Evaluating Local Susceptibility Profile of Bacterial Isolates to Various Antibiotics Using Syndromic Antibiogram: A Cross-sectional Study

Abstract

ABSTRACT Background: A traditional antibiogram is a summary of the overall susceptibility profile of a bacterial isolate to a variety of antibiotics however it lacks the inclusion of the site of infection and hospital location. Hence, this study focuses on the importance of incorporating a syndromic antibiogram (SA) which provides an increased likelihood of appropriate empiric antibiotic therapy for a specific infectious syndrome and stratifying the susceptibilities based on patient location in providing effective antibiotic therapy. Objectives: The objective is to assess the local susceptibility profile of bacterial isolates to different antibiotics using SA in a tertiary care hospital. Methodology: A cross-sectional study was carried out in a tertiary care hospital over 6 months. A total of 400 samples were collected, out of which 350 samples were included based on inclusion criteria. The SA for urinary tract infection (UTI), respiratory tract infection (RTI), and bloodstream infection (BSI) was prepared. The collected data were analyzed using Microsoft Excel 2019 and SPSS version 24. The Chi-square test was used to find out the association between the isolates, patient location, and the syndromes. Continuous data were presented as mean ± standard deviation. Categorical data were presented as frequency and percentage. Results: Three hundred and fifty positive culture reports were included in our analysis, and the majority of isolates were Gram-negative bacilli rather than Gram-positive Cocci. Escherichia coli, streptococci, and Salmonella typhi were the most predominant organisms found in UTI, RTI, and BSI. E. coli showed a high level of susceptibility to fosfomycin (99%) and amikacin (99%). Streptococci showed a high susceptibility to linezolid (97%) and penicillin (94%) and S. typhi showed resistance to ciprofloxacin (0%). Conclusion: This study clearly depicted the variations in isolated microorganism’s susceptibility rate and their resistance pattern in specific units of the hospital. Incorporation of SA provides better guidance for the clinician in selecting the most appropriate empiric therapy for individual patients.