Susceptibility trends in bacteraemias: analyses of 7544 patient-unique bacteraemic episodes spanning 11 years (1990–2000) (original) (raw)
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Microbiology Research Journal International, 2019
Introduction: In the light of changing anti-microbial resistance pattern, the understanding of the local antibiogram is essential in the antibiotic selection procedures and preparation of hospital antibiotic policy. Aim: This retrospective study was aimed to analyze the antibacterial susceptibility pattern of major isolates from ICU and IPD. Materials and Methods: Antimicrobial susceptibility testing was done for a total of 565 Gramnegative isolates including E. coli, K. pnuemoniae, A. baumannnii and P. aeruginosa from ICU and IPD patients enrolled between July 2016 to December 2016. Results: The majority of the isolates were reported from urine samples (52%) in IPD and sputum (59%) in ICU. The susceptibility to BL/BLI was 50-75% in IPD patients and Carbapenem Original Research Article
Antimicrobial susceptibility testing and antimicrobial drug dosage
To establish a hospital-based surveillance network with national coverage for antimicrobial resistance (AMR) and antibiotic consumption in Viet Nam. Methods: A 16-hospital network (Viet Nam Resistance: VINARES) was established and consisted of national and provincial-level hospitals across the country. Antimicrobial susceptibility testing results from routine clinical diagnostic specimens and antibiotic consumption data in Defined Daily Dose per 1000 bed days (DDD/1000 patient-days) were prospectively collected and analysed between October 2012 and September 2013. Results: Data from a total of 24 732 de-duplicated clinical isolates were reported. The most common bacteria were: Escherichia coli (4437 isolates, 18%), Klebsiella spp. (3290 isolates, 13%) and Acinetobacter spp. (2895 isolates, 12%). The hospital average antibiotic consumption was 918 DDD/1000 patient-days. Third-generation cephalosporins were the most frequently used antibiotic class (223 DDD/1000 patientdays, 24%), followed by fluoroquinolones (151 DDD/1000 patient-days, 16%) and second-generation cephalosporins (112 DDD/1000 patient-days, 12%). Proportions of antibiotic resistance were high: 1098/ 1580 (69%) Staphylococcus aureus isolates were methicillin-resistant (MRSA); 115/344 isolates (33%) and 90/358 (25%) Streptococcus pneumoniae had reduced susceptibility to penicillin and ceftriaxone, respectively. A total of 180/2977 (6%) E. coli and 242/1526 (16%) Klebsiella pneumoniae were resistant to imipenem, respectively; 602/1826 (33%) Pseudomonas aeruginosa were resistant to ceftazidime and 578/ 1765 (33%) to imipenem. Of Acinetobacter spp. 1495/2138 (70%) were resistant to carbapenems and 2/333 (1%) to colistin. Conclusions: These data are valuable in providing a baseline for AMR among common bacterial pathogens in Vietnamese hospitals and to assess the impact of interventions.
Bacteraemia in Europe antimicrobial susceptibility data
The in vitro antimicrobial susceptibility of organisms isolated from bacteraemic versus non-bacteraemic patients was evaluated using data (1997–2001) from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Programme. Minimum inhibitory concentration values and susceptibility breakpoints of meropenem and other broad-spectrum antimicrobials were determined using standard methodology. Three thousand one hundred and thirty-six blood culture (BC) isolates and 17,261 non-BC isolates were obtained from 51 European MYSTIC centres. Gram-positive bacteria appeared to be more prevalent in BC isolates compared with other sources. Escherichia coli, methicillin-susceptible Staphylococcus aureus and Pseudomonas aeruginosa were isolated most frequently. Antimicrobial susceptibility of isolates from bacteraemic versus non-bacteraemic patients was similar. Meropenem and imipenem were the most active agents against the majority of the Gram-positive and Gram-negative organisms. Ceftazidime, gentamicin and ciprofloxacin generally exhibited the lowest activities against the most commonly isolated organisms. Meropenem was most active against P. aeruginosa and showed the highest potency and activity against all extended-spectrum and AmpC-lactamase producers. These results are relevant to the choice of initial, empirical therapy for patients with suspected bacteraemia.
PLoS ONE, 2013
OBJECTIVE: We studied whether the change in antibiotic susceptibility testing (AST) guidelines from CLSI to EUCAST influenced cumulative antibiograms in a tertiary care hospital in Switzerland. METHODS: Antibiotic susceptibilities of non-duplicate isolates collected within a one-year period before (period A) and after (period B) changing AST interpretation from CLSI 2009 to EUCAST 1.3 (2011) guidelines were analysed. In addition, period B isolates were reinterpreted according to the CLSI 2009, CLSI 2013 and EUCAST 3.1 (2013) guidelines. RESULTS: The majority of species/drug combinations showed no differences in susceptibility rates comparing periods A and B. However, in some gram-negative bacilli, decreased susceptibility rates were observed when comparing CLSI 2009 with EUCAST 1.3 within period B: Escherichia coli / cefepime, 95.8% (CLSI 2009) vs. 93.1% (EUCAST 1.3), P=0.005; Enterobacter cloacae / cefepime, 97.0 (CLSI 2009) vs. 90.5% (EUCAST 1.3), P=0.012; Pseudomonas aeruginosa / meropenem, 88.1% (CLSI 2009) vs. 78.3% (EUCAST 1.3), P=0.002. These differences were still evident when comparing susceptibility rates according to the CLSI 2013 guideline with EUCAST 3.1 guideline. For P. aeruginosa and imipenem, a trend towards a lower antibiotic susceptibility rate in ICUs compared to general wards turned into a significant difference after the change to EUCAST: 87.9% vs. 79.8%, P=0.08 (CLSI 2009) and 86.3% vs. 76.8%, P=0.048 (EUCAST 1.3). CONCLUSIONS: The change of AST guidelines from CLSI to EUCAST led to a clinically relevant decrease of susceptibility rates in cumulative antibiograms for defined species/drug combinations, particularly in those with considerable differences in clinical susceptibility breakpoints between the two guidelines.
