European Journal of Molecular & Clinical Medicine

Background: Urinary tract infection isamong the most common bacterial infections ingeneral population.The etiology as well as antibiotic sensitivity pattern of UTI varies with the widespread availability of antimicrobial agents; As a result of widespread use of antimicrobial agents, UTIs are becoming increasingly difficult to treat as pathogens with increasing resistance to commonly used antimicrobials are encountered more frequently in clinical practice.
Methods: A cross-sectional study done during April 2021-April2022. All positive urine culture and sensitivity reports of males and females aged 10-80years were included. A total of200 positive urine culture cases were taken from the culture and sensitivity register from Microbiology department of Hindu Rao Hospitaland details were tabulated using a questionnaire.
Results: Out of200 adults, males were 62 (31 %) and females were 138 (69 %). E. coli (63.1%) was the most common organism, followed byEnterococcus (17.68), Klebsiella Pneumoniae (11.1%) Pseudomonas and Staphylococcus. The incidence of UTI was morein female patients in the agegroup of21-30years.E.coli andKlebsiella weresensitive to Amikacin (97.1%), Nitrofurantoin (90.7%), Gentamycin and Imipenem. Both organisms were resistant to Ampicillin (>90%).
Conclusions: In this study, females were predominately affected and on culture the most common organisms were E. coliand Klebsiella. These organisms were most sensitive to Amikacin, Nitrofurantoin and resistant predominantly to Ampicillin. While planning treatment for UTI the sensitivity and resistance pattern ofuropathogensto common antimicrobial agents must betaken into account.

Background: To diagnose bacteremia blood culture still remains the gold standard despite its limitations. While collecting samples, focus must be given that there is strong association between timing of specimen collection at different time points during admission and their yield.
Methods: A retrospective observational study was carried out by analyzing 100 positive blood cultures from April 2021-April2022. All positive blood culture and sensitivity reports of males and females aged less than one month to 60years were included. A total of 100 positive blood culture cases were taken from the culture and sensitivity register from Microbiology department of Hindu Rao Hospital and details were tabulated using a questionnaire.
Results: The commonest organism found on cultures was Coagulase Positive Staphylococcus (CONS) 34% of the cultures, this was followed by Actinobacter in 17% and Klebsiella pneumoniae in 11% of the culture samples. The most common fungi were Candida in 3% and Budding Yeast which was found in 2% of the samples. The most sensitive antibiotic was Gentamycin (27) which was sensitive for Coagulase-positive SA (12), K. pneumoniae (5), Actinobacter (5), S. typhi (3), E. coli (1) and P. aeuroginosa (1). The second most sensitive antibiotic was Vancomycin (20), which was sensitive for Coagulase-positive SA (9), Enterococcus (4), Methicillin resistant coagulase-positive SA (2), Methicillin sensitive SA (2), Actinobacter (1), MRSA (1), and S. aureus (1).
Conclusion: Positive blood culture is a crucial parameter for both the diagnosis of the patient as well as the associated prognosis, the correct interpretation of the blood culture results is essential. While planning treatment the sensitivity and resistance pattern of pathogens found in blood culture to common antimicrobial agents must be taken into account.

CONTEXT: Carbapenems, including imipenem (IPM) and meropenem (MRP), are the most potent antibacterial agents used for the treatment of infections initiated by multidrug-resistant gram-negative bacilli. Pseudomonas aeruginosa, is a commonly encountered nosocomial pathogen, especially in immunocompromised patients, thus, inflicting significant morbidity and mortality, worldwide. The emergence of MBL‑producing Pseudomonas aeruginosa is a challenge to microbiology laboratories because there are no standardized guidelines available to detect them. This study aimed to compare four phenotypic methods to detect MBL production in Pseudomonas aeruginosa and to determine the antibiotic sensitivity of MBL‑producing isolates.
 
MATERIALS AND METHODS: A total of 200 clinical isolates of Pseudomonas aeruginosa were tested for MBL production. Meropenem (MRP) resistant Pseudomonas aeruginosa were taken as MBL screening. MBL detection was done by three phenotypic methods 1) Combined disk synergy test (CDST). 2) Double disk synergy test (DDST) and 3) E-test.
 
RESULTS: out of 200 Pseudomonas aeruginosa, 73 were resistant to Meropenem as screening positive. Out of 73, 34(46.5%) isolates were MBL positive by CDST methods, 33(45%) by DDST method and 33(45%) by E-test. Colistin and polymyxin B were found to be 100% sensitive.
 
