Salmonella typhi and S. paratyphi are important causes of bacteremia in children, especially those from the developing world. There is a lack of standardized treatment protocols for such patients in the literature, and there are also reports of therapeutic failure related to resistance to commonly used antibiotics. We analyzed the epidemiological, clinical, and antimicrobiological sensitivity patterns of disease in patients diagnosed with blood culture-positive typhoid fever over a 6-month period in a tertiary-care pediatric hospital in western India. Data were retrospectively analyzed for all patients with Salmonella isolates on blood culture between January 1 and June 30, 2011 at the Synergy Neonatal and Pediatric Hospital. Susceptibility of isolates to antimicrobials and minimum inhibitory concentrations were determined. Demographic data, symptoms and signs, basic laboratory results, treatment courses, and clinical outcomes were collected from clinical charts. All of the 61 isolates of S. typhi were sensitive to cefepime (fourth-generation cephalosporin), 96% to third-generation cephalosporins, and 95% to quinolones. There was intermediate sensitivity to ampicillin (92%) and chloramphenicol (80%). Notably, azithromycin resistance was observed in 63% of isolates. All patients ultimately made full recoveries. There is an urgent need for large scale, community-based clinical trials to evaluate the effectiveness of different antibiotics in enteric fever. Our antimicrobial susceptibility data suggest that quinolones and third-generation cephalosporins should be used as first-line antimicrobials in enteric fever. Although fourth-generation cephalosporins are useful, we feel their use should be restricted to complicated or resistant cases.
Background: Mostly intensive care unit (ICU) patients are more susceptible to nosocomial infections caused by hospital-based various strains of bacteria and other opportunistic pathogens. Due to the widespread use of broad-spectrum antibiotics, these strains of pathogens are often multi-drug resistant. To prevent resistance against the antimicrobial agent various departments of the health care system have to work together, so we can use the antimicrobial agents as effectively as we can to treat illnesses.
Aim and Objectives: The objective of this study was to know the prevalence of different micro-organisms causing infections in ICU and their sensitivity and resistance pattern and to determine the overall microbiological and resistance profile which helps formulate therapeutic guidelines in ICU.
Materials and Methods: A cross-sectional study was conducted at a tertiary care teaching hospital in Ahmedabad to assess the culture and sensitivity pattern of clinical samples such as blood, urine, sputum, wound, and endotracheal aspiration for a 1-year duration (August 2019 - August 2020).
Results: A total of 941 samples were received for microbiological investigation from ICU, out of which 322 were positive. The Utmost isolated organism was - Klebsiella (37.26%) followed by Escherichia coli (16.45%), Pseudomonas (12.42%), and Staphylococcus aureus (7.45%). The Gram-negative bacteria (GNB) were most sensitive to drugs like colistin (96.26% %) and tigecycline (83.40%) followed by carbapenems (71.79%), aminoglycosides (71.36%), and fluoroquinolones (67.21%). More sensitive drugs for isolated Gram-positive organisms were linezolid (100%) followed by teicoplanin (98.41%) and vancomycin (98.41%).
Conclusion: High prevalence of multidrug-resistant organisms such as methicillin-resistant S. aureus, vancomycin-resistant enterococci and GNB producing Extended-spectrum Beta-lactamase, AmpC, or carbapenem-resistant GNB in our study, raise serious concerns about antibiotic resistance. The main reason for increasing antimicrobial-resistant bacteria is poor infection control practices and inappropriate use of antibiotics. Hence, research regarding antibiotic sensitivity and resistance will be very helpful for doctors to initiate appropriate empirical antibiotics in treating critical illnesses.
Background: Staphylococcus aureus is one of the most common causes of hospital- and community-acquired infections globally. The increasing prevalence of methicillin-resistant S. aureus (MRSA) has led to the widespread usage of higher antibiotics such as vancomycin and linezolid, leading to the emergence of resistance to these reserved antibiotics.
Aims and Objectives: This study aimed to analyze the burden of MRSA infections in various setups.
Materials and Methods: A retrospective study was conducted over a period of 1 year in a tertiary care hospital in Ahmedabad, Gujarat. The isolates were identified as S. aureus by phenotypic methods such as Gram stain, colony morphology, and standard biochemical reactions. The antimicrobial susceptibility of all S. aureus isolates was determined. The cefoxitin disk diffusion method as per Clinical and Laboratory Standards Institute guidelines was used to interpret the isolates as MRSA.
Results: Out of 12500 different types of samples processed, 190 isolates of S. aureus were identified. Among them, 102 (53.68%) were found to be MRSA and 88 (46.32%) were found to be methicillin-sensitive S. aureus.
Conclusion: The rising trend of MRSA stresses the need for continuous monitoring of MRSA and their antibiogram. Regular MRSA surveillance of health-care workers to identify MRSA carriers, strict hand hygiene compliance, and formulation of antibiotic policies to prevent overuse and misuse of antibiotics with effective infection control practices are the most effective ways to prevent MRSA infection.
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