Bacterial profile, their anti biogram and a light on emerging multi drug resistant organisms from sterile body fluids in a northern tertiary care hospital in India

Abstract

Sterile body sites, if infected by micro-organisms than it can lead to severe morbidity and mortality. Infections caused by multidrug resistant (MDR) bacteria remain a public health threat for patients and health care workers. Therefore early diagnosis and prompt initiation of empiric treatment is necessary. Hence, this study aimed at assessing bacterial profiles and their antimicrobial susceptibility patterns (AST) from body fluids and also looks for multidrug resistant organisms. Methods: A retrospective study was conducted from Jan 2017 to dec 2017 by recruiting 1800 study samples. Different body fluids were collected and cultured on Blood agar, MacConkey agar and chocolate agar then incubated aerobically and micro-aerobically. Moreover, gram staining and White blood cell count (WBC) were performed for all collected body fluids sample. Bacterial identification was made using colony morphology, gram stain and biochemical tests. Antimicrobial susceptibility testing was performed on Muller-Hinton agar using disk diffusion method. Results: Overall 15% (n=270/1800) of the body fluids had bacterial growth. Most bacteria were isolated from Cerebrospinal Fluid (CSF) 56.4% and pleural fluids 34.3%. Most frequent bacterial isolates were K. pneumoniae 66.7% followed by, alpha streptococcus30% (n=8/54) and E.coli Gram-negative and gram-positive bacteria showed highest resistance for Gentamycin (76%) and Erythromycin (59%) respectively. The MDR level recorded was 62.9%. Conclusion: Significant numbers of bacteria with high MDR level were isolated from body fluids that call all health care workers and policy makers for concerted efforts for prudent antibiotic use, and limit the transmission of MDR bacteria in hospital and community settings. Regular monitoring of antimicrobial resistance patterns is essential. Low culture positivity may be due to presence of anaerobic; fastidious organisms with lack of enrichment techniques & prior antibiotic administrations.