Rapid diagnosis of community-acquired pneumonia using the Bac T/ alert 3D system

Abstract

We compared BacT/Alert 3D with conventional culture for the diagnosis of community-acquired pneumonia (CAP). Antimicrobial susceptibility testing of the isolates was performed with the disk diffusion method, and the minimum inhibitory concentration (MIC) was calculated. Automation was superior in terms of recovery and time to detect pathogens. The bacterial spectrum in CAP was Streptococcus pneumoniae (35.3%) Staphylococcus aureus (23.5%), Klebsiella pneumoniae (20.5%) and Haemophilus influenzae (8.8%). Three of the 12 S. pneumoniae isolates showed penicillin resistance on MIC and two showed erythromycin resistance. There were two H. influenzae strains resistant to penicillin; these were beta lactamase producers. One-fourth of the S. aureus were oxacillin resistant. All isolates were sensitive to cefepime by disc diffusion and MIC methods. In the treatment of CAP, cefotaxime and cefepime are useful drugs when given as empirical therapy against multidrug resistant strains. The use of automation is vital in CAP, as rapid diagnosis and effective therapy can reduce mortality.

Increasing invasive disease due to penicillin resistant <i> S. pneumoniae </i> in India

“…[11] This latest recommendation for the Þ rst time is based on the clinical syndrome and route of penicillin administration. Further, this MIC break point tends to change the earlier Þ ndings of PIRSP, published in the literature up to early 2008, to a much lower percentage for non meningitis isolates [1][2][3]5,[8][9][10] and higher percentage of complete penicillin resistance to meningitis isolates. [6,7] However, this particular study isolate antimicrobial MIC break point interpretation remains valid as it conforms to CLSI 2008 recommendation also.…”

“…Likewise, point prevalence studies reported by other groups in India also had similar trends. This includes 7.3% (n = 11) isolates; [7] 15.4% (n = 2) [8] and 25% (n = 3); [9] 20% (n = 30) with 0.12 -1 µg/mL and 2 µg/mL of 26 and four respiratory isolates respectively. [10] However, in 2008, the Clinical Laboratory Standards Institute (CLSI) after re-evaluating with the more recent clinical data published new MIC penicillin break points for S. pneumoniae.…”

Management and outcome of community acquired pneumonia: hospital based study

“…10 Capoor et al, reported that in the multidrug-resistant CAP, cefepime and cefotaxime could be used. 11 In our study, the mortality rate was 6% with the death of 3 patients during the study period. Khadanga et al, study from eastern India have reported a mortality rate of 7.3% overall for CAP.…”

Prospective Study of Pathogens Associated With Community Acquired Pneumonia in a Mixed Population of Hiv and Non-Hiv Infected Adults

“…10 In the study from Delhi, S. pneumoniae (35.3%) was the most common isolate followed by Staphylococcus aureus (23.5%), Klebsiella pneumoniae (20.5%) and Haemophilus influenzae (8.8%). 8 The study from Shimla showed S. pneumoniae to be the most common cause (35.8%). 7 Mycoplasma pneumophila is an important cause, which is often not considered in the Indian setting.…”