CONCLUSION: The study result demonstrates the antibiotic sensitivity pattern of MBL-positive isolates suggests that early detection of MBL-producingP. aeruginosa and determination of their antibiotic sensitivity are of crucial importance to start appropriate treatment. It was observed in this present study that the MBL E-test followed by DDST were effective options for MBL detection in this part of the country.

Background: The broad spectrum ß-lactam antibiotics are commonly used empirically for the treatment of gram negative sepsis. But the emergence of ESBL producing organisms has posed a serious threat for their continuing use. Present study was undertaken to find out the magnitude of the problem of infections due to extended spectrum β-lactamase producing organisms.
Material and Methods: Present study was a descriptive & observational study, conducted in patients < 18 years age, all cultures showing a significant growth of ESBL producing organisms from any of the clinical specimens, as per CLSI guidelines.
Results: Infections by ESBL producing organisms were found more common in 13-18 years of age group (36.25%) & males (71.25%). K. pneumoniae has been found to be the most commonly isolated ESBL producing organism (56.25%) followed by E. coli (38.75%). ESBL producing organisms were most commonly grown in urine samples (51.25%) followed by pus culture (11.25%) and blood (10%). All were sensitive to tigecycline and colistin (100%). In the carbapenem group, sensitivity to imipenem was highest (93.75%) followed by ertapenem (66.25%), doripenem (65%) and meropenem (53.75%). Among the 45 isolates of ESBL K. pneumoniae, all were sensitive to tigecycline and colistin. Sensitivity to imipenem is 93.33% while that to meropenem, doripenem and ertapenem were 46.66%, 62.22% and 64.44% respectively. Out of the 31 isolates of ESBL producing E. coli, all were sensitive to tigecycline and colistin. Sensitivity to Imipenem was 96.77% while that to meropenem, doripenem and ertapenem were 64.71%, 70.96% and 70.96% respectively. Sensitivity to meropenem has gone down dramatically from 71.42% to 22.22%, which is significant.
Conclusion: A growing resistance in the ESBL producing organisms is noted which is very alarming. A limited number of drugs are available against these ESBL producing organisms and the drug of choice is carbapenem.

Aim: In light of the paucity of data on the bacteriological layout of AECOPD sufferer in
our country, the current study examined the layout of sputum bacteria and antibiotic
sensitivity in AECOPD hospitalized patients.
Material and methods: It was a prospective observational study conducted among 45
AECOPD patients diagnosed according to GOLD guideline (2019) in the department of
pulmonary medicine, TMMC & RC, Moradabad. Sputum sample was collected in the
morning before any meal & patient should not use oral antiseptics. After inoculating the
sample for 48 hours, inoculation culture plate with growth was identified on the basis of
culture characteristics, gram staining and biochemical reaction according to standard
guidelines.The antibiotic sensitivity of recovered isolates were determined by Kirby
Bauer disc diffusion method.
Results: The findings revealed that pseudomonas aeruginosa (42.2%) was the most
common isolated organism.It was sensitive to Cefepime (except one case),
Cefoperazone+Sulbactum, Ceftazidime (except one case), Meropenam (except two
cases), Colistin and Piperacillin+Tazobactum but resistant to Tigecycline and
Levofloxacin.Enterococcus species were sensitive and resistant to Linezolid and
Levofloxacin respectively. All the Escherichia coli cases were sensitive to Cefepime,
Cefoperazone+Sulbactum (except one case), Meropenam, Tigecycline, Colistin,
Piperacillin+Tazobactum but resistant to Ceftazidime and Levofloxacin.
Staphylococcus aureus were resistant to Levofloxacin and Linezolid.Staphylococcus
aureus (MRSA) was resistant to Levofloxacin and sensitive to Linezolid, Clindamycin
and Vancomycin.
Conclusion:Antibiotics must be prescribed depending on the bacterium susceptibility
profile found in the area. Prescribed patients with history for production of purulent
sputum is worth following the guidelines or protocol. It is high time to have a policy for
antibiotics usage at different levels- district, state and country to prevent the emergence
of MDR strains.

Background:Urinary tract infections (UTI) are among most prevalent illnesses seen in diabetics. To reduce the morbidity of symptomatic infection, early diagnosis and treatment is indicated. This study was done to assess the prevalence of UTI in diabetics, responsible organism & antibiotic sensitivity.
Materials and Methods: A total of 100 diabetics >18 years of age reporting to department of Microbiology were studied. Urine examination was done for isolation and antibiotic sensitivity testing.
Results: Prevalence of UTI was 39 %. E. coli followed by Enterococcus and Klebsiellaspp were most commonly isolated. These were sensitive to amikacin, imipenem and linezolid.
Conclusion: Isolation and antimicrobial sensitivity testing of uropathogens is vital in diabetics with UTI.