regional referral hospitals in Uganda. Data on bacterial aetiology and antimicrobial susceptibility testing retrieved from the studies was imported into Microsoft Excel, cleaned, sand then exported to IBM SPSS statistics (version 16) for statistical analysis. The databases used were PubMed and Embase.  Results: We report that; Escherichia coli and Klebsiella pneumoniae are the most prevalent Enterobacteriaceae species in the samples that were collected in the studies reviewed; these species account for the highest proportions of extended-spectrum β-lactamase producers; Staphylococcus aureus is the most prevalent of the gram-positive bacteria isolated from the same samples, and accounts for the highest proportions of extended-spectrum β-lactamase producers in the gram-positive bacteria isolated, and similar Enterobacteriaceae species and gram-positive bacteria, are predominant in samples from in-patients, their immediate hospital environments, and out-patients. Conclusion: The insights provided indicate antimicrobial resistance transmission dynamics be re-thought and more comprehensive studies aimed at investigating the same be done to ascertain the source and transmission routes of antimicrobial-resistant bacteria in clinical settings.

scholarly journals Difference of Procalcitonin Levels in Gram-Positive and Gram-Negative Bacterial Sepsis Patients of Indonesia Army Central Hospital Gatot Soebroto in 2016

2022 ◽  
Vol 13 (1) ◽  
pp. 38
Author(s):  
Nindy Handayani ◽  
Soroy Lardo ◽  
Nunuk Nugrohowati
Keyword(s):  
Mean Difference ◽  
P Value ◽  
Central Hospital ◽  
Bacterial Sepsis ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Significant Difference ◽  
The Mean

Introduction: Procalcitonin is known as a marker of infection and indicator for severity of infections. In sepsis, elevated procalcitonin levels in blood have a significant value that can be used as a sepsis biomarker. The aim of this study was to determine the mean difference of procalcitonin levels in Gram-positive and Gram-negative bacterial sepsis patients.Methods: This study used quantitative method with cross sectional approach. The sample of this study were bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 which were divided into two groups: Gram-positive and Gram-negative bacterial sepsis patients with the number of each group was 30 samples. The data were analyzed by using independent t test.Results: This study showed that mean levels of procalcitonin in Gram-positive bacterial sepsis patients was 6.47 ng/ml and Gram-negative was 66.04 ng/ml. There was a significant difference between mean levels of procalcitonin in Gram-positive and Gram-negative bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 with p value = 0.000 (p < 0.05).Conclusion: The mean difference of procalcitonin levels in Gram-negative bacterial sepsis patients were higher than Gram-positive bacterial sepsis patients, because Gram-negative bacteria have lipopolysaccharide which is a strong immunostimulator and increases TNF-α production higher than Gram-positive bacteria. 

scholarly journals Incidence and Bacterial Etiologies of Surgical Site Infections in a Public Hospital, Addis Ababa, Ethiopia

2019 ◽  
Vol 13 (1) ◽  
pp. 301-307
Author(s):  
Alem A. Kalayu ◽  
Ketema Diriba ◽  
Chuchu Girma ◽  
Eman Abdella
Keyword(s):  
Drug Resistance ◽  
Addis Ababa ◽  
Surgical Site Infections ◽  
Resistant Bacteria ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Clinical Criteria ◽  
Gram Positive Bacteria

