Scholarly article on topic 'A study on prevalence and antibiotic sensitivity pattern of bacteria causing lower respiratory tract infections and their association with risk groups'

A study on prevalence and antibiotic sensitivity pattern of bacteria causing lower respiratory tract infections and their association with risk groups Academic research paper on "Clinical medicine"

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Academic research paper on topic "A study on prevalence and antibiotic sensitivity pattern of bacteria causing lower respiratory tract infections and their association with risk groups"

Type: Poster Presentation

Final Abstract Number: 58.027 Session: Bacterial Infections Date: Saturday, April 5,2014 Time: 12:45-14:15 Room: Ballroom

Type: Poster Presentation

Final Abstract Number: 58.028 Session: Bacterial Infections Date: Saturday, April 5,2014 Time: 12:45-14:15 Room: Ballroom

Molecular detection of Mycoplasma pneumoniae m ^

among patients with severe respiratory and " s '

influenza-like illness in South Africa, 2012-2013

M. Carrim1, N. Wolter1, M. du Plessis1, L. de Gouveia1, S. Walaza1, E. Variava2, F. Moosa1, H. Dawood3, C. Cohen1, A. von Gottberg1

1 National Institute for Communicable Diseases, Johannesburg, South Africa

2 Klerksdorp-Tshepong Hospital, North West Province, South Africa

3 Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa

Background: The burden of disease caused by Mycoplasma pneumoniae is unknown in South Africa due to the lack of reliable diagnostic tools and clinicians rarely requesting testing. We sought to describe the prevalence of M. pneumoniae.

Methods & Materials: Patients with severe respiratory illness (SRI), influenza-like illness (ILI) and asymptomatic individuals were enrolled from May 2012 to August 2013. Nasopharyn-geal/oropharyngeal specimens were collected from all patients; induced sputum was collected from SRI patients only. Real-time PCR targeting the community-acquired respiratory distress syndrome toxin gene (MP181) was used to identify M. pneumoniae. Macrolide susceptibility testing, using high-resolution melt curve analysis (HRM) of the 23S rRNA gene and multiple-locus variable-number tandem-repeat analysis (MLVA) was performed on 70% (30/43) of M. pneumoniae-positive nasopharyngeal/oropharyngeal specimens. Of these, 80% (24/30) had sufficient volume for cultur-ing. P1 typing was performed on culture-positive specimens using HRM.

Results: 3201 SRI patients, 2073 ILI patients and 714 asymptomatic individuals were enrolled, and testing was performed on 71% (2280/3201), 80% (1657/2073) and 74% (525/714) with a detection rate of 2% (46/2280), 1% (15/1657) and 0.2% (1/525), respectively. Among the 46 SRI cases with positive specimens, M. pneumoniae was detected in 24 nasopharyngeal/oropharyngeal specimens, 16 induced sputum specimens and 6 cases were positive in both specimen types. M. pneumoniae was detected in all age groups with 61% (28/46) of cases occurring in children<5 years. Of those tested using MLVA (73%, 22/30), 3 distinct types, 3/5/6/2 (36%, 8/22), 3/6/6/2 (36%, 8/22) and 4/5/7/2 (27%, 6/22) were identified. Macrolide susceptibility testing results were obtained for 77% (23/30) of M. pneumoniae-positive nasopharyngeal/oropharyngeal specimens, all of which were susceptible. A positive culture for M. pneumoniae was obtained for 13% (3/24) of nasopharyn-geal/oropharyngeal specimens, of which two were P1 type 2 and one was P1 type 1.

Conclusion: Prevalence of M. pneumoniae was the highest amongst children < 5 years with SRI. No macrolide resistance was detected. Both P1 type 1 and type 2 were present in culture-positive specimens.


