Open Access Original Research Article

Ventilator Associated Pneumonia in a Tertiary Care Hospital: Incidence, Risk Factors and Etiological Agents

Nahla Y. Sahlo, Lamiaa A. Madkour, Youssef M. Soliman

Microbiology Research Journal International, Page 1-10
DOI: 10.9734/BMRJ/2016/24360

Aims: With an escalating mortality rate reaching 50%, ventilator associated pneumonia (VAP) continues to pose an enormous threat to ICU patients worldwide. 

Study Design: Prospective cohort study.

Place and Duration: The study was conducted from March 2014 through February 2015 at Kasralainy University Hospital. Hundred patients who were on Mechanical Ventilation (MV) for more than 48 hours were monitored for the development of VAP.

Methodology: We endeavored to identify the incidence, risk factors, and the most common etiological pathogens of VAP in ICU patients.

Results: Out of the 100 enrolled patients, 34 patients developed VAP. With univariate analysis, it was proven that the duration of MV and trauma were significant risk factors for VAP. The most common isolated pathogens were Klebsiella, Pseudomonas, and Acinetobacter. Alarmingly, 89.8% of the isolated organisms were multi-drug resistant (MDR).

Conclusion: The duration of MV has to be reduced to minimize the incidence and morbidity associated with VAP. Likewise, unnecessary prolonged hospitalization should be avoided. The choice of antibiotics should be judicial and guided by sensitivity patterns of the pathogens. These predictors, however, need further work to validate reliability.

Open Access Original Research Article

Listeria Contamination of Raw Bovine Milk and the Factors Influencing Its Occurrence in Greater Luweero District, Uganda

David Mukasa, Clovice Kankya, Jesca Lukanga Nakavuma

Microbiology Research Journal International, Page 1-10
DOI: 10.9734/BMRJ/2016/23027

Aim: To establish the occurrence of Listeria contamination of raw bovine milk and the contributory factors in Greater Luweero.

Methods: A cross-sectional study was carried out during 2013; in Luweero, Nakaseke and Nakasongola districts, in Central Uganda. All the 16 milk collecting centers in the study area were sampled and the supplying farms identified for trace back. A total of 100 bulk raw milk samples, each representing a farm, were analysed using the VIDAS® Listeria monocytogenes II (LMO2) enzyme-linked fluorescent immunoassay (ELFA) kit (BioMérieux, Durham NC, USA). The supplying farms were systematically random sampled; and the managers together with those of the milk collecting centers were interviewed to establish the management practices and environmental risk factors associated with Listeria contamination of the milk.

Results: High level of Listeria contamination of raw milk from farms (72%); knowledge gap and significant non-adherence to milk trade guidelines (50% and 31.25%; and 88% and 39% among milk collecting center and farm managers, respectively) were encountered. Among the factors influencing occurrence of Listeria in raw milk, the significant ones (P=.05) included improper hygienic practices; such as poor faecal disposal, improper cleaning of milking utensils and of hands before milking; and non-adherence to Dairy Development Authority (DDA) guidelines; lack of access to dairy extension services; and absence of farm entry restriction and biosecurity measures.

Conclusions: There is a high occurrence of Listeria contaminated raw bovine milk from farms in Greater Luweero district. The risk factors that were significantly associated with the contamination can be minimized through sensitization and training of farmers and center managers. Listeriosis is of great public health significance, hence effective inspections to assess compliance to guidelines for quality and safety is recommended. Establishing Listeria monocytogenes carrier status of cattle; and microbial levels in milk will inform on policies for prevention of contamination.

Open Access Original Research Article

Bacterial Isolates from Otitis Media Infections and their Antibiograms, Hodeidah City, Yemen

Mohammed Suhail, Ahmed Al-Kadassy, Salem Bashanfer, Ahmed Ismail Moad

Microbiology Research Journal International, Page 1-8
DOI: 10.9734/BMRJ/2016/23629

Aims: This study was aimed to determine the predominant bacterial isolates and their antimicrobial susceptibility patterns from ear discharge among children and adults in Yemen.

Study Design: Prospective cross sectional.

Place and Duration of Study: Department of Medicine and Department of Microbiology, Al-Thawrah and Al-Amal hospitals, Hodeidah city, Yemen, between August 2014 to March 2015.

Methodology: Ear swabs collected from 80 patients with otitis media were inoculated into blood, chocolate, MacConkey agar plates and subjected to several bacteriological tests and analysis. Isolated bacterial pathogens were tested against thirteen antibiotics using standard bacteriologic techniques.

Results: The most common isolated bacteria were Gram positive (27=42.9%) of Staphylococcus aurues and Gram negative (21=33.3%) of Pseudomonas aeruginosa. Gentamycin, Tetracyclin, Ciprofloxacin, and Norfloxacin revealed high level of sensitivity to Staphylococcus aurues, whereas Polymyxin-B and Cotrimoxazol to Pseudomonas aeruginosa.

Conclusion: Staphylococcus aureus and Pseudomonas aeruginosa were the predominant pathogens of discharging ear. In the study area, gentamicin and tetracycline would be the drug of choice in Staphylococcus aureus isolates, while Pseudomonas aeruginosa was highly sensitive topolymyxin-B and cotrimoxazol.

