Profile Of Blood Stream Infections Research Articles

Bloodstream infections in cardiac intensive care units from a tertiary care center

Blood stream infections (BSIs) occur more frequently in patients hospitalized in Intensive care units (ICUs). Intravascular devices are the most frequent predisposing factor causing BSI. To compare the proportion, risk factors, microbiological profile of Blood stream Infections and Central line associated bloodstream infection in Cardiology Intensive care units (CICU) and Cardiothoracic Intensive care units (CTICU).This is a prospective study conducted by the Dept. of Microbiology along with Cardiology Intensive care unit(CICU), and Cardiothoracic Intensive care unit (CTICU) of a tertiary care centre, from June 1st 2017-Oct 312018.Laboratory confirmed BSIs (LCBSI’s), occurring more than 48hrs after ICU admission were included in the study. Identification of pathogens were done by standard methods.A total of 1640 blood cultures were analyzed (CICU=890,CTICU=750).73 Primary BSIs were observed with male preponderance.68/73 diagnosed to have non CLABSI (CTICU=35/68 51.4%, CICU=33/68, 48.5%) and 5/73 cases diagnosed to have CLABSI (CTICU=5/73, 6.84% CICU=0%) 47.94% of our isolates were Gram negative pathogens with as the predominant followed by 35.6% of Gram positive with as the major pathogen & 16.4% were Candida spp. 20.5% were multi drug resistant and 10% were ESBL producers. Prevalence and incidence rates were high in CTICU (5.3% & 1.5%) compared to CICU (3.7% & 0%) of BSI & CLABSI respectively.BSI is preventable costly complication that occur with greater frequency in the ICU settings. Strict adherence to Infection control measures such as hand hygiene, aseptic precautions during blood culture collection and bundle care measures can decrease the BSI and CLABSI incidence rates.

The Epidemiology and Incidence of Bloodstream Infections (BSIs) in Under-Five Children in a Tertiary Care Hospital of Northern India – IGMC Shimla

Background: Clinical and diagnostic challenges are due to the result of a variable presentation of neonatal sepsis and bloodstream infections (BSIs) and uncertain disease epidemiology in children below five years of age. Although the criteria for achieving an adequate blood culture specimen in adults have been well described, there is much more equivocation in the pediatric population, especially for the under-five-year age group. Therefore, the present study is designed to evaluate the etiological profile of BSI among under-five children by the automated BACTEC systems. Materials and Methods: All blood culture samples received in the Department of Microbiology for culture falling in the age group were included in the study for a period of one year from 01 July 2015 to 30 June 2016 using the BD BACTEC FX except in the exclusion criteria. The blood culture was observed in the BD BACTEC FX system for at least five days before being reported as sterile. Results: A total of 1533 samples in the age group of < 5 years and suspected of BSIs were received in the Department of Microbiology, Indira Gandhi Medical College (IGMC), Shimla. Among them, 963 (62.8%) were males, while 570 (37.2%) were females. Among the total of 1533 samples, 604 (39.40%) were found positive in culture, 898 (58.57%) were negative, and 31 (2.02%) were contaminants. Among the 604 positive cases, 390 (64.6%) were men, while 214 (35.4%) were women. S. aureus was the highest among the gram-positive isolates 98 (16.22%), followed by coagulase-negative Staphylococcus, group B Streptococcus, and S. pneumoniae. Among the gram-negative organisms, E. coli 80 (13.24%) was isolated mostly followed by K. pneumoniae 70 (11.58%), P. aeruginosa 68 (11.25%), Salmonella typhi 50 (8.27%), Citrobacter koseri 18 (2.98%), Acinetobacter baumannii 12 (1.98%) and a group of organisms without fermentation 86 (14.23%). Conclusion: There was quite high positivity in culture in the preschool group. Positivity was significantly high in males as compared to females. It is essential to administer appropriate and synergistic antimicrobial agents empirically early and appropriately for treating children under five-year age with BSI.

Microbial profile of blood stream infections in a tertiary care teaching hospital

Background: Blood stream infections (BSI) are one of the major life-threatening infections responsible for prolonged hospital stays and significant mortality. It can be a community-acquired or hospital-acquired infection. A proper antibiotic policy can help in the selection of a proper antibiotic to reduce mortality and increase the patients’ outcomes. Aims and Objectives: The objectives of the study are to identify the organism causing BSI and determine its antibiotic susceptibility pattern. Materials and Methods: The present study was conducted in the Department of Microbiology, SBKS MI & RC, Piparia, over a period of 18 months and included 397 clinically suspected cases of BSIs after approval from HREC. Positive blood cultures indicated by the BACTEC 9050 were processed for further identification and antibiotic susceptibility testing by conventional methods according to standard laboratory techniques. Results: Out of 397 samples, 104 (26.19%) were positive, and 13 microorganisms were isolated. Staphylococcus aureus and Klebsiella spp. were the most frequently isolated organisms. Imipenem and vancomycin were highly effective antibiotics. The study showed 37.84% extended-spectrum beta-lactamase producers among Klebsiella and Escherichia coli. S. aureus showed 47.82% methicillin-resistant Staphylococcus aureus. Conclusion: This study was intended to serve as a reference to guide clinicians in applying appropriate empirical therapy and the best regimen based on the local condition to improve the overall outcome of the patients’ management.