Background: Surgical Site Infections (SSIs) are among the frequently reported healthcare-acquired infections worldwide. Successful treatment of SSIs is affected by the continuous evolvement of drug-resistant microbes. This study investigated the incidence of SSIs, identifying the major etiologic agents and their drug resistance patterns in Yekatit 12 Hospital, Ethiopia. Methods: A cross-sectional study was conducted on 649 patients who underwent surgery at Yekatit 12 hospital from April 2016 to April 2017. Socio-demographic and clinical data were collected from each patient on admission. After surgery, they were followed for SSI occurrence. SSI was initially diagnosed by a senior surgeon based on standard clinical criteria and then confirmed by culture. Isolates were tested for drug resistance according to the clinical and laboratory standards institute guideline. Results: Of the 649 study participants, 56% were females. Their age ranged from 9 months to 88 years with a median age of 37 years. The incidence of culture-confirmed SSI was 10.2% (66/649) where 73 isolates were recovered. About two-third of the isolates were Gram-positive bacteria. Staphylococcus aureus was the most frequently isolated (27/73, 37%) followed by Coagulase-negative staphylococci (18/73, 24.7%), Escherichia coli (11/73, 15.1%) and Klebsiella species (10/73, 13.7%). About 89% and 44% of S. aureus isolates were resistant to penicillin and trimethoprim-sulfamethoxazole, respectively. MRSA constituted 11% of the S. aureus isolates. All the Gram-negative isolates were resistant to ampicillin and trimethoprim-sulfamethoxazole but susceptible to amikacin and meropenem. Klebsiella species showed 70-100% resistance to ceftazidime, cefuroxime, augmentin, chloramphenicol, ciprofloxacin, cefepime and gentamicin. About 82% of E. coli isolates were resistant for chloramphenicol, cefepime, ceftazidime, augmentin, cefuroxime and 64% for gentamicin and ciprofloxacin. Conclusion: The incidence of surgical site infection in Yekatit 12 hospital is 10.2%. Most of the SSIs were due to Gram-positive bacteria. Gram-negative isolates showed high resistance to the most commonly prescribed drugs. No resistance was found for meropenem indicating the absence of carbapenem-resistant bacteria. SSI treatments should be guided by culture and drug resistance test. Better infection prevention practices and continuous surveillance of antimicrobial resistance in the hospital are recommended for better patient care.

scholarly journals Microbiological Profile and Antibiotic Sensitivity Pattern of Bacteria in Diabetic Foot Ulcers in a Tertiary Care Hospital

2021 ◽  
Vol 08 (01) ◽  
pp. 1-8
Author(s):  
Gajender Singh Ranga ◽  
Keyword(s):  
Diabetic Foot ◽  
Tertiary Care ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
E Coli ◽  
Gram Positive Bacteria ◽  
Sensitivity Pattern

Introduction: Diabetic foot is any foot pathology due to diabetes or sequelae of diabetes mellitus. This study was conducted to identify the common microorganisms isolated from diabetic foot and to analyse the antibiotic susceptibility pattern of bacteria isolated from diabetic foot. Materials and Method: The study was a hospital based cross-sectional study where 146 foot ulcer samples (who had type 2 diabetes) were analysed. Swabs were collected from the edge and margins of ulcers, and organisms were identified by gram staining culture and biochemical reactions. Result:Out of 146 patients, 69 specimens showed growth of organisms. Total 84 aerobic organisms were isolated and out of them, 64 cases showed bacterial growth, in which 84 bacteria were isolated, which represented an average of 1.28 organisms per case. Among these organisms, 62 gram-negative and 22 gram-positive organisms were isolated. E. coli was the most common gram-negative isolate (23.81%), followed by Pseudomonas aeruginosa (21.4%), and Klebsiella pneumonia(8.33%), while among gram-positive bacteria, S. aureus was the most common isolate (22.6%). Conclusion: Incidence of growth was 47.2% in which E. coli (23.8%) was the most common isolate. Gram-negative bacteria were more common than gram-positive bacteria. Diabetic foot infections are polymicrobial in nature.

scholarly journals Bacterial etiology and antibiotic resistance pattern of neonatal sepsis: a study in a tertiary care hospital, in Bangladesh

2019 ◽  
Vol 6 (5) ◽  
pp. 1839
Author(s):  
Mahfuza Shirin ◽  
M. Monir Hossain ◽  
Manifa Afrin ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Mortality And Morbidity ◽  
Gram Positive Bacteria

