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Introduction: Carbapenem Resistant Enterobacteriaceae (CRE) are major cause of community as well as healthcare associated infections and have limited treatment options. Measuring the magnitude of the problem of CRE, it is important for making strategies to lower its spread. Aim: To assess the incidence and prevalence rate of CRE in a tertiary care hospital of Gujarat, India. Materials and Methods: Retrospective data was collected for a period from 2014 to 2018 using Laboratory Information System (LIS). Prevalence of CRE was determined as number of CRE isolated per 100 Enterobacteriaceae isolated during the study period whereas incidence rate was determined as number of CRE cases per 1000 patient-days. Consumption of Carbapenems was calculated as Defined Daily Dose (DDD) per 1000 patient-days. Demographic data including age, gender, location in the hospital and sample type from which CRE was isolated was also analysed using Microsoft Excel. Results: The incidence of CRE cases per 1000 patient-days in 2014 to 2018 was 1.66, 2.11, 1.90, 2.26 and 1.91, respectively with an overall incidence of 1.99 per 1000 patient-days. The overall prevalence of CRE over a period of five years was found to be 29.07%. Klebsiella sp. was the most common CRE and had the highest percentage of Carbapenem resistance among all Enterobacteriaceae. Conclusion: The rate of CRE in present study was high and worrisome. Screening of the patient for CRE, source isolation and stringent implementation of infection control practices is required to confine the spread of CRE in this institute. [ABSTRACT FROM AUTHOR]

Background & objectives: Urinary tract infection is a common clinical condition affecting neonates to geriatric patients. Present study was undertaken to identify and characterize different uropathogens, to assess antimicrobial resistance pattern and, to find out factors associated with urinary tract infections. Methods: Observational study was carried out during February-2015 to January-2016 in a tertiary care teaching hospital. Relevant demographic and clinical details were collected. Identification and antimicrobial susceptibility testing of uropathogens was done by using VITEK®2-Compact microbiology systems. Results: From the 1,167 urine samples analyzed, 192 (16.5%) were positive for bacterial and fungal infections. UTIs were more frequent in males 109 (56.8%) and its incidence varied with age affecting the elderly patients more i.e. 57 (29.7%). E. coli was the most common pathogen implicated in UTI i.e. 82 (42.7%). Distribution of sample from intensive care units and various wards were similar i.e. 96 (50%) each. 112 (58.3%) patients had a urinary catheter; majority of the patients had 8-29 days of catheterization i.e. 46.4%. Resistance to antimicrobials was common but highly variable in our study. Predominant clinical conditions in the catheterized patients were cardio vascular failure followed by respiratory ailments. Interpretation & conclusion: E. coli was the most common etiological agent of UTI. Distribution of urine sample from intensive care units and various wards were similar. Majority of the patients were catheterized in ICU. [ABSTRACT FROM AUTHOR]

Background: Production of metallo-β-lactamase, an enzyme that hydrolyze a variety of β-lactams including carbapenems leaving little therapeutic option is increasing. To manage patients effectively, it is important to know the local prevalence of MBLs in the hospital. Present study was undertaken to determine prevalence of metallo-β-lactamase production along with the clinical profile of Acinetobacter baumannii and Pseudomonas aeruginosa. Methods: Prospective cross sectional study was carried out during December-2010 to November-2011. Relevant demographic and clinical details were collected. Acinetobacter baumannii and Pseudomonas aeruginosa were subjected to antimicrobial susceptibility testing by Kirby-bauer disc diffusion method and mini API system, (bioMerieux-France). Imipenem/meropenem resistant isolates were tested for metallo-β-lactamase production by imipenem-EDTA combined disc test. Results: 81 strains of Acinetobacter baumannii and 28 strains of Pseudomonas aeruginosa were isolated. Most common specimens from which Acinetobacter baumanni and Pseudomonas aeruginosa isolated were from respiratory tract i.e. 47 (58%) and 12 (42.9%) respectively. Majority of the strains of Acinetobacter baumannii 44 (54.3%) and Pseudomonas aeruginosa 17 (60.7%) were isolated from non critical areas. Both organisms showed high prevalence of multidrug resistance with MBLs production of 29.6% in Acinetobacter baumannii and 42.9% in Pseudomonas aeruginosa. Conclusion: Metallo-β-lactamase-mediated carbapenem resistance is a significant threat in hospitalized patients. It should be addressed with rapid detection and stringent infection control measures. [ABSTRACT FROM AUTHOR]

Background & objectives: Stenotrophomonas maltophilia causes opportunistic infections and is emerging as an important hospital-acquired pathogen. Present study was undertaken to investigate the prevalence, clinical profile, associated factors and antimicrobial susceptibility of S. maltophilia. Methods: Cross sectional retrospective study was conducted whereby patients' details including type of infection, hospital stay, indwelling devices, comorbid conditions and outcome till discharge were collected from January 2012 to March 2016. Identification and antimicrobial susceptibility were done by using Vitek2-compact-microbiological system. Results: 45 (0.17%) S.maltophilia strains were isolated from 27,132 samples received, forming 1.63% of total non-fermenters. Prevalence of S.maltophilia infection ranged from 0.06% in 2012 to 0.26% in 2015. Common sites involved were respiratory tract i.e. 55.5%, followed by bloodstream (20%), urinary tract (13.3%) and soft tissue (11.1%). 64.4% patients were male, and adults (26.7%) between 51-60 years of age. 66.7% of the isolates were from critical care units followed by wards (33.3%). Co-morbid conditions observed were COPD with respiratory complications i.e. 26.7% followed by cardiovascular diseases 22.2%, malignancy 11.1%, post surgical patients 11.1%, complicated UTI and trauma 8.8% each, CNS complications 6.7%, burns and cellulitis 2.2% each. All patients had exposure to broad-spectrum antibiotics and 66.6% had indwelling devices. 17.8% isolates were resistant to trimethoprim-sulfamethoxazole. Mortality observed was 20%. Interpretation & conclusion: S maltophilia is an emerging pathogen and its prevalence has gradually increased at our hospital. ICUs are the main hospital sites and respiratory infections main clinical condition. [ABSTRACT FROM AUTHOR]