Prevalence and Susceptibility Analysis of Gram Negative Pathogens in Super Specialty Tertiary Care Centers, Pune in India from January 2018- January 2019

Abstract

Background and Objective: The encumbrance of antimicrobial resistance worldwide is substantive and likely to rise without any appropriate treatment which has enhanced the urge for the development of either new antibiotics or adjuvant therapy with antibiotics. Thus, we aimed to study a comparative antibiogram pattern of 758 clinical isolates collected from Pawana Hospital and Accord SDH, Pune (India), towards Elores (a novel antibiotic and adjutant entity of ceftriaxone, sulbactam and disodium edetate) and other antibiotics (imipenem, meropenem and piperacillin + tazobactam).
 Methods: The clinical samples collected from outpatients and inpatients during a period of one year (January, 2018 to January, 2019), from Pawana Hospital and Accord SDH, Pune (India) and were further subjected to bacterial identification. Antibiotic susceptibility testing was executed in accordance with the recommendations of Clinical Laboratory Standards Institute (CLSI) guidelines.
 Results: Out of 758 collected samples, urine samples contributed 69.41 and 37.63% among Enterobacteriaceae and Non-Enterobacteriaceae followed by pus (20.25 and 19.35%) and sputum (4.2 and 19.89%) while <4% and <12% Enterobacteriaceae and Non-Enterobacteriaceae isolates were collected from rest of the specimen. E. coli were found most prevalent (50.13%) along with 19.13 and 16.09% prevalence of Pseudomonas spp. and Klebsiella spp. whereas rest of the pathogens were <7% present. The antibacterial activity of Elores (87.80%) was observed superior to carbapenem drugs (meropenem; 62.67% and imipenem; 60.95%) and far better to piperacillin + tazobactam (48.42%) against 758 clinical pathogens. Antibiogram profile depicted Elores as most susceptible (95.10%) drug towards Enterobacteriaceae isolates which was approximately 31-50% more sensitive than other test drugs. Similar pattern was obtained for Non-enterobacteriaceae isolates (62.90%) where Elores contributed approximately 1-5% higher activity. However, Elores also conquered 79.51-86.59% resistance among meropenem, imipenem and piperacillin + tazobactam resistant pathogens.
 Conclusion: Susceptibility profile data revealed the equivalence of Elores (Antibiotic-adjuvant entity; AAE) with carbapenem drugs (meropenem and imipenem) and superiority over piperacillin + tazobactam against clinical pathogens. Elores was also found active towards meropenem, imipenem and piperacillin + tazobactam resistant pathogens. Therefore, Elores, a resistance breaker, can be used as an efficient treatment alternate towards infections caused by resistant pathogens.

A Comparative In Vitro Sensitivity Study of “Ceftriaxone–Sulbactam–EDTA” and Various Antibiotics against Gram-negative Bacterial Isolates from Intensive Care Unit

“…A similar study performed by Satras reported superior antibacterial activity of CSE (87.80%) as compared to carbapenem drugs (meropenem: 62.67% and imipenem: 60.95%) and was far better to piperacillin + tazobactam (48.42%) against 758 clinical pathogens. 24 Antibiogram profile depicted CSE as most susceptible drug toward both Enterobacteriaceae and non-Enterobacteriaceae isolates. 24 In our study, among, the “ESBL group”, CSE and colistin showed 100% sensitivity toward Acinetobacter .…”

“… 24 Antibiogram profile depicted CSE as most susceptible drug toward both Enterobacteriaceae and non-Enterobacteriaceae isolates. 24 In our study, among, the “ESBL group”, CSE and colistin showed 100% sensitivity toward Acinetobacter . “CSE” was much more effective toward Enterobacteriaceae (95%) as compared to colistin (89%).…”

CSE (Ceftriaxone+ Sulbactam+ Disodium Edta): A Possible Solution to the Global Antimicrobial Resistance Pandemic

“…while it was K. pneumoniae among the members of Enterobacteriaceae that showed high resistance. Indian studies on gram negative bacterial infections have reported high rates of resistance for β-lactams, β-lactamsβ-lactamase inhibitors and rapidly rising trend for carbapenems 19,20 . Irrational and overuse of the reserve antibiotics like carbapenems and colistin which are recommended only in MDR cases 21 has led to their increased resistance.…”