Background: Neonatal sepsis is a leading cause of neonatal mortality and morbidity. The objective of the study was to detect causative microorganisms of neonatal sepsis and their antimicrobial resistance patterns.Methods: This prospective cross-sectional study was conducted from July 2017 to June 2018 in the Department of Neonatal Medicine and NICU of Dhaka Shishu (Children) Hospital (DSH). Neonates diagnosed with probable sepsis were studied. After enrollment, 1 mL blood was taken and sent to Microbiology department of DSH for culture and sensitivity. With baseline characteristics, clinical examination findings and outcome, were also recorded.Results: Rate of isolation of single organism was 9.2% (84/913). Out of 84 isolates, gram negative bacteria were 77.4% with Klebsiella pneumonae being the commonest (35, 41.7%), gram positive bacteria were 11.9% with Staphylococcus aureus and Streptococcus were equal (5, 5.95% each) and the remaining (9, 10.7%) isolated organism was Candida. Most of the isolated gram-negative bacteria were resistant to ampicillin, gentamicin, and ceftazidime; but gram-positive bacteria preserved 20-80% sensitivity. Klebsiella was more resistant than Acinetobacter to amikacin, netilmicin, ciprofloxacin and levofloxacin. Around 45-65% of gram-negative bacteria were resistant to imipenem and meropenem but gram-positive bacteria showed lesser resistance. Among the gram-negative bacteria, Klebsiella and Acinetobacter were resistant to piperacillin as same as carbapenem group, but gram-positive bacteria were 100% sensitive to piperacillin. All the gram-negative bacteria showed more resistance to 4th generation cephalosporin, cefepime than carbapenem. Out of culture positive 84 neonates, 63 (75.0%) were cured but 21 (25.0%) died. Among the 21 expired neonates, 47.6% (10/21) were infected with Klebsiella.Conclusion: This study observed that gram-negative bacteria causing neonatal sepsis predominantly, with emergence of Candida. All the isolated gram-positive and gram-negative organisms were mostly resistant to available antibiotics

scholarly journals IDENTIFIKASI BAKTERI PADA DEPOT AIR MINUM ISI ULANG DI KOTA MANADO

2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Perisai P. Rumondor ◽  
John Porotu’o ◽  
Olivia Waworuntu
Keyword(s):  
Drinking Water ◽  
Bacillus Subtilis ◽  
Enterobacter Cloacae ◽  
Gram Negative Bacteria ◽  
Enterobacter Agglomerans ◽  
Proteus Vulgaris ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Gram Positive Bacteria

