English

Abstract

BACKGROUND: Antibiotic resistance is a global problem in the hospitals as well as in the community. Selection pressure exerted by overuse of antimicrobial agents is the commonest predisposing factor of development of resistance. Problems faced are especially with Methicillin Resistant Staphylococcus aureus (MRSA), Vancomycin Resistant Enterococci (VRE) and Multidrug resistant Gram-negative bacilli (MDR-GNB). AIMS: A study was undertaken to find out the prevalence of all bacteria isolated in this hospital from different specimens, which are resistant to first line antibiotics and their antimicrobial susceptibility pattern with higher antibiotics during a six-month period. MATERIAL AND METHODS: All isolates from different specimens were processed by standard techniques and identified by standard biochemical tests. Antibiotic susceptibility was performed on Mueller Hinton Agar (MHA) by Kirby-Bauer Disc Diffusion Method (KBDDM), according to CLSI guidelines. Those resistant to first line antibiotics were further tested for higher antibiotics. For Extended Spectrum β-lactamse (ESBL) detection, double disc synergy method was carried out for all Gram-negative bacilli. RESULTS: Out of 2987 bacteria grown, 904 (30.3%) were multidrug resistant bacteria. Resistance to first line antibiotics was 83.4% and resistance to all higher antibiotics tested was 16.6%. Sixty percent of Staphylococcus aureus was MRSA and all were sensitive to vancomycin. Prevalence of VRE was 5.3%. Carbapenem resistant Pseudomonas aeruginosa and Acinetobacter species were 19.1% and 9.8% respectively and 10.1% of Klebsiella species was carbapenem resistant. CONCLUSIONS: This study highlights the extensive problem of antibiotic resistance encountered in this hospital. Thus, prudent and appropriate uses of antibiotics are required to reduce the emergence of resistance. Each hospital should also have its own antibiotic policy based on the susceptibility pattern of bacteria at a particular time, which should be reviewed as and when required. Rational antibiotic use and effective infection control practices can go a long way in preventing the development of antibiotic resistance.