Bacteriological Profile and Multidrug Resistance Patterns of Blood Culture Isolates in a Teaching Hospital in South India.
Bacteriological Profile and Multidrug Resistance Patterns of Blood Culture Clinical
DOI:
https://doi.org/10.70284/njirm.v3i3.2038Keywords:
Andhra Pradesh , Bacteriological Profile , Antibiotic Resistance , Septicaemia , Blood cultureAbstract
Background: Blood stream infections can lead to life threatening sepsis and require rapid antimicrobial treatment . The organisms implicated in these infections vary with the geographical alteration . Further , infections caused by MDR organisms are more likely to increase the risk of death in these patients . Objectives : To study the profile of organisms causing blood stream infections and analyse their antibiotic resistance patterns in our teaching hospital.: Materials and methods : Prospective study of 524 blood samples from clinically suspected cases of bacteraemia was performed over a period of three years. The isolates were identified by standard biochemical tests and antimicrobial resistance patterns were determined by CLSI guidelines. Results : Positive blood cultures were obtained in 22.9% of cases. Among the culture positives , gram positive bacteria accounted for 61.5% of cases ; the most common isolate being Staphylococcus aureus(29.2 %) . Of the gram negative isolates , bacteria belonging to Enterobacteriaceae were the predominant isolate , Klebsiella being the commonest isolate.The most sensitive drugs for gram positive isolates were Amikacin, Erythromycin , Ofloxacin and Piperacillin –Tazobactam.And the most sensitive drugs for gram negative isolates were Amoxyclav and Piperacillin – Tazobactam.The prevalence of MRSA in our Staphylococcal isolates was 37.1% and Vancomycin resistance in these isolates was 25.7%. Vancomycin resistance in E nterococcal isolates was 33.3 % .ESBL prevalence was 32.6 %.Conclusion : Increasing incidence of Drug resistant organisms in blood stream infections calls for increased efforts by clinicians to exercise caution in use of these drugs . Vancomycin should be replaced by simpler drugs like Linizolid or Cotrimoxazole to preserve this useful antibiotic and prolong its therapeutic usefulness.
References
2.F uselier PA, Garcia LS, Procop G Wetal. Blood stream Infections . In : Betty AF, Daniel FS, Alice SW , editors. Bailey and Scot s Diagnostic Microbiology. Mosby,2002; 865 – 83.
3.Trevini S, Mahon CR, Bacteraemia. In: Connie RM, Manusel G, editors. Textbook of diagnostic Microbiology.WB Saunders, 2000; 998 – 1008.
4.Ehlag KM, Mustafa AK , Sethi SK. Septicaemia in teaching hospital inkUWAIT – 1 : Incidence and aetiology. Journal of Infection 1985;10 : 17-24.
5.Crowe M, Ispahani P, Humphreys H etal. Bacteraemia in the adult intensive care unit of a teaching hospital in Nottingham, UK, 1985 – 1996.Eur J Cli Microbiol Infect Dis 1998; 17 : 377 – 84.
6.Atul Garg, S.Anupurba, Jaya Garg. Bacteriological Profile and Antimicrobial resistance of Blood Culture Isolates from a University Hospital. JIACM 2007; 8(2) : 139 – 43.
7.Kamga, H.L.F, Njunda, A.L, Nde, P.F., Prevalence of Septicaemia and Antibiotic Sensitivity Pattern of Bacterial isolates at the University Teaching Hospital, Yaoundae, Cameroon. African journal of Clinical and Experimental Microbiology 2011; 12(1): 2 -8.
8.Kavitha P, Sevitha B, Sunil R.. Bacteriological Profile and antibiogram of blood culture isolates in a pediatric care unit. Journal of Laboratory Physicians 2010; 2: 85 -88.
9.Roy I, Jain A, Kumar M, Agarwal SK. Bacteriology of neonatal seticaemia in a tertiary care hospital of northern India. Indian Journal of Medical Microbiology 2002; 20 :156 – 9.
10.Arora U, Jaitwani J. Acinetobacter Spp – An Emerging pathogen in Neonatal Septicemia in Amritsar. Indian Journal of Medical Microbiology, 2003;21: 66 – 68.
11.Kariowsky JA, Jones ME, Draghi DC etal. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood culture of hospitalized patients in the United States in 2002. Annals of Clinical Microbiology and Antimicrobials 2004;3: 7 .
12.Mehta M, Dutta P, Gupta V. Antimicrobial Susceptibility Pattern of Biood isolates from a teachin g hospital in North India. Jpn J. Infect Dis. 2005; 58 : 174 – 6.
13.Shrma M, Goel N, Chaudhary U Aggarwal R, Arora DR. Bacteraemia in children. Indian J Pediatr 2002; 69 : 1029 – 32.
14.Chaturvedi P, Agarwal M, Narang P. Analysis of blood – culture isolates from neonates of a rural hospital. Indian Pediatr 1989;26:5:460-5.
15.Weinstein MP, Towns ML, Quartey SM etal . The Clinical significance of positive blood cultures in the 1990s : a prospective comprehensive evaluation of the microbiology, epidemiology and outcome of bacteraemia and fungemia in adults. Cli Infect Dis 1997; 24 : 584 – 602.
16.Chang. S, Sievert DM, Hageman JC. Infection with Vancomycin – Resistanmt Staphylococcus aureus containing the van A Resistance Gene. N Engl J Med 2003; 348: 1342-1347.
17.Erik L. Munson, Daniel J. Diekema, Susan E. Beckmann. Detection anfd Treatment of Blood Stream Infection : Laboratory Reporting an d Antimicrobial Management. J Clin Microbiology 2003;41: 495 – 7.
18.Rahbar M, Mehragan H, Akbari NHA. Prevalence of Drug Resistance in Nonfermenter Gram negative Bacilli. Iran J Pathol 2010; 5(2): 90 -96.
Kapoor L, Randhawa VS and Deb M. Antimicrobial Resistance of Enterococcal Blood Isolates at a Pediatric Care Hopspital in India. Japanese Journal of Infectious Diseases 2005; 58 : 101 -103.