A STUDY ON CHANGING TRENDS IN ISOLATION RATE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF KLEBSIELLA PNEUMONIAE ISOLATES IN PEDIATRIC AND ADULT BLOOD STREAM INFECTIONS.

Abstract

Back ground: Blood stream infection is defined as positive blood cultures in a patient with systemic signs of infection. Aim and objective: To identify the changing trends in isolation rate and antimicrobial susceptibility pattern of Klebsiella pneumoniae isolates from blood stream infection both in adult and paediatric patients. Materials and Methods: The study was conducted at Osmania Medical College, Hyderabad. A review analysis of 11,805 cases of clinically suspected blood stream infection was done over a period of 3 years from 2019 to 2022. The study included blood culture data from Niloufer hospital for women and children and Osmania general hospital, Hyderabad. Results: Out of 6752 paediatric blood samples 678 were culture positive contributing for 10.5% of positivity rate. Among 5053 adult blood samples 559 were culture positive contributing for 11% positivity rate. Among the blood culture isolates Klebsiella pneumoniae isolation rate was 29.79% in paediatric samples and 16.81% in adult samples. Resistance to amoxiclav is increased in Klebsiella pneumoniae isolates among paediatric age group in last three years (21%(2019), 77%(2020), 83% (2021). Significant reduction in susceptibility towards cefaperazone in Klebsiella pneumoniae isolates in adult samples which shows 100% in 2019, 47% in 2020 and 32% in 2021. Susceptibility of piperacillin/tazobactum was increased in Klebsiella pneumoniae isolates among both adult and paediatric isolates. Klebsiella pneumoniae isolates among paediatric samples sensitivity towards ciprofloxacin and gentamicin is increased, this can be explained by reduced usage of these antibiotics in paediatric population. Conclusion: Judiciary use of antimicrobial agent in clinical setting is important to reduce the emergence of drug resistant Klebsiella pneumoniae.