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.
Shayosree Sarkar, Sonal Chavan, Geetika Agrawal, Heena Rahangdale, Sunanada Zodpey,
Volume 19, Issue 2 (3-2025)
Abstract
Background: Burkholderia cepacia complex is are opportunistic nosocomial pathogen that can cause severe infections in neonates, involving the respiratory tract, the urinary tract and bloodstream infections. Therefore, it can lead to outbreaks through different sources. This study was conducted with the aim of early detection and successful control of an outbreak caused by Burkholderia cepacia complex.
Methods: A cross-sectional study was conducted in a tertiary care hospital over a one-month period, July 2023. Blood culture samples of 11 neonate’s yielded growth of non-fermenting, oxidase-positive and motile, Gram-negative bacilli. Isolates were provisionally identified to be Burkholderia cepacia complex by conventional biochemical tests and antimicrobial susceptibility patterns. The increased, repeated, and continuous isolation of the same isolate raised the suspicion of an outbreak in the neonatal intensive care unit. Active surveillance was undertaken to trace the source and contain the bacteria. Identification of isolates was confirmed by VITEK 2 (BioMérieux, France) compact microbiology analyser.
Results: Surveillance revealed sources of Burkholderia cepacia complex for all 11 neonates. Sources of infection could be traced to intravenous catheters and cradles of the neonates and operation theatre beds, and instrument trolleys of the labour room where the babies were delivered. All the environmental isolates showed strain-relatedness of Burkholderia cepacia complex with the clinical isolates, along with a similar antibiotic susceptibility pattern. Timely interventions aided in the control of the outbreak.
Conclusion: This study presents the importance of the hospital infection control team in the management of an outbreak of Burkholderia cepacia complex in neonates.
