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| Year:
2016 |
Month:
January
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Volume:
5 |
Issue:
1 |
Page:
17 - 21 |
Microbiological Profile and Antimicrobial Resistant Pattern of Blood Culture Isolates, Among Septicaemia Suspected Patients
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Correspondence
Nidhi Pal, Ramamurthy Sujatha,
Dr. Ramamurthy Sujatha,
Professor and HOD, Department of Microbiology, Rama Medical College Hospital & Research Centre, Mandana, Kanpur, U.P, India.
E-mail: drsujatha152@gmail.com :
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Introduction: Microorganisms cause septicaemia,a systemic disease due to their multiplication and toxins in the blood. These bloodstream infections constitutes significant public health problems and are a major cause of morbidity and mortality in the hospitalised patients and require rapid antimicrobial treatment. Infection by MDR organisms are more likely to increase the risk of death in these patients.
Aim: To determine the microbiological profile and antimicrobial resistant patterns among patients suspected to have septicaemia at a tertiary care hospital.
Materials and Methods: A total number of 121 patients were included in this study suspected to have septicaemia. The blood culture samples were processed and identified in the microbiology laboratory according to CLSI guidelines in RMCH&RC over a period of six months. Drug resistant strains in primary screening were further processed for ESBL and MRSA by standard guidelines.
Results: Out of 121 patients, 27(22.3%) developed septicaemia with the positive blood culture. Of the 27 positive culture, 24(88.9%) showed bacterial growth, in which 16(59.3%) were gram negative bacilli, 8(29.6%) were gram positive cocci and 3(11.1%) isolates were gram positive budding yeast cells. Most common isolates were E.coli (22%), Klebsiella pneumoniae (22%), Coagulase negative Staphylococcus (CONS) spp. (15%) followed by Pseudomonas aeruginosa (11%) S.aureus (11%), Klebsiella oxytoca (4%), Enterococcus faecalis(4%) and Candida spp (7% C.glabrata and 4% C.krusei) was mainly isolated in neonates. Maximum isolated strains showed high resistance towards penicillins, cephalosporins and fluoroquinolones. S.aureus and CONS were mostly resistant to co-trimoxazole and erythromycin. Resistance to imipenem was seen approximately in 66% in E.coli, Klebsiella pneumoniae and Pseudomonas spp. ESBL producers among the E.coli and Klebsiella isolates were 50% and 66.6% respectively, while 33.3% were MRSA and 50% MR-CONS among Gram positive cocci. Tigecycline and polymyxin-B were the most effective antimicrobial agents for Gram-negative bacteria, while linezolid, teicoplanin for Gram-positive bacteria.
Conclusion: The present study provides much needed information on the prevalence of bacterial pathogens in blood stream infections and also demonstrates the presence of fungaemia due to non-Candida albicans spp., which highlights the need for periodic surveillance of etiologic agents, their antibacterial and antifungal susceptibility pattern. Also changing trends in the distribution of Candida species to prevent further emergence and spread of resistant pathogens.
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