Urinary tract infection is one of the most common human infections. Furthermore there is rise in the Resistance of causative pathogens against the commonly prescribed antibiotics. Present study was aimed at finding the prevalence of such uropathogens and their antibiogram. Among 1059 suspected urinary samples were processed in the Department of Microbiology, D Y Patil Hospital, Nerul.,Navi-Mumbai. 580 (54.78%) were found to be culture positive. The predominant pathogen was E.coli (37.79%), while Enterococcus (30.30%), Klebsiella spp. (13.55%), Pseudomonas spp. (7.13%), Enterobacter spp. (2.67%), Acinetobacter spp. (2.67%), Citrobacter spp. (1.96%), Proteus spp. (2.14%), Staphylococcus aureus (0.71%), Streptococcus spp. (0.89%), Providentia rettgeri (0.18%) were other uropathogens isolated in this study.
Of the isolated pathogens, 98.58% Gram negative organisms were sensitive only to Colistin and 95.28% to Imipenem except Pseudomonas species, Enterobacter species and Acinetobacter species. More than 95.28% Gram negative organisms showed resistance to Amoxycillin-clavulanic acid. The resistant pattern for other antibiotics was as follows, Ciprofloxacin (83.96% except for Klebsiella, Enterobacter, Citrobacter, Proteus and Pseudomonas aeruginosa), Cephalosporins (73.3% except for Klebsiella, Pseudomonas aeruginosa and Proteus vulgaris).
Amongst Gram positive isolates (Enterococcus faecalis & Staphylococcus aureus), 100% of the isolates showed sensitivity to Linezolid and Vancomycin. Staphylococcus aureus also showed 100% sensitivity to Imipenem. 100% of the Staphylococcus aureus showed resistance to Penicillin by 94.71%. Enterococcus faecalis showed resistance to Penicillin 98.82% and to Co-trimoxazole. Enterococcus showed more multidrug resistant pattern amongst Gram positive isolates.
Background: The growing increase in the rate of antibiotic resistance is a major cause for concern in both non-fermenting bacilli. β-lactams have been the mainstay of treatment for serious infections, and the most active of these are the carbapenems. Acquired metallo-β-lactamases (MBL) have recently emerged as one of the most worrisome resistance mechanisms owing to their capacity to hydrolyze all β-lactams, including carbapenems. We have undertaken this investigation to ascertain the incidence of MBL-producing non-fermenting bacilli, like Pseudomonas Spp. and Acinetobacter Spp. Aim: To determine the incidence of MBL in Nosocomial infections of non-fermenters and their clinical correlation. Objectives : Screening of nosocomial isolates for multidrug resistance by antibiotic sensitivity tests as per CLSI guidelines as a reference. To perform phenotypic confirmatory test of potential MBL isolates by double disc synergy test Clinical correlation with detection of these enzymes and the patients morbidity/mortality correlation with age, immunocompromised status and hospital stay. Materials and Methods : The study was conducted over a period of 12 months in a teaching hospital, in Navi Mumbai. Isolates included in the study were screened for imipenem resistance by conventional methods. The isolates that showed imipenem resistance were tested for MBL production by imipenem (IMP)-ethylene-diamine-tetra-acetic acid (EDTA) combined disc test. Imipenem-resistant non-MBL isolates also were tested for Modified Hodge test and AmpC β-lactamases production to detect other mechanisms of carbapenem resistance. Results: Total number of isolates tested were 107.Out of 107, 29 (27.1%) were MBL producers and 78(72.9%) were non-MBL producers. Among both types of non-fermenters , 66(61.68%) were Pseudomonas aeruginosa and 41(32.23%) were of Acinetobacters. In the sex distribution, 65.5%were males and 34.5% were females.18.18% were MBL positive Pseudomonas and among Acinetobacter species 41.46% were MBL positive. Mean age of MBL producers was 34 years. Mean hospital stay was 28 days. Mortality rate was 51.7% in MBL producers. Mortality was higher in Acinetobacter MBL producers.when compared to Pseudomonas MBL producers.
Candida contains a wide range of organisms, and more than 17 different Candida species have been linked to human infections. Newer species are emerging and Candida albicans and other Species are re-emerging. Isolated strains showing increased antifungal resistance, which necessitates the need for new antifungal drugs. Candida Spp can cause a wide range of mycoses, including invasive candidiasis, which can be deep, widespread, and extremely painful. The majority of the time, it spreads by endogenous Candidaemia. They adhere to host tissues and medical equipment, form biofilms, and release enzymes that break down proteins. Conventional techniques and molecular techniques have made laboratory diagnosis of Candida easy. However, Candida infections are more common in immunocmpromised and hospitalised patients.
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