Frequency of Blood Culture Isolates and their Antibiogram in a Teaching Hospital

Raj Kumari Shrestha,Ritu Amatya,Subha Shrestha,Rajiv Shrestha

doi:10.31729/jnma.2295

Raj Kumari Shrestha, Ritu Amatya + Show 2 more

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https://doi.org/10.31729/jnma.2295

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Abstract

Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia. Blood sample received from the patient attending Nepal Medical College and Teaching Hospital from March, 2012 - August, 2012 were subjected to culture. Isolate identification and antimicrobial susceptibility testing was done by standard microbiological method. Out of the total 2,766 blood samples, 368 (13.3%) showed bacterial growth. The percentage of neonatal septicemia was 368 (13.3%). Staphylococcus aureus (28%) was the most common isolates followed by Salmonella enterica Serotype Typhi (22%), Coagulase negative Staphylococci (9.5%), Salmonella enterica Serotype Paratyphi ((7.6%) and Klebsiella pneumoniae (7.6%). 26.3% of the isolates of Staphylococcus aureus were oxacillin resistant. Most of the gram positive organisms were susceptible to amikacin and vancomycin and showed high level resistance to cefuroxime and cotrimoxazole. Out of 109 isolates of typhoid bacilli, 95.3% were resistant to nalidixic acid,79% to ciprofloxacin and 60.5% to ofloxacin. More than 50% of the isolates of Klebsiella pneumoniae and Escherichia coli showed resistance to cephalosporins and cotrimoxazole. Acinetobacter sp. showed high resistance (more than 60%) to ceftriaxone and ofloxacin. More than 20% of the isolates of Pseudomonas aeruginosa were resistant to ciprofloxacin and amikacin. Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread.

Highlights

Bloodstream infections are associated with significant patient morbidity and mortality
Blood samples were cultured in Brain Heart infusion (BHI) broth which supports the growth of all common pathogens causing bacteremia/septicemia
The antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion technique that is recommended by Clinical Laboratory Standards Institute (CLSI) recommendations.[10]

Summary

Introduction

Bloodstream infections are associated with significant patient morbidity and mortality. Shrestha et al Frequency of Blood Culture Isolates and their Antibiogram in a Teaching Hospital requires understanding of common pathogens and drug resistance pattern in the region.[6] Nowadays, bacterial drug resistance is an important problem, and due to wide variations in bacterial drug resistance, results of studies and reports vary from one region to another and in different periods of time.[3,6,7] The surveillance of blood stream pathogens in a hospital is important in monitoring the spectrum of microorganisms that invade the blood stream and the types of organisms associated with a particular clinical discipline Such data are often used to determine empiric antibiotic therapy and to alert the clinicians to emerging pathogens that may pose a threat to the community.[8]

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