ANTIBIOTIC RESISTANCE DETECTION AND REPORTING FROM INTENSIVE CARE UNITS IN RESOURCE POOR LABORATORIES
Dr.T.V.Rao MD
The diagnosis of infection in critically ill patients and identification of causative microorganisms and their antibiotic susceptibilities can be a challenge and yet early, appropriate antibiotic therapy is associated with improved outcomes , so accurate, rapid diagnosis is important If you ask me sincerely how good you are in selection and testing of Antibiotics in critically ill patient, good ?certainly I say I am just a learner trying to be better, however we are today supported by good references and always available on online resources, I am less confused than many as I was using WHONET software, which can be updated to the latest protocols with CLSI, However a Junior Microbiologist working alone or with least facilities find the matters confusing what truly important in a critical patient
WHAT IS OUR AIM – The simple solution is optical identification of the bacterial isolate and choosing the right antibiotic Target antimicrobial resistance data for ICU-acquired infections Because of the rapid evolution of antimicrobial resistance, the 2009 HAI surveillance meeting approved the below extended list for the surveillance of ICU-acquired infections.
I wish the one should test the following Antibiotics with capacity to make proper decision making and reporting on Antibiotic resistance in Intensive care patients, and continues to the essential antibiotics in all resource poor Diagnostic Microbiology
S. aureus
• Oxacillin (OXA)
• Glycopeptide (GLY) (vancomycin, teicoplanin)
Enterococci
• Aminopenicillins (AMP) (ampicillin and/or amoxicillin)
• Glycopeptide (GLY) (vancomycin, teicoplanin)
Enterobacteriaceae (Escherichia coli, Klebsiella, Serratia, Enterobacter, Proteus, etc.)
• Amoxicillin/clavulanic acid (AMC)
• Third-generation cephalosporins (C3G) (cefotaxime, cetriaxone, ceftazidim)
ESBL confirmed Y/N (ESBL)
• Carbapenems
P. aeruginosa
• Piperacillin or ticarcillin with or without enzyme inhibitor (PIP)
• Ceftazidim (CAZ)
• Carbapenems (CAR) (imipenem/meropenem/doripenem)
• Colistin (COL)
Acinetobacter spp.
• Carbapenems (CAR) (imipenem/meropenem/doripenem)
• Colistin (COL)• Sulbactam (SUL)
Certainly, the clinicians and Microbiologists should in coordination in time of crisis - Diagnosis of infection still relies largely on culture-based techniques, which can take several days for a positive result to be available. Moreover, in patients already receiving antibiotics, cultures may be negative
Ref and Adopted from -European surveillance of healthcare-associated infections in intensive care units HAI-Net ICU protocol version 1.02
Dr.T.V.Rao MD
The diagnosis of infection in critically ill patients and identification of causative microorganisms and their antibiotic susceptibilities can be a challenge and yet early, appropriate antibiotic therapy is associated with improved outcomes , so accurate, rapid diagnosis is important If you ask me sincerely how good you are in selection and testing of Antibiotics in critically ill patient, good ?certainly I say I am just a learner trying to be better, however we are today supported by good references and always available on online resources, I am less confused than many as I was using WHONET software, which can be updated to the latest protocols with CLSI, However a Junior Microbiologist working alone or with least facilities find the matters confusing what truly important in a critical patient
WHAT IS OUR AIM – The simple solution is optical identification of the bacterial isolate and choosing the right antibiotic Target antimicrobial resistance data for ICU-acquired infections Because of the rapid evolution of antimicrobial resistance, the 2009 HAI surveillance meeting approved the below extended list for the surveillance of ICU-acquired infections.
I wish the one should test the following Antibiotics with capacity to make proper decision making and reporting on Antibiotic resistance in Intensive care patients, and continues to the essential antibiotics in all resource poor Diagnostic Microbiology
S. aureus
• Oxacillin (OXA)
• Glycopeptide (GLY) (vancomycin, teicoplanin)
Enterococci
• Aminopenicillins (AMP) (ampicillin and/or amoxicillin)
• Glycopeptide (GLY) (vancomycin, teicoplanin)
Enterobacteriaceae (Escherichia coli, Klebsiella, Serratia, Enterobacter, Proteus, etc.)
• Amoxicillin/clavulanic acid (AMC)
• Third-generation cephalosporins (C3G) (cefotaxime, cetriaxone, ceftazidim)
ESBL confirmed Y/N (ESBL)
• Carbapenems
P. aeruginosa
• Piperacillin or ticarcillin with or without enzyme inhibitor (PIP)
• Ceftazidim (CAZ)
• Carbapenems (CAR) (imipenem/meropenem/doripenem)
• Colistin (COL)
Acinetobacter spp.
• Carbapenems (CAR) (imipenem/meropenem/doripenem)
• Colistin (COL)• Sulbactam (SUL)
Certainly, the clinicians and Microbiologists should in coordination in time of crisis - Diagnosis of infection still relies largely on culture-based techniques, which can take several days for a positive result to be available. Moreover, in patients already receiving antibiotics, cultures may be negative
Ref and Adopted from -European surveillance of healthcare-associated infections in intensive care units HAI-Net ICU protocol version 1.02
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