Microbiological profile of blood stream infections in children with cancer with febrile neutropenia- A single centre study

Microbiological profile of blood stream infections in children with cancer with febrile neutropenia- A single centre study

Microbiological Profile of Bloodstream Infections in Cancer Patients

Background: Bloodstream infections (BSIs) remain a major cause of mortality in patients with malignancies. Up to 17% of patients who develop a nosocomial BSI in the hospital have an underlying malignancy. Gram-negative bacilli are the predominant etiologic agents of BSI, and their multidrug resistance rate is increasingly being recognized. This study attempts to identify the likely causative agents and their antibiotic susceptibility profile of BSI in cancer patients. Methodology: We conducted a prospective study for a period of 1 year and analyzed the spectrum of BSI and their antimicrobial susceptibility profile in cancer patients. Blood samples were collected aseptically and inoculated in BacT/ALERT (BioMerieux) blood culture bottles. Identification and antimicrobial susceptibility testing of the isolates including their methicillin resistance and β-lactamase and carbapenemase production were done by Vitek-2 (BioMerieux) method. Results: Of a total of 250 cancer patients, 60 (24%) were found to have BSI. The most common underlying malignancy associated with BSI was of gastrointestinal system (45%) followed by acute myeloid leukemia (21.7%). Most of the isolates belonged to Gram-negative bacteria (53.3%). Coagulase-negative Staphylococcus was the most common organism isolated followed by Escherichia coli. Conclusion: The treatment of infections in patients with malignancy relies on the use of established guidelines along with the consideration of local epidemiological data. The poor activity of primary empirical agents and the emergence of multidrug-resistance is alarming.

Microbiological Profile of Blood Stream Infections in Febrile Neutropenic Patients at a Tertiary Care Teaching Hospital in Rishikesh, Uttarakhand.

Context Febrile neutropenia is a serious complication of chemotherapy affecting patients with both hematological and solid malignancies, respectively. To the best of our knowledge, there is paucity of literature from Uttarakhand, India on microbiological profile of blood stream infections (BSIs) in febrile neutropenic patients. Aims The study aims to generate preliminary data on microbiological profile and antibiotic resistance pattern of BSIs in febrile neutropenic patients. Settings and Design The design involved cross-sectional study from January 1, 2019 to July 31, 2019. Methods and Materials Data of nonrepetitive paired peripheral blood samples obtained from 306 consecutive febrile neutropenic cancer patients of all age groups and both sexes, for culture and sensitivity testing, were retrospectively analyzed. All blood samples were subjected to aerobic culture using BACT/ALERT three-dimensional microbial detection system. Growth obtained in culture was identified by conventional biochemical methods. Antibiotic susceptibility testing of bacterial isolates was performed using modified Kirby Bauer disk diffusion method. Statistical Analysis Used Fisher’s exact test was used for the analysis. Results Mean age ± SD of the study population was 32.39 ± 10.56 years with a male to female ratio of 1.55:1. 74.18% of the blood samples were received from patients suffering from hematological malignancies. Microbiologically confirmed BSIs were observed in 27.1% patients. Gram-negative bacilli were predominantly isolated in culture with Klebsiella spp . being the most common. Percentage resistance values of gram-negative bacilli to aminoglycosides, β-lactam/β-lactamase inhibitor combinations, fluoroquinolones, cephalosporins, carbapenems, chloramphenicol, ampicillin, co-trimoxazole, and doxycycline were 26.6 to 91.7%, 8.3 to 86.6%, 10 to 66.7%, 13.3 to 73.3%, 8.3 to 73.3%, 80 to 93.3%, 13.3 to 20%, 16.7 to 66.6%, and 13.3 to 16.7%, respectively. Conclusion Implementation of antimicrobial stewardship program along with hospital infection control practices is needed for preventing BSIs due to MDR organisms.

Bacterial etiology and antibiotic resistance profile of bloodstream infections in human immunodeficiency virus patients from Southern India.

Bacterial etiology and antibiotic resistance profile of bloodstream infections in human immunodeficiency virus patients from Southern India.