A study on prevalence and antibiotic sensitivity pattern of bacteria causing lower respiratory tract infections and their association with risk groups

A. Banerjee1, D. Pal2, S. Pal2, A. Naskar2, M. Ghosh2, S. Mallik2, I. Chaudhuri3, B.B. Mukhopadhyay1, K.Karak1, B. Saha2

1 KPC Medical College & Hospital,, Kolkata, India

2 School of Tropical Medicine, Kolkata, West Bengal, India

3 School of Tropical Medicine, Kolkata, India

Background: The study aimed to look into prevalence of bacterial pathogens among patients with Lower Respiratory Tract Infection(LRTI) in Kolkata, their antibiotic sensitivity pattern and association with special risk groups.

Methods & Materials: The study was conducted in two Kolkata hospitals from January 2012 to September 2013.

Patients more than 12 years of age presenting with acute illness of lesse than 21 days having usually cough as the main symptom with or without expectoration were selected.

Laboratory investigations included complete blood count and routine biochemical tests. Sputum, Endotracheal Tube suctions or Induced sputum (when patient could not expectorate) was collected. Quantitative sputum cultures were performed in each accepted specimen.

Bacterial Identification was done by standard methods. Antibiotic sensitivity of the organism isolated was done by Kirby Bauer Disc Diffusion Technique (According to CLSI Guideline)

Results: 214 patients could produce acceptable quality of sputum (187) or endotracheal suction material (27)-146 were male (68%) and 68 female (32%).Age of patients ranged from 12 to 87 years.

122 (57%) organisms were isolated - 99 (52.94%) from sputum and 23 (85%) from endotracheal aspirate materials. Gram positive organisms were isolated more in the younger age group. The patients with more comorbidities and older age showed greater isolation of Gram negative pathogens. Klebsiella pneumoniae was predominant. MDR were common. Majority of Gram negative bacteria were producers ofseveral types ofbeta lactamase enzymes e.g. ESBL, KPC, MBL. MajorityAcinetobacterbaumanni group (MBL) and Klebsiella pneumoniae(KPC) were sensitive to Tigecycline, Polymixin B and Colistin only. Amongst the Gram positive group, all Staphylococcus aureus were MSSA except one MRSA.

Microbes were isolated in the older age group in significantly higher percentage (p< 0.005). 90.9% Staphylococcus aureus was isolated in the age below 64 years.

Among risk factors smoking scored highest (50.93%) followed by alcoholism, previous hospitalisation. Associated comorbidities included chronic lung diseases (28.03%-highest), diabetes & hypertension.

Conclusion: LRTI occurred equally among both the sexes and rural and urban population. Gram positive organisms were isolated more in the younger age group. Elderly population were more vulnerable to the MDR group of Gram negative pathogens. Major risk

factor was smoking. Most important comorbidity was underlying structural lung diseases. Type: Poster Presentation

Final Abstract Number: 58.029 Session: Bacterial Infections Date: Saturday, April 5,2014 Time: 12:45-14:15 Room: Ballroom

Hyperbaric oxygen treatment on diabetic foot and associated risk factors of lower limb amputation: Descriptive study

J. Valbuena, P. Burgueno, J.L. Teja, J.F. Gutierrez, A. Arnaiz

hospital marques de valcecilla, Santander, Spain

Background: Approximately 10-15% of diabetic patients develop diabetic foot (DF), which precede 85% of the lower limb amputation (LLA). The use of hyperbaric oxygen therapy (HBOT) has been suggested to encourage ulcer healing thus reducing the risk of LLA. The objective of this study is to evaluate the efficacy of HBOT in DF and asses the risk of LLA in this group of patients.

Methods & Materials: Description of the cohort of patients diagnosed with DF that received HBOT from 1st of January, 2010 to 31 of May of 2013 in the University Hospital Marques de Valdecilla (Santander-Spain).

