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01 January13
Original article
10, 11
11, 12
. A study conducted by
non-enteric bacteria
National Healthcare Network (NHN), Dhaka,
showed that 43% of the isolated S. aureus were
MRSA and 10-20% Enterobacteriaceae was ESBL
producers
13-14
16
Kirby-Bauer disc diffusion technique recommended by the National Committee for Clinical
Laboratory Standards (NCCLS) was applied to
determine the bacterial susceptibility against different antibiotics used. The quality of the antibiotic
discs were tested by using ATCC strains of E. Coli
25922 and S. aureus 25923, collected from the
Laboratory of Bangladesh Institute of Research and
Rehabilitation for Diabetes, Endocrine and
Metabolic Disorders (BIRDEM) hospital.
Amoxyclav (30 g), ceftazidime (30 g), cefexime
(5 g), cefuroxime (30 g), ciprofloxacin (5 g),
cephalexin (30 g), cotrimoxazole (25 g), tetracycline (30 g), amikacin (30 g), gentamicin (10 g),
imipenem (10 g), nitrofurantoin (300 g), ampicillin (10 g), oxacillin (1 g), penicillin (10 g),
vancomycin (30 g) and carbenecillin (100 g) were
used for the assay. Suspensions of the test organisms
were prepared using Muller-Hinton broth by adjusting the turbidity of the broth with normal saline to
match the equivalent turbidity standard of
35
19
.
Suspensions of S. aureus and
tibility to oxacillin
S. epidermidis were inoculated onto Mueller-Hinton
agar media. A disc containing 1 mg of oxacillin was
placed over the inoculated media and incubated at 37
oC for 24 hours. Zone diameter of <10 mm referred
37
Stool
05
(45.46%)
03
(27.27%)
Organisms
Urine
Escherichia coli
424
(56.46%)
98
(13.04%)
Staphylococcus aureus
29
(3.86%)
54
17
(45.76%) (31.5%)
03
(27.27%)
103
(9.86%)
Pseudomonas spp.
12
(1.60%)
23
10
(19.5%) (18.51%)
45
(4.31%)
Enterococcus spp.
37
(4.93%)
03
(2.54%)
05
(9.26%)
45
(4.31%)
Enterobacter spp.
16
(2.13%)
04
(3.39%)
03
(27.27%)
41
(3.93%)
Streptococcus agalactiae
37
(4.93%)
02
(1.69%)
39
(3.73%)
Citrobacter spp.
01
(0.85%)
02
(1.69%)
01
(1.85%)
04
(7.41%)
Beta haemolytic
Streptococci
12
(1.60%)
25
(3.32%)
32
(3.06%)
31
(2.97%)
Staphylococcus
epidermidis
02
(0.27%)
13
03
(11.02%) (5.55%)
08
(72.73%)
26
(2.50%)
03
(2.54%)
0
02
(3.70%)
0
4
(3.39%)
0
1
(2.86%)
0
1
(2%)
0
11
(100%)
0
20
(1.91%)
19
(1.82%)
16
(1.53%)
15
(1.44%)
4
(0.38%)
Klebsiella spp.
Proteus spp.
15
(2%)
Streptococcus pyogens
08
(1.06%)
Acinetobacter spp.
10
(1.33%)
Candida spp.
15
(2%)
Group D Non4
Enterococcus
(0.53%)
Streptococcus (other)
Pus
09
09
(18%) (25.71%)
0
09
09
(18%) (25.71%)
0
0
Throat
swab
0
0
4
(0.53%)
3
(0.40%)
0
Streptococcus
pneumoniae
1
(2%)
3
(100%)
0
Salmonella typhi
Salmonella spp.
1
(2.86%)
1
(2.86%)
11
(1.05%)
11
(1.05%)
11
(1.05%)
03
(0.29%)
Moraxella spp.
Shigella spp.
