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ANTIBIOGRAMS
Dr.T.V.Rao MD
3/7/16
Dr.T.V.Rao MD
What is a Antibiogram
Antibiogram
Microbiology The
profile of an
organism's
susceptibility/resistanc
e to a panel of
antibiotics, which can
be used to determine
genetic relatedness of
various bacteria Cf
Molecular strain typing
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It also Means
antibiogram (antbgram),
Dr.T.V.Rao MD
An antibiogram is the
result of an antibiotic
sensitivity test, a
laboratory test for the
sensitivity of an isolated
bacterial strain to
different antibiotics. It is
by definition an in vitro
sensitivity, but the
correlation of in vitro to in
vivo sensitivity is often
high enough for the test Dr.T.V.Rao MD
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to be clinically useful.
growing importance
The prevalence of antimicrobial resistance
in the hospital setting and its associated
clinical and economic impact. With this as
the background, the basics of antibiograms
are discussed their purpose, how to read
them, and how to avoid common pitfalls
when using them. Understanding these
aspects is an important first step when
utilizing antibiograms as a routine part of
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What we routinely
Prescribe
In clinical practice, antibiotics
are most frequently prescribed
on the basis of general
guidelines and knowledge about
sensitivity: e.g.
uncomplicated urinary tract
infections can be treated with a
first generation quinolone, etc.
This is because Escherichia coli
is the most likely causative
pathogen, and it is known to be
sensitive to quinolone treatment
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Surveillance with
Antibiograms helps to
initiate
Treatments
Treatment
is then
generally started on the
basis of surveillance data
about the local pathogens
probably involved. This
first treatment, based on
statistical information
about former patients,
and aimed at a large
group of potentially
involved microbes, is
called empirical
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treatment.
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Kirby-Bauer
method
Semi-quantitative way
based on diffusion
(Kirby-Bauer method);
small discs containing
different antibiotics, or
impregnated paper
discs, are dropped in
different zones of the
culture on an agar
plate, which is a
nutrient-rich
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Minimal Inhibiting
Concentration.
A quantitative way based
on dilution: a dilution series
of antibiotics is established
(this is a series of reaction
vials with progressively
lower concentrations of
antibiotic substance). The
last vial in which no
bacteria grow contains the
antibiotic at the Minimal
Inhibiting Concentration.
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E-Test is
Epsilometer
test
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E-Test
This type of test is
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Antibiograms helps to
Educational
efforts to
forecast Growing
Antibiotic
present charts to
Trends
highlight resistance
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trends Disseminate
information on
appearances of rare
phenotypes which may
have been missed
through the first
isolate approach
Teaching to facilitate
understanding and use
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WHONET Software
Data entry of clinical and
microbiological information
at surveillance sites
Exporting of AMR statistics
into the format required for
the production of local and
national reports and for
uploading to the GLASS
web interface
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WHONET Software
Simple data file structure and
output formats compatible with
major database, spreadsheet,
statistical and word processing
software
WHONET runs on Microsoft
Windows and through Windows
emulators, can be run
successfully on Linux and Mac
OS X
The software is multilingual and
is available in over 20 languages
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Principles of Reporting
and Auditing
Supply printed versions to microbiology, infection control
and epidemiology, quality improvement departments,
nursing, and pharmacy personnel
Discuss development of chart dividers, empiric therapy
guidelines by disease state
Disseminate information on the web which is useful for
antibiogram analysis
Become familiar with Chi-square analysis tables (in M39)
to interpret significance of trend changes
Analyse culture positivity and improve culturing practice
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stratification of data
will dictate the clinical
usefulness of the
cumulative
antimicrobial
susceptibility report.
Allotment of space
should be considered
for other data of
clinical relevance
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Specific Objective
To determine the
demographic profile
of the patient as to:
age sex
To determine the
most common
microorganism(s) in
biologic specimens
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Outcome of Antibiogram
Documentation
Laboratory: to make
available a quick
reference guide of
antibiogram, to know
emerging trends or
patterns in antimicrobial
resistance and; Patients:
to ensure that they are
given the most effective
yet inexpensive antibiotic
course of therapy for their
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Infection Control
Noncompliance with
infection control policies
Spread of resistant clones
through contact with
colonized healthcare
personnel
Entry of resistant
pathogens into hospital
Changes in resistance
patterns within the
community
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Demographics
Average length of stay Number of long-term care
facilities in-service area Changes in case-mix
index, severity of diseases, number of ICU beds
Addition of transplantation services,
oncologycare, burn unit, etc.
Changes in patient populations who
arepredisposed to nosocomial pathogens
Acute care versus ICU beds
Interhospital transfers
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Surveillance of antimicrobial
resistance
In May 2015, the Sixtyeighth World Health
Assembly adopted the
global action plan on
antimicrobial
resistance. One of the
five strategic
objectives of the action
plan is to strengthen
the evidence base
through enhanced
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AMR surveillance
Emerging Trends
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New Happenings in
Tracking Antibiotic
Resistance
AMR surveillance is the cornerstone for
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Participation in GLASS
Countries can benefit from
participation in GLASS through
enhanced capacity building,
access to training and
implementation tools, and
support in collecting AMR data
at local and national levels.
Country participation in GLASS
must be with the agreement of
the national government and
is subject to the fulfilment of a
number of criteria.
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References
Surveillance of antimicrobial resistance Global Antibiotic
Ressitance system WHO World Health Organization
WHONET org
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Attention of Viewers
I am thankful to many in the world who made me to achieve my desired goals faster than
I thought, having > 3-5 million health professionals share and utilize my knowledge for the
benefit of mankind, Today I wish to be freelancer to the world to create interest in
Medical, Clinical and Diagnostic Microbiology with more emphasis on Infectious diseases
and Hospital associated Infection wish to be your partner in educating many millions who
know well the importance of Infectious diseases
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