Results: Forty patients with an average age of 61.35 years, received 16.13 sessions of HBOT. Epidemiological characteristics of patients were: 92.5% men, 72.5% had hypertension, 57.5% were non smokers, 40% had chronic renal failure and 30% had polyneuropathy. Average development time of the wound was 3.92 months. Indication of HBOT was infection in 72.5% of patients (20% due to chronic osteomyelitis). Wounds were located: 22.5% in calcaneus and 17.5% in interdigital area. Revascularization treatment of the lower limb was needed in 47.5% of the patients. Granulation tissue at the beginning of HBOT was presented in 5% of patients. Wounds were closed in 8.8% patients at the first month, 35.7% at the third month, 68% at the sixth month and 79.2% in the first year after treatment. 35.9% patients needed amputation, with an average of 32.5 days after HBOT. 69.4% patients did not need antibiotherapy. Associated risk factors for amputation were the presence of infection (4.527, p = 0.033) and non related-DF returns to the system (10.89, p = 0.001).

Conclusion: Adjunctive HBOT can be valuable for treating selected cases of hypoxic DF ulcers. In our cohort, HBOT was used as adjuvant treatment in 40 cases, most of them with vascular injury. We observe increasing rates of granulation tissue after HBOT that persists in the first year of follow up. Risk of amputation (35.9%) is lower than shown by other series. However, it still remains high, mostly associated to the presence of infection and need of readmission to hospital. However a multidisciplinary approach and further long-term evaluation are needed to define patient selection and the role of HBOT in the treatment of DFTORS for PPS salivary gland neoplasms.


Type: Poster Presentation

Final Abstract Number: 58.030 Session: Bacterial Infections Date: Saturday, April 5, 2014 Time: 12:45-14:15 Room: Ballroom

Studies on bacterial agents of surgical site infection in Osogbo, South Western Nigeria

M.A. Bisi-Johnson1, O.A. Olowe2

1 Obafemi Awolowo University, Ile-Ife, Nigeria

2 Ladoke Akintola University of Technology, Osogbo, Nigeria

Background: Surgical site infection is one of the most frequent types of nosocomial infections in developing countries. The infection follows interference with the skin barrier, and is associated with the intensity of bacterial contamination of the wound at surgery or later in wards during wound care and has been difficult to manage due to bacterial resistance. The study aim was to isolate and identify bacterial agents from patients with postoperative surgical site infections and assess the antimicrobial susceptibility patterns of the isolates.

Methods & Materials: A cross sectional study was conducted at the Ladoke Akintola University Teaching Hospital, Osogbo from January to March 2013. Seventy surgical samples were collected using sterile cotton tipped swabs. The samples were analyzed using standard bacteriological media. All the bacterial isolates thus obtained were characterized and identified using standard microbiological and biochemical tests, and assessed for sensitivity to antibiotic of frequent use in the study area.

Results: A total of 70 bacterial pathogens were recovered from all specimens, 60 samples yielded bacterial growth (51 samples had pure growth and 9 had mixed growth) while 10 of the samples showed no bacterial growth.Staphylococcus aureus was the predominant bacteria18(25.7%) followed by Klebsiella aero-genes 17(24.3%), Escherichia coli 11(15.7%), Pseudomonas aeruginosa 10(14.3%), coagulase negative staphylococci 9(12.9%), and Proteus species 5(7.14%). Gram negative rods were deemed highly resistant to most of the antibiotics tested. Of the isolates, 41 (95%), 38 (88.4%), 37 (86.1%), 36 (83.7%), 36 (83.7%), 35 (81.4%) 34 (79.1%), 34 (79.1%) and 31 (72.1%) were found to be resistant to augmentin, amoxycillin, streptomycin, chloranphenicol, pefloxacin, tarivid, gentamycin, septrin, sparfloxacin in their respective order. S. aureus demonstrated high level resistance to cotrimoxazole, ofloxacin, amoxicillin, pefloxacin, streptomycin, zinnacef and cef-triazone. However, ciprofloxacin, erythromycin, chloramphenicol and gentamycin were found to be effective against the S. aureus isolates.

Conclusion: To keep resistance level to the barest minimum, it is imperative that all professionals should take an active role in infection control within their organization. More resources should be provided to encourage good antibiotic practice and good hygiene in the hospital.