Total
number
475
(45.50%)
120
(11.50%)
4
(0.38%)
3
(0.29%)
3
(0.29%)
1
(0.096%)
1
(0.096%)
1
(0.096%)
1044
38
CL
CIP
TET
COT
NIT
E. coli
62% 59% 58% 59% 89% 69% 64% 15%
n=475
Klebsiella
58% 51% 52% 51% 78% 53% 49% 17%
spp.
n=120
Pseudomonas 97% 95% 96% 96% 89% 95% 97% 100%
spp.
n=45
Enterobacter 90% 87% 80% 87% 73% 70% 68% 12%
spp.
n=41
Citrobacter 68% 56% 59% 59% 81% 71% 78% 14%
spp.
n=32
Proteus spp. 80% 85% 90% 90% 75% 90% 80% ND
n=20
Acinetobacter 62% 62% 62% 62% 75% 68% 75% 80%
spp.
n=16
AMC: Amoxyclav (30 g)
CAZ: Ceftazidime (30 g)
CXM: Cefuroxime (30 g)
CL: Cephalexin (30 g)
CIP: Ciproflaxacin (5 g)
TET: Tetracycline (30 g)
COT: Cotrimoxazole (25 g)
NIT: Nitrofurantoin (300 g)
ESBL: Extended Spectrum - Lactamase
IMI
AK
GEN
CAR
ESBL
00%
11%
26%
ND
35%
00%
9%
11%
ND
22%
11%
70%
73%
94%
ND
00%
17%
24%
ND
21%
00%
15%
25%
ND
19%
02%
5%
10%
ND
20%
00%
00%
43%
ND
ND
AK
GEN VAN
MET
resistance
31% 00%
46%
MRSA
80%
66%
93%
46%
51%
69%
44%
49%
29%
84%
76%
92%
30%
61%
73%
57%
69%
23%
34% 00%
30%
MRSE
97%
94%
97%
ND
56%
74%
20% 00%
ND
96%
93%
96%
ND
61%
74%
32% 00%
ND
00%
00%
00%
00%
00%
73%
5%
00%
ND
13%
8%
13%
ND
22%
66%
8%
00%
ND
39
80
60
40
%Resistance
20
20
40
60
80
100
CIP
CL
COT
Escherichia
coli
TET
TET Tetracycline 30 g
CIP
Ciprofloxacin 5 g
Cephalexin 30 g
CL
COT Cotrimoxazole 25 g
AMC Amoxyclav 30 g
AMC
AMC
TET
TET
CIP
CIP
CL
CL
COT
COT
AMC
AMC
TET
TET
CIP
CIP
CL
CL
COT
COT
AMC
AMC
TET
TET
CIP
CIP
CL
CL
COT
COT
AMC
AMC
TET
TET
CIP
CIP
CL
CL
COT
COT
AMC
AMC
TET
TET
CIP
CIP
CL
CL
COT
COT
AMC
AMC
100
80
60
40
%Resistance
20
20
40
60
80
Klebsiella spp.
COT
CL
COT
Citrobacter spp.
CIP
CL
Proteus spp.
TET
CIP
Acinetobacter spp.
Enterococcus spp.
Streptococcus
pyogenes
- haemolytic
streptococci
Strptococcus
agalactiae
Staphylococcus
epidermidis
Staphylococcus
aureus
AMC
TET
100
%Resistance
Figure I. Model of antibiotic resistance index. The resistance patterns exhibited by Gram positive and
Gram negative bacteria against the similar antibiotics (amoxyclav, ciprofloxacin, tetracycline,
cotrimoxazole and cephalexin) were assembled. Purple bars are indicative of resistance against Gram
positive bacteria while the red bars denote the antibiotic resistance against Gram negative bacteria.
40
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27. Howe RA, Bowker KE, Walsh TR, Feest TG,
MacGowan
AP.
Vancomycin-resistant
Staphylococcus aureus. Lancet 1998 ; 351 :
6 0 2 . h t t p : / / d x . d o i . o rg / 1 0 . 1 0 1 6 / S 0 1 4 0 6736(05)78597-4
28. Bierbaum G, Fuchs K, Lenz W, Szekat C, Sahl
HG. Presence of Staphylococcus aureus with
reduced susceptibility to vancomycin in
Germany. Eur J Clin Microbiol Infect Dis 1999
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10.1007/s100960050380Pmid :10584894
29. Bradford PA. Extended spectrum ?-lactamase in
the 21st century: characterization, epidemiology,
and detection of this important resistance threat.
Clin Microbiol Rev 2001; 14 (4): 933951.http://dx.doi.org/10. 1128/CMR.14.4.9339
5
1
.
2
0
0
1
Pmid:11585791 PMCid:89009
23. Takahashi H, Hayakawa I, Akimoto T. The history of the development and changes of quinolone
antibacterial agents. Yakushigaku Zasshi 2003;
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(2):
161-179.
http://dx.doi.org/10.5264/eiyogakuzashi.61.161
Pmid:15143768
32. Ahmed I, Salam A. Extended spectrum ?-lactamase and bacterial resistance. Pak J Med Sci
2002; 18 (2): 151155.
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