Assessment of Bacterial Profile and Antimicrobial Resistance Pattern of Bacterial Isolates from Blood Culture in Addis Ababa Regional Laboratory, Addis Ababa, Ethiopia

Background: Bacterial bloodstream infection is the major public health problem which leads to high morbidity and mortality of patients. Early diagnosis and appropriate treatments of bacterial blood stream infections are the best approach to reduce the patients' are becoming worsen conditions and to prevent the developments of drug resistance bacteria. The aim of this study was to determine the bacterial profile of blood stream infections and their antibiotic resistance pattern in Addis Ababa, Ethiopia. Methods: Records of 500 patients blood culture result from Clinical microbiology laboratory unit of Addis Ababa Regional Laboratory was reviewed from January, 2015 to December, 2016. Data was entered and analysed by using SPSS version 20.0 statistical software and results were expressed using frequency and percentages. Tables and graphs were used to summarize the results. The chi-square test was employed to assess the association between variables. A p-value of less than 0.05 was considered as statistically significant. Results: Out of 500 blood culture results reviewed, among these the frequency of blood culture positive was 164 (32.8%). Out of a total 164 isolates, 127 (77.4%) were gram-positive bacteria and 37 (22.6%) were gram-negative bacteria. The predominant bacteria species isolated comprise Staphylococcus aureus 82 (50.0%), Coagulase negative staphylococci (CONS) 43 (26.21%), Klebisella pneumoniae 23 (14.02%), Escherichia coli 6 (3.6%), Acinobacter baumannii 4 (2.4%), Streptococcus species 3 (1.8%), Pseudomonas aeruginosa 2 (1.2%) and Nesseriae meningitidis 1 (0.6%). Generally, in this study majority of gram-positive isolates showed high resistance to commonly used antimicrobials to Penicillin(83.5%),Trimethoprim-sulphamethoxazole (83.5%), Erythromycin (77.3%), Doxycycline (76.5%), Tetracycline (76.5%), Gentamycin (75.0%), and least resistant to Clindamycin (5.4%) and Chloramphenicol (46.1%) and high resistant gram-negative isolates was seen to Ampcillin (88.5%),Amoxicillinclavulanic acid (80%), Trimethoprim-sulphamethoxazole (80%), Ceftriaxone (77.1%) and least resistant to Ceftriaxone (42.8%) and Cefepime (51.5%). In this study it was also revealed that isolated bacteria species developed multi drug resistance to most of the antibiotics commonly tested. Conclusions: In this study the overall blood culture positive bacterial isolate rate was high (32.8%). The most predominant blood culture isolates were Staphylococcus aureus, Coagulase negative staphylococci and Klepsiella pneumonia. Antibiotic resistances of isolates were alarmingly high so that proper management of patients with blood stream infections needs careful selection of effective antibiotics.

Blood stream infections with Candida species: a prospective study in a tertiary care center

Aims and Objectives: To study the profile of blood stream infections with Candida species, their current epidemiological trend at our setting, clinical management, resistance trends and outcome in terms of mortality. Methods: This is a prospective observational study conducted among all adult in-patients, at AIMS, Kochi from August 1st 2014 to February 28th 2016, both in wards and ICUs, who have positive isolates of Candida species in bloodstream infection among the positive blood culture samples. Incidence rate of Candidemia was calculated and distribution of Candidemia with respect to characteristics like age, gender, comorbid illness, mechanical ventilation, prior antibiotic therapy, prolonged ICU stay. Results: Out of 1600 blood stream infection isolates, Candidemia was fourth most common blood stream isolate infection in our study with an incidence rate of 7.5%. Candida tropicalis was the predominant species in our study (30.8%). Mortality rate due to Candidemia was (61%). Urethral catheterization, Central venous access, neutropenia at presentation, prior antibiotic therapy, renal failure, Dialysis patients, prolonged ICU stay were some of the risk factors found to be statistically significant in assessing the mortality of patients in our study with a p value of <0.001. Conclusion: All patients with Candidemia should be treated with an antifungal agent at the earliest without any delay, as delay causes increase in mortality. All vascular catheters should be removed to help clear Candida from blood more quickly. Improved survival was found with the use of an Echinocandin and the removal of central venous catheters.

