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Hina Rahangdale, Tejaswini Olambe, Priyanka Klabhor, Sangita Bhalavi, Varsha Wanjare, Sunanda Shrikhande,
Volume 18, Issue 2 (Mar-Apr 2024)
Abstract

Background: Urinary tract infections (UTIs) are among the most common types of infections affecting people in community and hospital settings. Bacteria are the leading cause of UTIs, followed by fungi. 39% of all healthcare-associated infections (HAIs) affecting all age groups are UTIs, causing high morbidity and mortality rates. The antibiotic susceptibility pattern of causative organisms is changing due to improper antibiotic use. The study was conducted to determine the microbiological profile of both community and HAIs and their antimicrobial susceptibility pattern.
Methods: Clean-catch, mid-stream urine samples collected in the universal wide-mouthed sterile containers were transported to the laboratory. Samples were processed by standard conventional microbiological procedures. Antimicrobial susceptibility was done using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar plates.
Results: The most common causative organisms among gram-negative bacteria were E coli (26.05%), followed by Klebsiella spp (20.37%), and Enterococcus spp (12.81%) was more common among the gram-positive bacteria. Non-albicans Candida (64.10%) were more commonly isolated than Candida albicans (35.90%). E coli was highly susceptible to nitrofurantoin and fosfomycin, and Klebsiella spp and Enterococcus spp were similarly highly susceptible.  Antibiotic resistance was more common among bacteria isolated in HAIs.
Conclusion: In both settings, E coli was the most common causative organism. The incidence of non-albicans Candida species has increased in comparison to Candida albicans. Antimicrobial susceptibility to empirical 3rd-generation cephalosporins and fluoroquinolones has drastically decreased. Hospital-acquired UTIs are a rising threat to the healthcare system and community. Based on hospitals’ antimicrobial policy formulated by studying antimicrobial susceptibility patterns, empirical treatment should be chosen.

 
Sonakshi Dwivedi, Vaishali Rahangdale, Swati Bhise, Sunanda Zodpey,
Volume 18, Issue 3 (May-Jun 2024)
Abstract

 Background: Rampant and irrational use of antibiotics led to antimicrobial resistance in intensive care units, directly influencing the clinical outcome. The prior introduction of antibiotics, especially broad-spectrum antibiotics, has been identified as a leading cause of hospital-acquired pneumonia. The present study aims to examine the existing scenario of antibiotic resistance due to multidrug-resistant organisms that are detected in mechanically ventilated patients.
Methods: This cross-sectional study was conducted in the department of Microbiology of a tertiary care hospital in Central India. A total of 410 endotracheal secretions were collected. The endotracheal aspirate of adult patients admitted to the medicine intensive care unit and on mechanical ventilation was received at the microbiology laboratory for processing by standard bacteriological techniques. Drug susceptibility testing was done using the Kirby-Bauer disc diffusion method according to the indications mentioned in Clinical and Laboratory Standards Institute 2021.
Results: Out of 410 collected endotracheal secretion samples, 332 (81 %) samples demonstrated bacterial growth. A total of 265 (80%) cases fulfilled the inclusion criteria. From 265 samples, 92 (34.7 %) patients were clinically and microbiologically confirmed as cases of ventilator-associated pneumonia. Over eighty percent of gram-negative bacilli were multidrug-resistant strains (Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa).
Conclusion: Real understanding of multidrug-resistant pathogens, early isolation as well as avoiding long-term antibiotic intake can reduce mortality levels currently linked with late-onset ventilator-associated pneumonia.


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