Introduction Universally, blood stream infections are linked with increasing morbidity and mortality. Timely diagnosis for identification of bacterial etiology, their susceptibility pattern and choice of empiric treatment plays a vital role in management. Objective To reveal the etiological profile and antibiotic sensitivity in blood culture specimens in a tertiary care setting. Methods This descriptive study was carried out in pathology laboratory of a tertiary care hospital from August 2016 to July 2019. All the 750 blood culture bottles were processed and isolates were recognized by morphological appearance on recommended media, gram stain, and different biochemical tests using Analytic Profile Index. Antibiotic sensitivity was implemented by modified disc diffusion method as per Clinical and Laboratory Standards Institute (CLSI) principles (2019). Results Out of 750 blood samples, 212 (28.26%) were culture positive. The percentage of gram-negative bacilli (n = 105) and gram-positive cocci (n = 104) was almost same (49.52%), while candida spp. was recovered from three (1.41%) isolates. The identified gram-negative bacteria were E. coli and Acinetobacter baumannii each (19.04%), Klebsiella pneumoniae and Pseudomonas aeruginosa each (16.19%), Enterobacter cloaca (11.42%), Salmonella typhi (8.57%), Burkholderia cepacia (1.90%), and Raoultella terrigena (7.61%). Among grampositive isolates, coagulase-negative staphylococci (79.80%), Staphylococcus aureus (6.73%), Enterococcus spp. (11.53%) and Streptococcus spp. (1.92%) were recovered. Colistin, imipenem, meropenem, and amikacin were most successful against gram-negative rods. The sensitivity to vancomycin, teicoplanin and linezolid was 100%, for gram positive organisms. Methicillin resistance was present in 84.4% Staphylococcal isolates. Conclusion Local data showing changing etiological pattern and antibiogram of isolated pathogens, along with adequate infection prevention and control measures can be useful to improve patient care, in terms of hospital stay, duration of medication and treatment cost.
Background: Staphylococcus aureus (SA) is a major etiological pathogen causing multiple infections and broadly known as a serious public health challenge faced due to antibiotic resistance. It is the need of time that infection prevention and control strategies; and antibiotic stewardship policies have to be employed conjointly to minimize the extended rise of antibiotic resistance. Objectives: To determine the frequency and sensitivity patterns of Staphylococcus aureus in tertiary care setting. Study Design: Descriptive study Place & Duration of Study: Pathology Laboratory of tertiary care center from 1st March’ 2020 till 28th February’ 2021. Materials & Methods: A total 643 Staph. aureus isolated from various clinical specimens received in a tertiary care hospital; were processed and identified by culture, staining and bench tests. Sensitivity testing was done by Disc Diffusion method. Resistance to cefoxitin(30µg) was labelled as Methicillin Resistant Staphylococcus aureus (MRSA). Constitutive and Inducible Clindamycin resistance was also evaluated. (CLSI, 2020-21). Results: During the study period 125 (19.44%) MRSA were recovered. Statistically, gender distribution regarding MRSA was significant, most of SA was recovered from blood (53.68%), while 46.31% from pus and wound swabs. The frequency of MRSA from Surgical and allied wards was higher (52.63%) than Medicine and allied wards (47.36%). Sensitivity to vancomycin, linezolid and tigecycline was noted 100% by all the isolates. Sensitivity to clindamycin and Doxycycline was 68.42% and 64.81% respectively; while resistance to erythromycin, ciprofloxacin and trimethoprim/sulfamethoxazole was 73.68%, 60% and 57.89%, respectively. Conclusion: The hazardous infections due to Staphylococcus aureus are worrisome in the present therapeutic scenario. A levelheaded prescription of sensitive antibiotics has to be ensured to minimize the rising frequency of resistant strains of SA.
ABSTRACT… Introduction: The versatility of Staphylococcus aureus has been transformed as "Methicillin resistant Staphylococcus aureus". The most challenging are the disastrous virulence patterns being expressed due to the selection pressure of antibiotics. For assessing the prevalence of methicillin resistant Staphylococcus aureus; screening by cefoxitin disc (30µg) diffusion method is still a realistic approach among conventional phenotypic methods, being applied in most of the laboratories. This reliable and feasible technique contributes significantly for MRSA detection. Objective: To evaluate the prevalence and identify the sensitivity pattern of methicillin resistant Staphylococcus aureus isolates from different clinical specimens in a tertiary care hospital. Study Design: Descriptive study. Setting: Pathology Department, Microbiology Laboratory, PGMI. Period: January 2015 to December 2015. Materials & Methods: A total 713 clinical isolates of Staphylococcus aureus were processed. Identification and confirmation of Staphylococcus aureus was done by colony morphology on blood agar, gram stain, catalase, coagulase and DNA-ase tests. Screening for methicillin resistance was done using cefoxitin disc (30µg, OXOID); while different antibiotic discs were used to assess the sensitivity profile by Modified Kirby-Bauer Disc Diffusion method according to CLSI guidelines (2016). Results: Out of 713 Staphylococcus aureus isolates, 92 (12.90%) isolates were labelled as methicillin resistant by cefoxitin disc diffusion test. Out of 92 MRSA isolates, 57 (14.65%) were recovered from male patients and 35 (10.80%) from female patients. While, 60 (65.22%) MRSA isolates showed hemolysis on blood agar. Among 92 MRSA isolates, 41 (44.57%) were recovered from pus specimen. Resistance to trimethoprim/sulfamethoxazole was highest (65.22%) after penicillin (100%); while all the MRSA isolates were 100% sensitive to both vancomycin and linezolid. Conclusion: The prevalence of MRSA in hospital care settings is of great clinical concern. To combat this public health threat effectively, continuous surveillance of healthcare associated infections, along with local antibiotic sensitivity pattern of MRSA; as well as formulation of a definite antibiotic policy is required.
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