Profile of Bloodstream infections in Pediatric cancer patients at a tertiary care center

Profile of Bloodstream infections in Pediatric cancer patients at a tertiary care center

Profile of Blood Stream Infections in Paediatric Patients in Rural Tertiary Care Hospital

Background: Blood stream infections (BSI) are the major cause of morbidity and mortality worldwide. It is often associated with hospitalization, and management involving invasive therapeutic and diagnostic procedures. Timely detection and identification of blood-borne pathogens, would reduce mortality, and turnaround time and improve patient management. Aims: 1. To identify the common pathogens causing bacteremia in different age group in pediatric patients. 2. To identify the risk factors and other screening parameters associated with bacteremia. 3. To study the turnaround time using automated BacT/Alert 3D system Settings and Design: Observational study done in a rural tertiary care Hospital, Tamaka, Kolar. Meterials and Methods: A total of 176 paired blood culture samples were collected from paediatric patients admitted signs and symptoms of sepsis and PUO in pediatric wards during February 2012 – August 2013 The samples were collected under strict aseptic precautions before starting of antibiotics. Blood cultures were processed by BacT/Alert 3D system (bioMerieux). Growth was identified by the standard microbiological techniques and antibiotic and antifungal susceptibility testing were done according to CLSI guidelines. Statistical analysis used: Results: Among the blood cultures processed, 41.5% were identified as pathogens, 0.5% as contaminants and 58% had no growth. Most of the positive blood cultures were detected within 24 hours. Bacteremia was more common among neonates (69.9%).The most common organisms isolated were, Staphylococcus aureus (17.8%), followed by Candida krusei (12.3%), Candida tropicalis (10.9%), C.albicans (10.9%), and Klebsiella species (9.6%). The predominant sepsis screening parameters in the positive cultures were CRP and tachypnea. The most common risk factors observed were birth asphyxia, preterm babies and low birth weight. Conclusion: BSI are more common among neonates and The BacT/ Alert 3D system is useful in detecting the infective organisms early and the paired samples are necessary us in confirming the pathogens from contaminants. Key-words: Blood stream infection, Bacteriological profile, neonatal septicemia, Bac T/Alert, pediatric BSI

Bacteriological profile of blood stream infections among febrile patients attending a tertiary care centre of Western Nepal

Background Blood stream infections (BSI) are significant cause of morbidity and mortality in the world. This study was conducted to determine the common bacterial agents associated with BSI with their antimicrobial susceptibility patterns in a tertiary care centre in the Western region of Nepal. Method This cross-sectional study was conducted for a period of two years from May 2010 to May 2012. All patients with fever (temperature ≥ 38°C) were included in the study. Results A total of 4,145 patients with febrile illness were included in this study, bacterial agents were isolated in 251 (6%) cases. Common bacterial isolates were Salmonella spp., Klebsiella pneumoniae, Escherichia coli, Pseudomonas species, Acinetobacter species, Staphylococcus aureus and Coagulase negative Staphylococci. Paratyphoid fever (Caused by S. Paratyphi A) is more common than typhoid fever. The members of Enterobacteriaceae were found to be resistant to ampicillin and cefazolin. Majority of the nonfermenters were found to be sensitive to most antibiotics. Gentamicin and Ciprofloxacin were sensitive to majority of gram positive bacteria. Conclusion Gram-negative bacteria were the predominant causes of BSIs. The occurrence of drug resistance among the isolated bacteria is of great concern. Imipenem showed 100% sensitivity against Pseudomonas aeruginosa indicating lack or low level of MBL activity. DOI: http://dx.doi.org/10.3126/ajms.v4i3.8165 Asian Journal of Medical Sciences 4(2013) 92-98

Epidemiology of bloodstream infections at a cancer center.

Cancer patients are at unusually high risk for developing bloodstream infections (BSI), which are a major cause of in-hospital morbidity and mortality. To describe the epidemiological characteristics and the etiology of BSI in cancer patients. Descriptive study. Terciary Oncology Care Center. During a 24-month period all hospitalized patients with clinically significant BSI were evaluated in relation to several clinical and demographic factors. The study enrolled 435 episodes of BSI (349 patients). The majority of the episodes occurred among non-neutropenic patients (58.6%) and in those younger than 40 years (58.2%). There was a higher occurrence of unimicrobial infections (74.9%), nosocomial episodes (68.3%) and of those of undetermined origin (52.8%). Central venous catheters (CVC) were present in 63.2% of the episodes. Overall, the commonest isolates from blood in patients with hematology diseases and solid tumors were staphylococci (32% and 34.7%, respectively). There were 70 episodes of fungemia with a predominance of Candida albicans organisms (50.6%). Fungi were identified in 52.5% of persistent BSI and in 91.4% of patients with CVC. Gram-negative bacilli prompted the CVC removal in 45.5% of the episodes. Oxacillin resistance was detected in 26.3% of Staphylococcus aureus isolates and in 61.8% of coagulase-negative Staphylococcus. Vancomycin-resistant enterococci were not observed. Initial empirical antimicrobial therapy was considered appropriate in 60.5% of the cases. The identification of the microbiology profile of BSI and the recognition of possible risk factors in high-risk cancer patients may help in planning and conducting more effective infection control and preventive measures, and may also allow further analytical studies for reducing severe infectious complications in such groups of patients.