Antimicrobial resistant gram negative isolates from blood stream infections: A report from BPKIHS

Abhilasha Sharma, Narayan Raj Bhattarai, Basudha Khanal

Abstract


Objective: To find out resistance pattern and production of ESBL among gram negative blood culture isolates.

Methods: This study was carried out in Microbiology laboratory, BP Koirala Institute of Health Sciences, Dharan, Nepal from July 2011-June 2012. Altogether 150 gram negative bacteria isolated from cases of blood stream infections were evaluated. Isolation, identification of bacteria, determination of antimicrobial susceptibility pattern and detection of ESBL were done following standard protocol.

Results: Resistance to commonly used antimicrobials were noted in varying frequencies. Most of the isolates were resistant to ampicillin (97%) and sensitive to imipenem (98%). Forty seven percent of isolates were ESBL producers and a substantial number of isolates were resistant to at least 3 routinely used drugs. 

Conclusion: The study concluded that high resistance was found among the blood culture isolates and ESBL production was seen in a significant number of isolates.


Keywords


Antimicrobial resistance, Blood culture, Gram Negative Bacteria, ESBL

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References


. Nelson N, Joshi M, Kirika R. Antimicrobial resistance: The need for action in the East, Central and South African region Submitted to the U.S. Agency for International Development by the Strengthening Pharmaceutical Systems (SPS) Program. Arlington, VA: Management Sciences for Health; 2009.

. Slama T. Gram negative antibiotic resistance: there is a price to pay. Critical care 2008; 12(suppl 4): S4.

. Al-Jasser AM. Extended –Spectrum Beta-Lactamases: A Global Problem. Kuwait Medical Journal 2006; 38:171-85.

. Citron DM, Edelstein MA, Garcia LS, Roberts GD, Thompson RB, Washington JA. Microorganisms encountered in the blood. In: Baron EJ, Peterson LR, Finegold SM editors. Bailey & Scott’s Diagnostic Microbiology. 9th ed. Missouri: Mosby-Year Book, Inc: 1994, p.193-209.

. Barrow GI, Feltham RKA. Bacterial characters and characterization. In: G.I. Barrow GI, Feltham RKA editors. Cowan and Steel’s manual for identification of medical bacteria. 3rd ed. Cambridge University Press; 1993. p21-8.

. Clinical and Laboratory Standard Institute (CLSI). Performance standard for antimicrobial disk susceptibility tests; Approved standard 9th edition. CLSI document M2-A9. Wayne, PA: CLSI; 2006.

. Clinical and Laboratory standard Institute. Performance Standards for Antimicrobial Susceptibility Tests; Fifteenth Informational supplement. CLSI document M100-S15.Wayne; PA: CLSI; 2005.

. Mehdinejad M, Khosravi AD, Morvaridi A. Study of Prevalence and Antimicrobial susceptibility pattern of bacteria isolated from blood cultures. J. Biol. Sci 2009; 9: 249-53.

. Alam MS,Pillai PK, Kapur P, Pillai KK. Resistant patterns of bacteria isolated from bloodstream infections at a university hospital in Delhi. J Pharm Bioallied Sci 2011; 3: 525-30

. Mohammadi-mehr M, Faizabadi MM. Antimicrobial resistance pattern of Gram-negative bacilli isolated from patients at ICUs of Army hospitals in Iran. Iran J Microbiol 2011; 3: 26-30

. Tahnkiwale SS, Jalgaokar SV, Ahamad S, Hassani U. Evaluation of Extended spectrum beta lactamase in urinary isolates. Ind J Med Res 2004; 120: 553-56.

. Shrestha S, Amatya R, Dutta R. Prevalence of extended spectrum beta lactamase (ESBL) production in gram negative isolates from pyogenic infection in tertiary care hospital of eastern Nepal. Nepal Med Coll J 2011; 13 : 186-89.

. Thompson JM, Bonomo RA. The threat of antibiotic resistant gram negative pathogenic bacteria: beta lactams in peril! Curr. Opin. Microbiol 2005; 8(5): 518-24.

. Paolo AG. Early appropriate therpy: what about new drugs? The conservative approach. Third European Conference on Bloodstream Infections; 2009 April 24-25; Sorento, Italy.

. Baral P, Neupane S, Marasini BP, Ghimire KR, Lekhak B, Shrestha B. High prevalence of multidrug resistance in bacterial uropathogens from Kathmandu, Nepal. BMC Research Notes 2012; 5: 38

. Saghir S, Faiz M, Saleem M, Younus A, Aziz H. Characterization and antimicrobial susceptibility of gram negative bacteria isolated from blood stream infection of cancer patients on chemotherapy in Pakistan. Ind J Med microbial 2009; 27: 341-47.

. Sabharwal ER. Antibiotic susceptibility patterns of uropathogens in obstetric patients. N Am J Med Sci 2012;4: 316-19.

. Sader HS, Jones RN, Stilwell MG, Dowzicky MJ, Fritsche TR. Tigecycline activity tested against 26,474 bloodstream infection isolates: a collection from six continents. Diag Microbial Infect Dis 2005; 52: 181-86

. Mark ER, Paul DF. Extended Spectrum beta-Lactamase (ESBL) producing Enterobacteriaceae: Considerations for Diagnosis, Prevention and Drug Treatment. Drugs 2003; 63: 353-65.

. Ali AM, Rafi S, Quresh AH. Frequency of extended spectrum beta lactamases producing gram negative bacilli among clinical isolates at clinical laboratories of Army Medical College, Rawalpindi. J Ayub Med Coll Abott 2004; 16: 35-7.

. Emery CL, Weymouth LA. Detection and clinical significance of extended spectrum beta lactamases in tertiary care medical center. J Clin Microbiol 1997; 35: 2061- 67.

. Mohanty S, Kapil A, Dhawan B, Das BK. Bacteriological and antimicrobial susceptibility profile of soft tissue infections from Northern India. Ind J Med Sci 2000; 19: 187-91.

. Duttatroy B, Mehta S. Extended spectrum beta lactamase in clinical isolates of Klebsiella pneumoniae and Escherichia coli. Ind J Pathol Microbiol 2005; 48: 45-8.

. Shah AA, Hasan F, Ahmed S, Hamid A. Prevalence of Extended spectrum beta lactamase in Nosocomial and outpatient (ambulatory). Pak J Med Sci 2003; 19: 187-91.




DOI: http://dx.doi.org/10.7439/ijbr.v8i9.4366

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