Prevalence and antibiotic susceptibility pattern of multidrug resistant gram negative bacilli in lower respiratory tract Infections in a tertiary care hospital of Tripura

Abstract

Introduction: Lower respiratory tract infections with multidrug resistant gram negative bacteria are hard to treat and cause high morbidity and mortality. This study gives an account of isolation of multidrug resistant bacterial pathogens causing Lower respiratory tract infections and their antibiogram, in this geographical area of North East India. Materials and Methods: A total of 500 samples were collected and processed following the standard protocol. Antibiotic susceptibility test were performed by disc diffusion method, from which multidrug resistant strains were detected as per the criteria. Results: Out of 190 Gram Negative Bacilli isolated, 76 (40%) strains were confirmed to be multidrug resistant. Klebsiella pneumoniae (45.61%) was the predominant multidrug resistant Gram Negative Bacilli isolated, followed by Pseudomonas aeruginosa (36.48%), Acinetobacter spp (33.33%) and Citrobacter spp (28.57%). The multidrug resistant strains exhibited considerable susceptibility to Amikacin (65.78%), Gentamicin (68.42%) and Levofloxacin (68.42%). The Carbapenems, Beta-lactams and Beta-lactamase inhibitor combinations exhibited significant resistance in the present study. Conclusion: Klebsiella pneumoniae and Pseudomonas aeruginosa can be stated as the major causative agents of LRTI in this region. The present data represents the effective antibiotic agents against the MDR pathogens causing LRTI to be Amikacin, Gentamicin and Levofloxacin. Since none of the MDR strains attained a significant level of sensitivity against the tested antibiotics, specific treatment in our centre need to be decided based upon the antibiotic sensitivity profile of the isolate. Keywords: Lower respiratory tract infections, Gram negative bacilli, Multidrug resistant strains, Antibiotic susceptibility.