Risk factors for drug resistant bacterial infections: Hospital based study
The aim of this study is to assess the possible risk factors of patients from whom were isolated microorganisms which were resistant to broad spectrum antibiotics so as to shed light on the measures that should be taken in hospitals and community. These patients were those admitted to Çan secondary care hospital between January, 2009 and November, 2010. The strains isolated from them were evaluated and compared with respect to extended spectrum beta lactamases (ESBL)-producing gram negative bacteria, MRSA and Enterococcus spp. A total of 289 patients and their 338 isolated strains were included in the study. The patients with 72 ESBL-producing gram negative bacteria were compared with the patients with 224 non-ESBL-producing gram negative bacteria, and five patients with MRSA were compared with 19 patients with MSSA. The patients treated with vancomycin which is sensitive 18 Enterococcus spp. strains were evaluated descriptively. Hospitalization in the previous three months, underlying conditions, and usage of quinolones were found to be significant risk factors for infections with ESBL-producing organisms. Urinary system disorders or malformations, chronic renal failure and hospitalization in the previous three months were found to be risk factors for MRSA infection. It is most likely that hospitalization and underlying conditions contribute to the spread and increase of antimicrobial resistance rates at community and hospitals.
Science of The Total Environment, 2019
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Cureus, 2023
Objectives: Breakpoints provided by European Committee on Antimicrobial Susceptibility Testing (EUCAST) are now being used in many countries. This study was planned to ascertain the agreement in antimicrobial susceptibility using the Clinical and Laboratory Standards Institute (CLSI) and EUCAST breakpoints during the Kirby-Bauer disk diffusion method. Methods: This was a prospective observational study. Clinical isolates belonging to the family Enterobacteriaceae recovered between January and December, 2022, were included in the analysis. The diameter of the zone of inhibition of the 14 antimicrobials (viz. amoxicillin/clavulanic acid, cefazolin, ceftriaxone, cefuroxime, cefixime, aztreonam, meropenem, gentamicin, amikacin, ciprofloxacin, levofloxacin, norfloxacin, trimethoprim/sulfamethoxazole and fosfomycin) was analysed. Antimicrobial susceptibility was interpreted using CLSI 2022 and EUCAST 2022 guidelines. Results: Susceptibility data from a total of 356 isolates showed a slight increase in the percentage of resistant isolates with most of the drugs using EUCAST guidelines. The level of agreement varied from almost perfect to slight. For two drugs, i.e., fosfomycin and cefazolin, the agreement was least among the drug analysed (kappa (κ) value < 0.5, p < 0.001). For Ceftriaxone and Aztreonam, with EUCAST, susceptible (S) isolates would have been categorised in the newly redefined "I" category. It would have indicated the use of higher dosages of drugs. Conclusion: Change in the breakpoints impacts the interpretation of the susceptibility. It can also lead to a change in the dosage of the drug used for treatment. Therefore, there is an urgent need to see the impact of recent modifications "I" category of EUCAST on the clinical outcome and usage of antimicrobials.
innovative publication, 2017
Background: The occurrence of bacterial infections is a major cause of morbidity and mortality in patients. Inappropriate and irrational use of antibiotics has led to increasing resistance in commonly isolated gram positive and gram negative organisms. Antimicrobial resistance is a matter of concern as its compromises the management of infectious diseases and increases the cost of health care as well. Aims and Objectives: This study was undertaken to document the common organisms isolated in patients in a variety of clinical conditions encountered and describe their antibiotic susceptibilities. Materials and Methods: This retrospective study was conducted in Department of Microbiology at Career Institute of Medical Sciences and Hospital. The records of bacteriology section were compiled for a period of 6 months from January 2016 to June 2016.The results were consolidated for types of clinical samples, organisms isolated and their susceptibility patterns. Results: Total 1121 samples were received in Department of Microbiology over a period of six months from January 2016 to June 2016 and 283(25.2%) were positive on culture. E coli, 38 (13.4%) was the predominant isolate followed by Staphylococcus aureus, 31(10.9%). The resistance pattern in E coli to Ceftazidime, Amoxicillin clavulanic acid and Imepenem was 30.3%, 22.9% and 14.7% respectively. Among S. aureus, 15.8%strains were Methicillin resistant. Conclusions: Gram negative bacteria still remain the predominant causes in most of the clinical infections in health care settings with E coli being the most common organism in most of the cases. Antimicrobial resistance is a major challenge and antibiotics need to be tested and prescribed according to standard guidelines. Local anti-biograms should be available periodically to help clinicians guide on antibiotic prescribing.