Open Access Original Research Article

Emerging Changes in Mortality Pattern of Burn Patients in Relation to Resistant Bacterial Isolates in a Tertiary Care Hospital

Shweta Sharma, L. K. Makhija, R. K. Mahajan, Charoo Hans

Microbiology Research Journal International, Page 1-6
DOI: 10.9734/BMRJ/2016/23746

Burn injury is a global public health problem with approximately 265,000 deaths annually. In India, over 1000,000 people are moderately or severely burnt every year and an annual mortality rate is 100,000 to 140,000. This study was aimed to identify and analyze the demographic aspects, various micro-organisms responsible for burn wound infections and antimicrobial resistance as predictors of mortality in burn patients so that preventive measures can be recommended and implemented to reduce mortality among burn patients. Wound swabs from 75 patients admitted in Burn unit with TBSA (total burn surface area) between 10% - 60% and having age between 10- 60 years were included in the study. In our study, case fatality rate was 26.7% with maximum mortality between 19-26 yrs of age and among females (36.6%). As the percentage of burns increase, the mortality rate also increases. The most common organism isolated was Pseudomonas aeruginosa (45%), followed by Klebsiella pneumoniae (28.2%) and Acinetobacter baumanii (19.7%) and all the bacterial isolates in expired patients were MDR (multidrug resistant). MBL (metallo-beta-lactamase) producing isolates were more common among non-survivors than among survivors. This suggests that all the isolates should be screened for drug resistance parameters to reduce mortality and antibiotic policy should be framed for burn unit to prevent the spread of MDR organisms in admitted patients. Further strict infection control strategies should be implemented to achieve the ultimate objective of improving infection related morbidity and mortality in burn patients.

Open Access Original Research Article

Isolation, Characterization, and Identification of Yeasts Associated with Foods from Assiut City, Egypt

Sadat Mohammad Rezq Khattab, Ahmed Mustafa Abdel-Hadi, Nageh Fathy Abo-Dahab, Omar Mohammad Atta

Microbiology Research Journal International, Page 1-10
DOI: 10.9734/BMRJ/2016/24170

The objective of this work was to isolate, characterize physiologically, and identify yeasts associated with foods from Assiut city, Egypt. Fifty-two colonies of yeasts associated with orange, mandarin, tomato, squash, sobia drink, mango juice, sugarcane juice, yogurt and buttermilk samples, collected from Assiut City, Egypt, were isolated. Out of which, Eleven isolates were selected randomly and subjected to morphological, biochemical studies and molecular identification techniques employing sequence of internal transcribed spacer (ITS) regions and partial D1/D2 large-subunit domains of the 26S ribosomal RNA. Identified yeasts were belonged to six genera and species; four species belonged to ascomycetes: Debaryomyces hansenii (five isolates), Saccharomyces cerevisiae (one isolate), Candida tropicalis (one isolate), and Pichia kudriavzevii (one isolate). In addition, two yeasts species belonged to basidiomyces: Rhodotorula mucilaginosa (two isolates), and Trichosporon dulcitum (one isolate). In spite of low frequency of yeasts isolates on the tested food, mango juice and buttermilk showed the higher sources for incidences during this study.

Open Access Original Research Article

Multiple Antibiotic-resistant Escherichia coli in Ready-to-eat Foods from Food Outlets in Ekiti State University and Its Environ

O. J. Oje, O. M. David, O. M. Adeosun, A. A. Adebayo, O. Famurewa

Microbiology Research Journal International, Page 1-11
DOI: 10.9734/BMRJ/2016/23477

The potential health risk associated with consumption of ready-to-eat (RTE) food sold in food outlets in and around Ekiti State University was investigated using standard techniques. The microbiological analysis of 96 food samples obtained randomly from 6 food outlets for a period of 12 months carried out. Antibiotic resistance of 379 Escherichia coli recovered from the samples was also determined using disk diffusion method. Results indicated that the total bacterial counts (TBC), total coliform counts (TCC) and total E. coli counts recorded for the food samples ranged between a mean value of 2.450±0.834 and 65.550±27.430x105 cfu/g; 0.050±0.022 and 12.250±6.735x105 cfu/g; and 0.033±0.021 and 5.333±2.809x105 cfu/g respectively. The values obtained for the TBC for rice, scotch egg, doughnut, semo and beans from all outlets were not significantly different (p<0.05). RTE Foods obtained from ST carried the highest number of E. coli with 21.1% of the total isolates, followed by food samples obtained from DKA with 20.3%. RTE foods from CJ had 18.5% of the total E. coli isolates, while 13.5% and 13.7% of the total E. coli isolates were recovered from foods from TTA and CCA respectively. Generally, the highest number of E. coli (61) was isolated from pounded yam while the least occurrence (26) was recovered from doughnut. Ofloxacin was the most effective antibiotic as only 2 (0.6%) of the E. coli isolates were resistant, while all the 379 isolates (100.0%) were resistant to augmentin and 80.2% and 65.7% of the isolates were resistant to ceftazidime and cefuroxime, respectively. Of the total E. coli recovered from this study, 73.1% were multiple antibiotic-resistant (MAR) with varying resistotypes. The highest percentage of MAR with 8 resistotypes was 0.3% of the E. coli isolates, while highest number (28%) had 4 resistotype with CXM-CRX-CAZ-AUG as the most common resistotype. The results of this study imply that there is need to improve on hygienic and good manufacturing practices in public food outlets in order to attain a relatively safe level in RTE foods for human consumption.