Abstract: Water is a chemical compound that has a very important role for the life of humans and other living creatures but also serve as a medium of transmission of diseases. Refillable drinking water has become a common choice for the people in Indonesia, including in the city of Manado. One of the diseases caused by drinking poor quality water is diarrhea. To determine the condition of the contaminated refillable drinking water, a research or clinical testing in the laboratory is needed. The purpose of this research was to determine the pattern of bacteria in refillable drinking water. This study uses a descriptive research method with a cross sectional approach. Samples were taken from 20 refillable drinking water depots in Manado city that have met the inclusion criteria. Identification of bacteria performed with the culture medium. The results showed 4 samples contained gram positive bacteria, 5 samples contained gram negative bacteria and 11 samples contained a mixture of gram positive and gram negative. Gram positive bacteria consists of three species which are Bacillus subtilis (14 samples; 42,42%), Streptococcus spp. (1 sample; 3,03%) and Staphylococcus spp. (1 sample; 3,03%) and. Six species of gram negative bacteria which are Shigella (1 sample; 3,03%), Diplococcus (1 sample; 3,03%), Enterobacter cloacae (2 samples; 6,06%), Enterobacter agglomerans (2 samples; 6,06%), Pseudomonas spp. (4 samples; 12,12%), and Proteus vulgaris (7 samples; 21,21%). The conclusion of this research most types bacteria of found were Bacillus subtilis. Keywords: bacteria, refillable drinking water    Abstrak: Air merupakan senyawa kimia yang sangat penting fungsinya bagi kehidupan umat manusia dan mahkluk hidup lainnya tapi juga dapat berperan sebagai media penularan penyakit. Air minum isi ulang telah menjadi pilihan umum masyarakat Indonesia, termasuk di kota Manado.Salah satu penyakit yang disebabkan oleh air minum yang kualitas mikrobiologisnya buruk adalah diare.Untuk mengetahui kondisi terkontaminasi tidaknya air minum isi ulang diperlukan penelitian atau pengujian secara klinis di laboratorium.Tujuan dari penelitian ini adalah untuk mengetahui pola bakteri pada air minum isi ulang. Penelitian ini menggunakan metode penelitian deskriptif dengan pendekatan cross sectional. Sampel diambil dari 20 depot air minum isi ulang di Kota Manado yang telah memenuhi kriteria inklusi. Identifikasi bakteri dilakukan dengan media kultur. Hasil penelitian menunjukkan 4 sampel terdapat bakteri gram positif, 5 sampel terdapat gram negatif dan 11 sampel terdapat campuran bakteri gram positif dan gram negatif.Bakteri gram positif terdiri dari 3 spesies yaitu Bacillus subtilis (14 sampel; 42,42%), Streptococcus spp. (1 sampel; 3,03%)dan Staphilococcus spp. (1 sampel; 3,03%). Enam bakteri spesies gram negatif yaitu Shigella (1 sampel; 3,03%), Diplococcus (1 sampel; 3,03%), Enterobacter cloacae (2 sampel; 6,06%), Enterobacter agglomerans (2 sampel; 6,06%), Pseudomonas spp. (4 sampel; 12,12%) dan Proteus vulgaris (7 sampel; 21,21%). Kesimpulan pada penelitian ini jenis bakteri terbanyak yang ditemukan adalahBacillus subtilis. Kata Kunci: bakteri, air minum isi ulang

scholarly journals Serious Antimicrobial Resistance Status of Pathogens Causing Hospital-acquired Lower Respiratory Tract Infections in North China

2009 ◽  
Vol 37 (3) ◽  
pp. 899-907 ◽  
Author(s):  
Y Wang ◽  
R Zhang ◽  
W Li ◽  
Y Feng ◽  
T Leng
Keyword(s):  
Antimicrobial Resistance ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Gram Negative Bacteria ◽  
Lower Respiratory Tract Infections ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Tract Infections ◽  
Hospital Acquired

Antimicrobial resistance patterns of pathogens causing hospital-acquired lower respiratory tract infections (LRTIs) in Shandong Province, China were investigated using data collected from January 2002 to December 2006. A total of 10337 isolates were characterized in sputum samples from 39 920 LRTI patients: 68.72% were Gram-negative bacteria, 20.65% were Gram-positive bacteria, and 10.62% were fungi. Organisms most frequently isolated were: Pseudomonas aeruginosa (16.88%), Klebsiella pneumoniae (10.80%), Escherichia coli (10.71%), fungi (10.62%), Staphylococcus aureus (9.68%) and Acinetobacter baumannii (9.03%). Imipenem was the most effective antibiotic against Gram-negative bacteria. Most Gram-positive bacteria were susceptible to vancomycin. Susceptibility to cephalosporins was not optimal and resistance to fluoroquinolones was high. Resistance of Gram-negative bacteria showed a rapid increase over the study period, while resistance of Gram-positive bacteria remained relatively stable. The emergence of resistance to commonly prescribed antimicrobial agents used against LRTI pathogens has compounded the problem of using empirical therapy and created selective pressure on physicians to use certain antibiotics.

scholarly journals Microbial Patterns and Antimicrobial Susceptibility on Pediatric Patients with Pressure Ulcers

