Antimicrobial Susceptibility Trends among Pathogens Isolated from Blood: A 6-Year Retrospective Study from a Tertiary Care Hospital in East Sikkim, India

Abstract

Background Bloodstream infections (BSIs) are one of the frequent nosocomial infections among hospitalized patients. To understand the local epidemiology and evolving antimicrobial drug resistance of blood-borne pathogens, we analyzed the distribution and antibiotic sensitivity profile of organisms causing BSI in our hospital-based study. Materials and Methods We reviewed retrospective data of laboratory-confirmed BSIs, from January 2013 to December 2018. Causative organisms and their antibiotic susceptibility profile of primary and secondary BSI reports were determined from BacT/Alert and Vitek systems findings (bioMérieux). A 6-year multidrug resistance indexing was done to document the resistance pattern of the commonly isolated organisms. Results A total of 1,340 (10.2%) BSIs were reported from 13,091 blood cultures. Organisms were frequently isolated from the younger population (≤20 years), especially from ages < 1 year (20.8% of total BSIs). Majority of pathogens were bacterial (97.1%) whereas 2.9% were fungal in origin. Monomicrobial growth was recorded in over 98% of BSIs. Gram-positive and gram-negative bacteria isolated were 518 (39.8%) and 783 (60.2%), respectively. Commonly isolated organisms were coagulase-negative Staphylococci (29.4%), Escherichia coli (19.8%), Klebsiella species (13.5%), Salmonella species (9.4%), and Staphylococcus aureus (7.5%). Multidrug-resistance index was observed highest in Acinetobacter species followed by Pseudomonas aeruginosa and S. aureus. Conclusion Overall, there has been a gradual decline in the reporting of BSI. However, infections by gram-negative bacilli and multidrug-resistant organisms remain persistently high. Ages < 20 years were the vulnerable group, with infants < 1 year contributing to the maximum number of BSI cases caused by both bacteria and fungi. Therefore, additional methods are required to study the origin and causation of these infections, particularly among vulnerable patients.

Changing Trends in Antimicrobial Susceptibility Patterns of Bloodstream Infection (BSI) in Secondary Care Hospitals of India

“…The present study observed Gram-negative BSI to be more common than Gram-positive BSI (65.4% vs. 34.6%). Our study was similar to studies from the United States, Rwanda, Bangladesh, Iran and other Indian studies as well [13,18,20,[22][23][24]. However a higher incidence of Gram-positive BSI has been identified by Banik et (2018) from North India (Jammu and Kashmir) had also previously documented the prevalence of fungal BSI as 20.9% [25].…”

“…The MRSA and VRSA BSI rates were higher than earlier studies from ICMR-AMRSN which were 47.4% MRSA and 0% VRSA at various tertiary care hospitals. Similar studies from India by Yangzom et al (2020) and Nazir et al (2018) were indicative of 44.3% MRSA, 6.2% VRSA and 22.20 MRSA and 0% VRSA respectively [18,25]. While comparing to other studies from developing nations in the region, our MRSA and VRSA rates were much higher than Pakistan, China, Iran, South Korea and Africa [20,23,[29][30][31].…”

Trends of Antimicrobial Susceptibility in Clinically Significant Coagulase-Negative Staphylococci Isolated from Cerebrospinal Fluid Cultures in Neurosurgical Adults: a Nine-Year Analysis

“…The trends of rifampin and teicoplanin resistance rates were similar. This conclusion is different from those of previous studies that reported that resistance rates usually increase ( 13 – 16 ).…”

“…The trends are not favorable. Several studies have reported that the resistance rates have significantly increased, especially for oxacillin ( 13 – 16 ).…”

Characteristics of and risk factors for biliary pathogen infection in patients with acute pancreatitis

“…Gram-negative bacilli, which are some of the most common opportunistic pathogens in hospitals, have shown increasing trends towards drug resistance in recent years [ 4 ]. Gram-negative bacilli mainly include those in the Enterobacteriaceae family and nonfermentative bacteria.…”