MICROBIOLOGICAL PROFILE AND ANTIBACTERIAL RESISTANCE PATTERN OF GRAM-NEGATIVE BLOOD ISOLATES IN A TERTIARY CARE CENTRE IN NORTHERN INDIA

Abstract

Bloodstream infections (BSIs) are one of the most frequent infections and a potentially lethal condition with a case fatality rate of 20–50%. The present study was done to determine the prevalence and antimicrobial resistance pattern of gram-negative bacteria in blood stream infections (BSI) in a tertiary care center in Northern India.

Methods- This was an observational study of antibiotic susceptibility data of gram-negative bacilli causing blood stream infections. 1939 blood cultures were received in the Department of Microbiology over a period of 1 year. Automated blood culture method was used (BacT/Alert3D). Bacterial identification as well as antibiotic-sensitivity was done using Vitek-2 automated systems.

Results- Out of the 1939 blood cultures received in the microbiology lab, 283 (14.6%) showed positive culture growth, 1136 (58.6%) were sterile and 520 (26.8%) were found to be contaminated. 140 (49.5%) cultures were found positive for gram-negative rods (GNR), 90 (31.8%) for gram-positive cocci and 53 (18.7%) for yeast-like candida. Among GNR, Klebsiella pneumoniae was the most common (20.1%), followed by Escherichia coli (7.7%), Actinobacter baumanii (7.4%), Salmonella species (5.3%), Enterobacter cloacae complex (3.1%), and Pseudomonas species (3.1%). Most of the Klebsiella species were found to be multi-drug resistant (MDR), with resistance rates observed against Ampicillin, Ceftriaxone, Cefepime, Piperacillin+Tazobactum, Meropenem, Ciprofloxacin, Amikacin & Cotrimaxazole as 57.8%, 57.8%, 42%, 50.8%, 54.3%, 52.6%, 47.3%, & 45.6% respectively. Similarly, resistance rates observed for E. coli against same antibiotics were 63.6%, 41%, 50%, 32%, 36%, 59%, 18%, & 50% respectively.

Conclusion- Klebsiella pneumoniae was found to be the leading cause of BSI among GNR in our set-up. Report of MDR organisms causing BSI is a cause for concern. Moreover, 26.8% of the samples were found to be contaminated, which is a high number, demonstrating the need for improved sampling and handling methods.

International Journal of Human and Health Sciences Supplementary Issue 02: 2023 Page: S106-S118