2019 ◽  
Vol 3 (1) ◽  
pp. 17
Author(s):  
Deryne Anggia Paramita ◽  
Khairina Nasution ◽  
Nova Zairina Lubis
Keyword(s):  
Acinetobacter Baumannii ◽  
Pressure Ulcer ◽  
Antimicrobial Susceptibility ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Cross Sectional Study ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: A pressure ulcer (PU) is localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with sharp surface. Several studies have found that PU is also a common problem in the pediatric population. Infection at PU sites is the most common complication, where PU can host resistant microorganisms and can turn into a local infection that is a source of bacteremia in hospital patients. This study aims to determine the most common bacteria and antimicrobial susceptibility at the site of PU in pediatric patients that serve as baseline data in Haji Adam Malik Hospital.Materials and Methods: A cross-sectional study was carried out in July-December 2017, involving 30 PU pediatric patients. For each subject, swab from ulcers were cultured in microbial laboratory to determine the microbial pattern and antimicrobial susceptibility.Results: The most common age group was 0-3 (53.3%), the highest gender was male (60%), the most common type was type 2 (46.7%), the main location was occipital (30%) and the most common undelying diseases were hydrocephalus (16.6%). The most common microbial pattern in PU pediatric patients is Acinetobacter baumannii (40%). The highest sensitivity is vancomycine for gram positive bacteria and amikacine for gram negative bacteria.Conclusion: The most common microbial pattern in PU pediatric patients in Haji Adam Malik Hospital is Acinetobacter baumannii (40%). The highest sensitivity is vancomycine for gram positive bacteria and amikacine for gram negative bacteria.Keywords: pressure ulcer, pediatric, microbial pattern, antimicrobial susceptibility

scholarly journals Selective Targeting of Human and Animal Pathogens of the Helicobacter Genus by Flavodoxin Inhibitors: Efficacy, Synergy, Resistance and Mechanistic Studies

2021 ◽  
Vol 22 (18) ◽  
pp. 10137
Author(s):  
Sandra Salillas ◽  
Juan José Galano-Frutos ◽  
Alejandro Mahía ◽  
Ritwik Maity ◽  
María Conde-Giménez ◽  
...  
Keyword(s):  
Health Concern ◽  
Titration Calorimetry ◽  
Gram Positive ◽  
Gram Negative ◽  
Ulcer Disease ◽  
Gram Positive Bacteria ◽  
Narrow Spectrum ◽  
Extended Spectrum ◽  
Animal Pathogens ◽  
H Pylori

Antimicrobial resistant (AMR) bacteria constitute a global health concern. Helicobacter pylori is a Gram-negative bacterium that infects about half of the human population and is a major cause of peptic ulcer disease and gastric cancer. Increasing resistance to triple and quadruple H. pylori eradication therapies poses great challenges and urges the development of novel, ideally narrow spectrum, antimicrobials targeting H. pylori. Here, we describe the antimicrobial spectrum of a family of nitrobenzoxadiazol-based antimicrobials initially discovered as inhibitors of flavodoxin: an essential H. pylori protein. Two groups of inhibitors are described. One group is formed by narrow-spectrum compounds, highly specific for H. pylori, but ineffective against enterohepatic Helicobacter species and other Gram-negative or Gram-positive bacteria. The second group includes extended-spectrum antimicrobials additionally targeting Gram-positive bacteria, the Gram-negative Campylobacter jejuni, and most Helicobacter species, but not affecting other Gram-negative pathogens. To identify the binding site of the inhibitors in the flavodoxin structure, several H. pylori-flavodoxin variants have been engineered and tested using isothermal titration calorimetry. An initial study of the inhibitors capacity to generate resistances and of their synergism with antimicrobials commonly used in H. pylori eradication therapies is described. The narrow-spectrum inhibitors, which are expected to affect the microbiota less dramatically than current antimicrobial drugs, offer an opportunity to develop new and specific H. pylori eradication combinations to deal with AMR in H. pylori. On the other hand, the extended-spectrum inhibitors constitute a new family of promising antimicrobials, with a potential use against AMR Gram-positive bacterial pathogens.

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